Knuckle Pads

What are knuckle pads?

Knuckle pads are benign (noncancerous) growths that form on the joints of your fingers or toes. They are also known as Garrod’s nodes or Garrod’s pads.

Are knuckle pads dangerous?

Knuckle pads don’t cause any health problems. However, if you have them you may dislike the appearance of your hands. They can sometimes be painful or tender. If they become large, they can make it more difficult for some people to use their hands. They could also cause discomfort or rubbing on your toes and feet.

What’s the difference between knuckle pads and warts?

Knuckle pads may look like warts, because both conditions cause bumps on your skin. However, unlike knuckle pads, most warts are caused by the human papillomavirus (HPV). And while warts can appear in many areas of your body, knuckle pads only occur on the:

• Backs of your hands on your finger joints.
• Tops of your feet on your toe joints.

What causes knuckle pads?

Knuckle pads are a type of fibromatosis, a condition that causes noncancerous tumors under your skin.

Some types of fibromatosis run in families, but others happen without a family history or obvious cause. You may be more likely to develop knuckle pads if you have another type of fibromatosis, such as:

• Dupuytren’s contracture.
• Ledderhose disease. This type of fibromatosis causes growths on the soles of your feet.
• Peyronie’s disease.

In addition to having fibromatosis, other conditions can cause knuckle pads, including:

• Epidermolytic palmoplantar keratoderma: A thickening of the skin on the palms of your hands and soles of your feet that's often associated with excessive sweating.
• Bart-Pumphrey syndrome: A genetic syndrome that causes hearing loss, nail changes and thickening of the skin on the hands and feet.
• Acrokeratoelastoidosis of Costa: A rare skin condition that causes wart-like growths on your hands and feet.
• Camptodactyly: A rare, benign, congenital (present at birth) condition that causes one or more fingers to be stuck in a curved or flexed position.

What are the symptoms of knuckle pads?

If you have knuckle pads, you may notice bumps on your knuckles or joints of your fingers or toes. These bumps are usually:

• Skin-colored.
• Solid and firm.
• Painless (although they can cause pain or tenderness in some cases).

Knuckle pads sometimes look like corns and calluses, which are thickened, rough areas of skin. However, knuckle pads are dense tissue that forms under your skin, and calluses/corns are caused by rubbing and irritation.

Are knuckle pads contagious?

Knuckle pads are not caused by a contagious illness. You cannot “catch” knuckle pads from another person, but they can run in families.

How are knuckle pads diagnosed?

Your healthcare provider will ask you about your symptoms and do a physical examination. They’ll also ask you about your:

• Health history, including any health conditions you currently have.
• Family history of fibromatosis or other conditions related to knuckle pads.
• Medications you take.
• Lifestyle, including how you use your hands for work, sports or other activities.

What tests are used to diagnose knuckle pads?

No testing is needed to diagnose knuckle pads unless symptoms are severe or your provider needs to rule out other health conditions. In these cases, your provider may perform these tests on your hands or feet:

• Magnetic resonance imaging (MRI).
• Skin biopsy.
• Ultrasound.
• X-ray.

How are knuckle pads treated?

If knuckle pads aren’t causing you pain or interfering with your life, you don’t need treatment. But if their appearance or symptoms bother you, treatment options may include:

• Topical medicines: Your provider may tell you to apply a prescription cream directly to your skin on the knuckle pads. These creams contain medicines that may help remove excess skin cells or that fight inflammation.
• Steroid injections: Your provider uses a needle to inject a small amount of medicine into the knuckle pads. Steroid medicines can shrink knuckle pads, making them less noticeable.
• Surgery: In rare cases, if other treatments aren’t successful or symptoms are severe, surgery to remove knuckle pads may be an option. Surgery isn’t recommended if you are prone to unusual scarring, such as keloids (raised scars) or hypertrophic scars.

How can I get rid of knuckle pads?

There are no proven home treatments for knuckle pads. However, keeping the skin on your hands and feet moisturized may help reduce discomfort. When washing your hands:

• Use lukewarm, not hot, water.
• Gently pat skin dry after washing — don’t rub.
• Choose fragrance-free, dye-free skin creams and soaps.
• Apply moisturizers that contain emollients, such as petroleum jelly, to your hands immediately after washing them.

For feet, apply a heavy moisturizing cream or petroleum jelly after showering or bathing. Cover your feet with cotton socks to keep moisture in longer. Focus on your heels and bottoms of your feet, as well as the knuckle pads. Putting emollients between your toes raises the risk of foot fungus.

How can I prevent knuckle pads?

There is no way to prevent knuckle pads. See your healthcare provider regularly and be sure to discuss your overall health and family medical history. With regular medical care, you will be better able to recognize any health concerns that arise and take care of them right away.

Are there long-term effects from knuckle pads?

Knuckle pads aren't harmful to your body, but they can cause skin irritation and emotional stress. If you have physical or emotional symptoms, ask your provider about treatment and support options.

Is there a cure for knuckle pads?

Treatment for knuckle pads can be successful, but there is no treatment that works for everyone. Work with your provider to find the best treatment option for you.

When should I see my healthcare provider?

Knuckle pads are not a medical emergency, but contact your provider if you notice:

• New or different bumps or lumps under your skin, or if they are growing larger.
• Pain or tenderness in your hands, fingers, feet or toes.
• Skin discoloration or rash.
• Trouble moving your fingers or toes.

A note from Cleveland Clinic

Knuckle pads are a benign condition that usually affects one or more of your fingers or toes. They are rarely painful, but they can cause unwanted changes to the appearance of your hands or feet. Although there is no guaranteed cure, treatment may help shrink or get rid of knuckle pads. Talk to your provider about your symptoms so you can decide whether treatment is right for you.