What Causes a Skin Rash on Palms on Soles?

A rash that appears on your palms and the soles of your feet can have a variety of causes, ranging from an allergic reaction to an infection. This type of rash could also stem from a chronic condition such as eczema or arthritis. While some causes may be minor, others are more concerning and could signal a serious underlying problem.

Let’s take a closer look at some of the most common causes of this type of rash, including symptoms to watch for, when you should see a healthcare provider, and explore diagnosis and treatment options.

Causes of a rash on hands and feet in adults

Each of the reasons for a rash appearing on your palms and soles has its causes and set of symptoms. Therefore, it’s crucial to understand what may be behind each of these so you can get the most effective treatment and relief of your symptoms.

Below, we’ll go over some of the common, as well as a few uncommon, causes of this type of rash, whether it's from an allergic reaction or a more serious problem.

Allergic reactions

Allergic reactions occur when your immune system overreacts to a substance. This substance, also called the allergen, is harmless in most people.

Allergens can be pollen, dust, mold, bee and other insect stings, animal dander, certain chemicals, and poison plants such as poison ivy. An allergic reaction can occur by touching the allergen or inhaling or swallowing it.

Eczema

Eczema, also known as atopic dermatitis, is a chronic skin condition that is most common in children but is also seen in adults.

This condition causes inflamed skin that is dry and itchy. If you have eczema you may notice a scaly rash, redness, oozing of lesions, and blisters. Eczema can be triggered by changes in weather, allergens, stress, exposure to cleaning products, and other chemicals found in cosmetics.

Psoriasis

Like eczema, psoriasis is also a chronic skin condition.

Psoriasis differs from eczema in that it causes inflamed, raised areas, known as plaques, to appear on the skin, especially on the scalp, elbows, knees, hands, feet, and back. Psoriasis is caused by an overreactive immune system.

Athlete's foot

Athlete’s foot is a fungal infection that causes a red, itchy rash between the toes.

The fungus can also affect the soles of the feet and toenails. Though commonly found on the feet, the infection is contagious and may spread to the hands.

Infection

Both bacterial and viral infections can be the source of a rash that appears on the palms and soles.

Several of these bacterial causes can be serious and even life-threatening without prompt treatment. Bacterial causes include toxic shock syndrome, Rocky Mountain spotted fever from tick bites, and meningococcal infections, which cause spinal meningitis.

Viral causes include herpes simplex virus-associated erythema multiforme, a complication of reactivated herpes infections, as well as measles, hand, food, and mouth disease, monkeypox, and in rare cases, the chickenpox virus.

Read our full guides on rash symptoms and types of rashes for more.

Causes of a rash on hands and feet in children

Rashes on the hands and feet of children are quite common, and similar to adults, can result from various factors. This section examines the causes of these rashes, potential treatment options, and when it may be necessary to seek medical advice.

Hand, foot and mouth disease

The most common cause of a rash in children appearing on the palms and soles is hand, foot, and mouth disease. Symptoms include a rash on the hands and soles of the feet.

This rash can look like small flat red spots or appear as small blisters. There are also painful sores in the mouth. This highly contagious viral illness is caused by the coxsackie virus.

Eczema

Similar to eczema in adults, eczema in children is a chronic skin condition causing dry, itchy, inflamed skin.

While the rash of adult eczema most often appears on the feet, backs of the knees, arms, and hands, eczema in a child is typically seen on the outside of the elbows, knees, and face.

Contact dermatitis

Contact dermatitis is a rash caused when the child comes into direct contact with a skin irritant, such as certain chemicals found in detergents and soaps, some fabrics, and metals such as nickel, or plants such as poison ivy.

Ringworm

The rash of ringworm is not caused by a worm, but by a fungal infection of the skin. The name comes from the appearance of the rash—a circular, raised rash with a clearing center—that can affect both the hands and feet.

Heat rash

Heat rash, also known as miliaria, appears as tiny red raised bumps that occur on areas of skin typically covered by clothing. This rash is particularly prevalent in hot weather.

Scabies

The rash of scabies is caused by mites that burrow beneath the skin’s surface. A scabies infestation commonly affects both the hands and feet.

Allergic reactions

Allergic reactions occur when a child’s immune system overreacts to an allergen. Allergic reactions to various foods, medicines, or insect bites are common in children and can produce a rash that appears on the hands and feet.

Impetigo

Impetigo is a bacterial skin infection that can affect the hands and feet. The rash appears as small blisters filled with pus.

Kawasaki disease

Kawasaki disease is a rare but serious condition affecting the heart and blood vessels, primarily in children under five.

It develops suddenly, causing high fever, red eyes, swollen glands, and redness with peeling of the skin of the hands and feet, among other symptoms.

Rashes on hands and feet with additional symptoms

A rash on your hands and feet, along with symptoms like a fever, may indicate a more serious condition that requires medical attention. Below are possible symptoms that can accompany the rash.

Rash and a fever

A rash on your palms and soles accompanied by a fever signals more concern than a rash without a fever.

Infection with hand, foot, and mouth disease is typically accompanied by a fever. The disease is usually mild and lasts seven to ten days. Impetigo can also cause a fever if large skin areas are affected.

More serious cases, such as bacterial or viral infections like toxic shock syndrome, Rocky Mountain spotted fever, meningococcal infections, measles, or monkeypox, present with both rash and fever and require urgent attention.

Rash and itchiness

Many rashes presenting on the palms and soles of the feet can also be itchy.

These include eczema, allergic reactions, scabies, athlete’s foot, hand foot, and mouth disease, impetigo, psoriasis, heat rash, ringworm, and contact dermatitis.

Diagnosis process for a rash on hands and feet

Your healthcare provider will consider several factors when evaluating the cause of a rash on your palms and soles.

The provider will take a history, which involves asking you questions such as how long the rash has been there, what parts of your body are affected, whether you have been exposed to any chemicals or known poisonous plants, or have come into contact with another person who has a similar rash.

They will likely want to know if you have a family history of eczema or allergies. The provider will then conduct a physical exam. This includes looking at the rash’s appearance, noting its location, and seeing if there is a pattern that fits a known diagnosis. Your provider will often be able to make a diagnosis based on these features alone.

Common treatment options for a hand and foot rash

Treatment options for a rash depend on its cause and range from home remedies to over-the-counter medications. Various approaches can provide relief, depending on the severity and nature of the rash.

Over-the-counter medication

One of the most commonly used over-the-counter medications for itchy rashes is 1% hydrocortisone cream, known for its effectiveness in soothing both itching and inflammation.

Other over-the-counter treatments include the topical application of calamine lotion. This can be very helpful for the rash of poison ivy. An ointment containing zinc oxide can help calm irritated skin due to contact dermatitis. Oral antihistamines like diphenhydramine (Benadryl) can help relieve itching caused by allergic reactions and other rashes.

Home remedies

Home remedies can be surprisingly effective for the discomfort caused by a rash, particularly if the symptoms are not severe.

These include placing a cup of oatmeal in a stocking or sock and using it as a sponge over the irritated area in the bath. Another remedy involves applying chilled aloe gel from a plant leaf to the affected area. Placing a cool, damp cloth over the rash several times a day can also provide relief. For very dry skin, using moisturizer may be effective.

When to seek medical attention for a hand and foot rash

While many rashes on the hands and feet are mild and can be treated at home, others are more serious. Below are guidelines for when to consult a medical professional and when to strongly consider going to the emergency room.

You should see a doctor if:

• Your rash is getting worse or is not getting better from home treatment.
• The rash is spreading to other parts of your body.
• The rash is accompanied by a fever.
• The rash is becoming infected. It could be draining pus or is swollen, warm, and red.

You should go to the emergency room if:

• You have a rash and fever or infection, and you cannot see your doctor right away.
• You have body or joint aches in addition to the rash.
• You develop shortness of breath.
• You have swelling in your mouth or throat.
• You have bruising or bleeding under or around the rash.
• Your skin is peeling or blistering.

Read our full guide on when to worry about a rash for more.

Takeaways on hand and foot rashes

Many rashes that develop on the palms and soles of the feet are self-limited and can be safely treated at home. Others are more serious and need the attention of a qualified medical professional for both diagnosis and treatment.

General Medicine follows a strict editorial process, including using real experts to write our articles, vetted primary sources, fact-checking, a secondary medical review, and updates as necessary. This article was medically reviewed and fact checked by Dr. Pallabi Sanyal-Dey, MD.

Sources

Allmon, Amanda, Kristen Deane, and Kari L. Martin. "Common Skin Rashes in Children." American Family Physician, vol. 92, no. 3, 2015, pp. 211-216.

Centers for Disease Control and Prevention. "About Rocky Mountain Spotted Fever." Centers for Disease Control and Prevention, n.d., https://www.cdc.gov/rocky-mountain-spotted-fever/about/index.html.

Tabasi, S. T. "Skin Rashes That Involve Palms and Soles: An Internist’s View." Annals of Nursing and Primary Care, vol. 1, no. 2, 2018, p. 1012.

Tamagawa-Mineoka, R., and N. Katoh. "Atopic Dermatitis: Identification and Management of Complicating Factors." International Journal of Molecular Sciences, vol. 21, no. 8, 2020, p. 2671, https://doi.org/10.3390/ijms21082671.