What causes black spots on the palm, and what should be done about it?
Dec 01, 2025
Source: Cainiu Health
Dr. Liu Wenmin
Introduction
In general, black patches on the palms may be caused by external staining, friction-induced pigmentation, pigmented nevi, lichen planus, or acropigmentation disorders such as palmoplantar melanosis. It is recommended to seek medical attention promptly, identify the underlying cause, and then improve the condition under a doctor's guidance through general management, medication, or other treatments. In daily diet, it is advisable to consume more fresh fruits and vegetables rich in vitamin C, such as oranges and strawberries.
Generally, the appearance of black patches on the palm may be caused by external staining, friction-induced pigmentation, pigmented nevi (moles), lichen planus, acropigmentation, or other conditions. It is recommended to seek medical attention promptly, identify the underlying cause, and follow a doctor's guidance for improvement through general management, medication, or other treatments. Specific analyses are as follows:
1. External staining: After contact with substances such as ink, hair dye, or dark food juices, pigment may adhere to the skin of the palm and form patches, often with unclear borders. Immediately wash thoroughly with warm water and neutral soap. For stubborn stains, gently wipe with a small amount of medical alcohol. Wear gloves when handling such substances in the future.
2. Friction-induced pigmentation: Long-term activities involving manual labor such as carrying or grinding can lead to repeated friction on the palms, causing thickening of the skin and pigment deposition. Reduce friction on the affected area, wear cotton gloves during work, and after daily cleansing, apply urea-vitamin E cream to soften the thickened skin and promote pigment metabolism.
3. Pigmented nevus (mole): Formed by clusters of melanocytes in the skin, these appear as black patches with clear borders and uniform color, usually benign. If the patch remains stable without changes, no special treatment is needed. If it affects appearance or shows changes, laser mole removal can be performed. This procedure precisely destroys pigment cells with minimal trauma and quick recovery.
4. Lichen planus: An inflammatory skin disease triggered by immune system abnormalities, which may present as purplish-brown or black patches on the palms, often accompanied by itching. Avoid scratching, and use medications such as tacrolimus ointment, mometasone furoate cream, or tretinoin cream as prescribed. Keep the palms clean and dry, and minimize irritation.
5. Acropigmentation (Palmoplantar hyperpigmentation): The exact cause is unknown, but it is characterized by diffuse or localized black patches on the palms, often symmetrically distributed. Treatment should be guided by a physician using topical agents such as hydroquinone cream, tretinoin cream, or azelaic acid cream. Avoid exposure to chemical detergents in daily life, and protect hands from sun exposure when outdoors.
In daily life, increase intake of fresh fruits and vegetables rich in vitamin C, such as oranges and strawberries. Apply hand cream promptly after washing hands to keep the skin moisturized, avoid frequent contact with irritants, and support healthy recovery of the skin on the hands.
