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With the wrong conditions, such as exposure to allergens, excessive washing or hereditary traits, dry skin can turn from mild redness into a painful cracking and peeling skin problem. Hands and fingers are two of the most common sites of skin dryness and cracking caused by most types of eczema-based skin rash 6. Treatment regimens include over-the-counter and prescription medicines but also rely on vigilant use of moisturizers and careful skin routines to encourage improvement of symptoms.
Cracking skin on only the hands and finger joints can be caused simply by contact allergies, by using too little moisturizer or by frequent hand washing. However, continued cracking, deep fissures, bleeding or no improvement with extra moisturizing may signify a more serious skin condition, usually a type of eczema 6.
Two types of eczema, atopic dermatitis and dyshidrosis, are frequent causes of cracking skin on the hands and fingers 123. Atopic dermatitis is a chronic, itchy rash that may be related to allergies and genetics and that worsens with dry air 1. It does not occur only on the hands, but affected skin on the hands and joint creases often cracks without proper treatment. Dyshidrosis begins as itchy blisters and is common on the fingertips, palms and even toes 23. When the blisters break, deep fissures and cracks become dry and bleed. A dermatologist is the only professional qualified to distinguish these and other types of skin problems.
People often turn to home remedies as a first treatment of dry skin, even cracked skin. Moisturizing with kitchen oils such as olive oil, wearing rubber gloves during dishwashing, avoiding the use of alcohol-based hand sanitizers and using petroleum jelly after hand washing are some common attempts to treat cracked skin at home. Soaking in diluted bleach solutions is an unusual home remedy, but it has official support--a study by Amy Paller, M.D., reported in the April 2009 issue of "Pediatrics," found that bleach solution can reduce staphylococcus infection in eczema, making the rash easier to treat with drugs and skin care 6.
By the time itchy or dry skin has started cracking, a doctor's visit usually is necessary to diagnose the type of skin condition and start prescription treatment. Corticosteroid creams and ointments are often the first treatment; these drugs decrease swelling, redness and itch at the site, which allows the cracked skin to begin healing. Sometimes, topical antibiotic cream is required because the swollen, cracked skin bleeds and becomes infected with staphylococcus bacteria. In addition to steroids, deep fissures common to dyshidrosis may require lactic acid lotion to shed the excess peeling skin and scar tissue 23. Application of any of these medications may be required once or twice a day and may continue for weeks or months.
Although medical treatment can reduce the flare of dry, cracked skin in eczema, it is not enough to control the chronic or recurring nature of eczema 6. A detailed regimen of daily skin care may be prescribed in addition to drug treatment, and this regimen is just as crucial to resolving cracked skin from any cause. Some aspects of routine care include use of products such as Vaseline, Eucerin or Aquaphor to hold in any moisture already on the skin and soothe dry areas; cool compresses on blistered or bleeding cracked skin, followed by moisturizer; and nighttime occlusion (applying ointment and medicine before wrapping or covering hands in non-breathable coverings for maximum effect).
Treatment for dry, cracked hands or fingers may be simple and short-term if there is a definite cause; conversely, cracked skin from a type of eczema may become a chronic skin condition that a person lives with for the rest of her life 6. A dermatologist is qualified to diagnose the cause of dry, cracked skin provide a specific care regimen. With proper care, even cracked skin with deep fissures can become healthy again.
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