Physiologic volar melanotic macules (P-VMMs) are benign pigmented macules on the palms and soles of individuals with darker skin colors. P-VMMs tend to be evenly distributed without a predilection for pressure-bearing sites. The prevalence of P-VMMs is unknown, given the sparsity of studies in the literature. The female-to-male ratio in 1 study of 200 individuals was approximately 2.5:1. In this study, there was an association with manual labor.