The pins and needles sensation in the palm of the hand may be caused by early herpes zoster or cholinergic urticaria. 1. Early herpes zoster: herpes zoster may be related to low immunity, overwork, mental stress, usually manifested in the early localized rash, followed by the gradual formation of small blisters, accompanied by pain and itching, and if it occurs in the hands, it can cause a pins and needles sensation in the palms of the hands. 2. Cholinergic urticaria: usually caused by elevated body temperature of the body skin, after exercise, the use of hotter food or emotional excitement can appear rash, can lead to the palms of the pins and needles, itching, burning sensation and other discomforts, to be triggered by the disappearance of the factors, the symptom will be slowly reduced. There may be other reasons for the pins and needles sensation in the palm of the hand, it is recommended to go to the hospital in time, to clarify the cause of the disease and follow the doctor’s instructions for treatment.