Sandeep Dhand
Nutritionist And Health Educator
Palmar erythema is a medical condition in which the palms of the hands, especially the areas near the base of the thumb and little finger, appear red. This condition is often linked to liver disease, particularly liver cirrhosis. It is not a disease by itself but rather a sign of an underlying health issue. Many people who develop palmar erythema may not even feel pain or discomfort, but the redness can be a sign of a serious condition.
In this detailed article, we will discuss the causes, symptoms, diagnosis, and treatment of palmar erythema, along with a detailed diet plan for people with liver cirrhosis.
What is Palmar Erythema?
Palmar erythema (PE) is a reddish discoloration of the palms. The redness is usually symmetrical, meaning it appears on both hands. The affected areas are mainly:
Thenar eminence (the base of the thumb)
Hypothenar eminence (the base of the little finger)
This redness is due to increased blood flow in the small blood vessels under the skin. It is not painful and does not cause itching or peeling. However, it can sometimes feel warm to the touch.
Causes of Palmar Erythema
Palmar erythema is commonly associated with liver disease, but it can also be caused by other conditions. Below are the main reasons why a person might develop palmar erythema:
- Liver Disease (Liver Cirrhosis) – The Most Common Cause
The most common cause of palmar erythema is chronic liver disease, especially liver cirrhosis. The liver plays a crucial role in filtering toxins and regulating hormones in the body. When the liver is damaged:
It fails to break down estrogen properly.
High levels of estrogen cause the blood vessels to widen, leading to redness in the palms.
- Pregnancy
During pregnancy, hormonal changes (increased estrogen levels) can cause temporary palmar erythema. This usually disappears after childbirth.
- Thyroid Disorders
Hyperthyroidism (overactive thyroid) can increase blood flow to the skin, causing palmar erythema.
However, this is less common than liver-related causes.
- Autoimmune Diseases
Conditions like rheumatoid arthritis can cause increased blood flow and inflammation, leading to redness in the palms.
- Genetic Factors
Some people are born with slightly reddish palms due to hereditary factors, and this is considered normal.
- Infections and Other Diseases
Certain infections, heart problems, and diabetes can also cause palmar erythema, but they are rare causes.
Symptoms of Palmar Erythema
Palmar erythema itself is a symptom, but it can be accompanied by other signs if it is caused by an underlying disease.
Primary Symptoms:
Redness of the palms, mostly on the thenar and hypothenar eminences
Warm feeling in the affected area
Symmetrical redness on both hands
Additional Symptoms (If Caused by Liver Disease):
If palmar erythema is due to liver cirrhosis, the person may also experience:
Fatigue and weakness
Jaundice (yellowing of the skin and eyes)
Swelling in the legs and abdomen (ascites)
Easy bruising or bleeding
Loss of appetite and weight loss
Diagnosis of Palmar Erythema
- Physical Examination
A doctor will examine the palms and ask about medical history to check for underlying conditions like liver disease, pregnancy, or thyroid problems.
- Blood Tests
If liver cirrhosis is suspected, the following blood tests may be done:
Liver Function Tests (LFTs) – To check liver enzymes and bilirubin levels.
Complete Blood Count (CBC) – To check for anemia or infections.
Hormone Tests – To check estrogen and thyroid hormone levels.
- Imaging Tests
Ultrasound or CT Scan – To check for liver damage.
Liver Biopsy – In some cases, a small sample of liver tissue may be taken to confirm cirrhosis.
Treatment of Palmar Erythema
Since palmar erythema is not a disease itself, the focus is on treating the underlying cause.
- Treatment for Liver Cirrhosis
Avoid alcohol – Alcohol damages the liver further.
Medications – Doctors may prescribe medicines to manage liver disease.
Liver Transplant – In severe cases, a liver transplant may be needed.
- Treatment for Other Causes
If caused by pregnancy, no treatment is needed. It usually resolves after childbirth.
For hyperthyroidism, thyroid medications are prescribed.
If caused by autoimmune diseases, anti-inflammatory medications may be given.
Diet Plan for People with Liver Cirrhosis and Palmar Erythema
A healthy diet is essential for managing liver disease and preventing further damage. Below is a detailed diet plan for people with liver cirrhosis:
- Foods to Eat
These foods help protect the liver and improve overall health:
High-Protein Foods (for muscle strength)
Egg whites
Fish (salmon, mackerel, tuna – rich in Omega-3)
Chicken (skinless, boiled or grilled)
Paneer (low-fat)
Lentils and legumes (moong dal, masoor dal, rajma, chana)
Fruits and Vegetables (for vitamins and minerals)
Apples, papaya, pomegranate, bananas (easy to digest)
Carrots, beetroot, spinach, bottle gourd (lauki), pumpkin
Tomatoes and bell peppers (rich in antioxidants)
Whole Grains (for energy and fiber)
Brown rice
Oats
Whole wheat roti
Quinoa
Healthy Fats (for liver protection)
Olive oil, coconut oil
Nuts and seeds (almonds, walnuts, flaxseeds)
Hydration (to flush out toxins)
Drink at least 2-3 liters of water daily
Coconut water, lemon water, and green tea
- Foods to Avoid
These foods damage the liver and worsen symptoms:
Alcohol (most harmful for liver cirrhosis)
Fried and processed foods (cause fat buildup in the liver)
Red meat (difficult to digest)
High-salt foods (increase swelling and fluid retention)
Sugary foods (sweets, sodas, bakery items)
Conclusion
Palmar erythema is not a disease but a sign of an underlying condition, most commonly liver cirrhosis. It occurs due to hormonal imbalances and increased blood flow in the hands. If you notice persistent redness in your palms, it is important to consult a doctor for a proper diagnosis.
The best way to manage palmar erythema caused by liver cirrhosis is through a healthy diet, lifestyle changes, and medical treatment. Avoiding alcohol, processed foods, and high-salt diets while including protein-rich foods, fruits, and whole grains can help protect the liver and improve overall health.
Taking care of your liver health is essential for preventing complications and leading a healthy life