Palmoplantar Keratoderma: Causes, Symptoms, and Treatment
Medically reviewed by Sumiran Racherla, MD, Internal Medicine. Last reviewed: October 23, 2026.
What kind of doctor treats Palmoplantar Keratoderma?
A dermatologist, a doctor who treats skin conditions, usually diagnoses and treats palmoplantar keratoderma. If it runs in the family, a geneticist, a doctor who studies inherited conditions, may also help. A direct primary care or concierge doctor can be a first stop for an evaluation and can refer you to a specialist when needed.
What is palmoplantar keratoderma?
Palmoplantar keratoderma, or PPK, is the name for a group of conditions that cause abnormal thickening of the skin on the palms of the hands and the soles of the feet. "Palmo" means palm, "plantar" means sole, and "keratoderma" means too much skin thickening. It is also called keratosis palmaris et plantaris.
PPK can be inherited, which means passed down in a family. It can also be acquired, which means it starts later in life. Doctors describe several patterns, including diffuse, focal, and punctate. In diffuse PPK, thick skin covers the whole palm or sole. In focal PPK, only small areas such as pressure points are affected. In punctate PPK, there are tiny bumps of thick skin.
Symptoms
The signs of PPK can differ from person to person, and from one family member to another. They can include:
- Thick, hard skin on the palms or soles that may look yellow, or red and flaky.
- A red band at the edge of the thickened skin.
- Pain and trouble walking.
- Fungal infections, thick yellow nails, or athlete's foot, an itchy, red, flaky rash between the toes.
- Heavy sweating or foot odor.
Some people also have changes in the nails, hair, or teeth. The look of the skin can also cause stress.
Causes and who gets it
Inherited PPK happens when a gene change is passed from parent to child. The gene makes keratin, a protein that is one of the key materials in hair, nails, and the outer layer of skin. In some forms, the change can also happen on its own, with no family history.
Some inherited forms are likely to affect every generation of a family. Others appear only when both parents carry the changed gene. A carrier does not have the condition but can pass the gene on.
Acquired PPK can be caused by another illness, an infection, a medicine, or another skin condition such as psoriasis or eczema. Chemicals and mechanical stimulation of the skin can also cause it.
How doctors diagnose it
The diagnosis is usually clinical. That means a doctor asks about your history and looks closely at your skin. Genetic testing may be offered if the doctor thinks the PPK is inherited. In severe cases where an inherited form is suspected, you may be referred to a geneticist for more testing.
Treatment
PPK can be hard to treat, and the best choice depends on the type and how severe it is. Hereditary forms cannot be cured, but treatment can help control symptoms. Acquired forms may improve when the underlying cause is treated. Options include:
- Emollients, which are moisturizers, and creams with urea to soften the skin.
- Peeling creams called keratolytics, such as ones with salicylic acid, to thin the thick skin.
- Topical retinoids, creams made from vitamin A. Do not use them if you are pregnant or trying to become pregnant.
- Corticosteroid creams, which a doctor may prescribe to calm skin inflammation.
- Oral retinoids, vitamin A pills, which some people find helpful. They have not been proven to work in most forms of PPK. Women who are pregnant or trying to become pregnant should not take them. Blood tests may be needed while taking them.
- Light treatment, if your doctor suggests it.
Self-care helps too. Wear comfortable, supportive shoes. Special insoles may help with pain. A podiatrist, a foot care doctor, can remove thick skin and give foot care advice.
When to see a doctor
See a doctor if the skin on your palms or soles is thick, hard, or painful, or if it makes walking hard. Signs of infection need medical care, because a doctor can prescribe an antifungal or antibiotic medicine. Regular follow-up visits help your doctor watch for skin irritation and side effects from treatment.
How a direct primary care or concierge doctor fits in
A direct primary care doctor charges a flat monthly fee instead of billing insurance, while a concierge doctor usually charges more and often works alongside insurance. Either type of doctor can examine your skin, start basic skin care, and refer you to a dermatologist. They can also help coordinate follow-up visits.
Common questions
Is palmoplantar keratoderma inherited?
Some forms are, but not all of them. Inherited forms come from a gene change passed from a parent. Acquired forms are not inherited and can be linked to other illnesses, infections, or medicines.
Can palmoplantar keratoderma be cured?
Hereditary forms cannot be cured, but treatment can help control the symptoms. Acquired forms may improve when the underlying cause is treated.
Does palmoplantar keratoderma make it hard to walk?
Yes, it can. Thick skin on the soles can cause pain and trouble walking. Comfortable, supportive shoes and special insoles may help.
How do diffuse, focal, and punctate PPK differ?
They differ in how much skin is covered and how the thick skin looks. Diffuse PPK covers the whole palm or sole. Focal PPK affects smaller areas, such as pressure points. Punctate PPK causes tiny bumps of thick skin.
Can palmoplantar keratoderma lead to infections?
Yes, people with PPK are susceptible to fungal infections. A doctor can prescribe antifungal or antibiotic medicine when needed.
Sources
- British Association of Dermatologists - Palmoplantar keratoderma
- Australasian College of Dermatologists - Palmoplantar keratoderma
- FIRST Foundation for Ichthyosis and Related Skin Types - Palmoplantar Keratodermas
Medical Disclaimer
This content is for general educational and informational purposes only and is not medical advice. It is not a substitute for professional medical advice, diagnosis, or treatment, and reading it does not create a doctor-patient relationship. Always seek the advice of your physician or another qualified health provider with any questions about a medical condition, and never disregard or delay seeking professional advice because of something you read here. If you think you may have a medical emergency, call 911 (or your local emergency number) immediately.
