Palmoplantar Pustulosis - Pictures of PPP Outbreaks

Real photos of Palmoplantar Pustulosis (PPP) outbreaks on hands and feet. See what PPP looks like, common symptoms, and how flare-ups appear over time

This page contains real photographs of palmoplantar pustulosis (PPP) outbreaks on hands and feet. These images come from my own experience living with PPP and from members of our global support community who have kindly shared their photos to help others understand this condition.
PPP can look different from person to person, and from flare to flare. What is consistent is the pattern: sterile pustules on the palms and soles, often accompanied by redness, scaling, deep cracks, and intense discomfort. Seeing real examples can help you recognise whether what you are experiencing might be PPP, and help you communicate it clearly to a doctor.

PPP Pustules: Early Stage

​This photo shows an early Palmoplantar Pustulosis outbreak ​on the palm, with small pustules filled with fluid

PPP on the Palms of the Hands

The female in the photos above have had PPP for 5 years. The really big blister in photo 4,  is taken just shortly after she stopped using a steroid cream. She ended up in remission after cutting out gluten and reduced her sugar intake. She recently had a re-laps of the disease probably due to stress. She has now started a stricter diet and are working towards remission once again.

PPP on the Soles of the Feet

This woman have palmoplantar pustulosis on both her feet (no outbreaks on her hands)
​Here you see PPP on the sole of the foot during a flare-up, causing redness, scaling, and cracks

Palmoplantar Pustulosis causes painful cracks in the skin

This lady above was diagnosed 8 years ago during the time of caring for her dad with Dementia, so her trigger to onset this disease was probably stress related. She had spells of remission about every 2 years but are going through a flare right now. In these photos you can see the typical cracks that characterise PPP. 

PPP During a Severe Flare-Up

​This 68 year old man in the pictures above are suffering from Palmoplantar psoriasis. His first outbreak happened really fast. The blisters on his hand in the first photo developed in less than three hours. 3 days later he had it all over his body and ended up in hospital for 9 days. He is now getting treated with biologics which is helping a little.

Skin Healing Between Flare-Ups

If what you see in these photos looks familiar, you may be experiencing palmoplantar pustulosis. PPP is frequently misdiagnosed, many people spend months being treated for eczema, fungal infections, or other skin conditions before receiving the correct diagnosis.
If you suspect you have PPP, I recommend:
  • Seeing a dermatologist and specifically asking about palmoplantar pustulosis
  • Bringing printed photos from this page to your appointment if your skin is not currently in a flare
  • Keeping a photo diary of your own outbreaks to track patterns and triggers
  • Joining our support community to connect with others who have been through the diagnosis process
A correct diagnosis is the most important first step.
​These photos exist to help you get there.

How to Treat Palmoplantar Pustulosis Naturally – Book by Åsa Kärrman

Want to understand PPP beyond the photos? I lived with palmoplantar pustulosis for years before healing naturally in 2011. In my book I share everything I learned — causes, triggers, and a step-by-step natural healing framework.
Available on Amazon as paperback, eBook, and audiobook.