Chapped, cracked fingertips

[John]

I'm 29.  Every winter the fingertips of my right index and middle finger become extremely dry and chapped.  Frequently the skin cracks bleed, and are quite painful, inhibiting use.

Only these two fingers are affected, and only during colder months.  Medicated hand creams have offered temporary relief, but do not improve the condition.  What is this, and where do I go from here?

[Alan Rockoff, MD]

John:

It's eczema.  Go right to your doctor and get a prescription-strength cortisone cream or ointment.  Apply this twice day, with or without moisturizer, to suppress the symptoms.

Eczema is not an allergy.  Changing soaps and other products is useless.  There is no rhyme or reason to eczema's tendency to affect one or two fingers and leave the others alone.

It gets worse in thw winter on most people, but there are many exceptions to that as well.

Best.

Dr. R

[Ron Embrey e-mail: [e-mail]]

I have been having skin problems mostly on my right hand (fingers only) for 1.5 years.  The dermatoligist says it is eczema/dermatitus.  He has prescribed a cortizone cream (Temovate E) which only helps temporarily.  1% hydrocortizone cream from the supermarket seems to help more, but nothing clears it up permanently.  It seems to go through a cycle where it is almost gone and then starts over again with the skin getting hard, splitting, healing over 4-5 days and then the cycle starts over again.  In the beginning I was put on a ten day oral cortizone series which cleared it up for a while but not permanently.  Am I stuck with this the rest of my life?  I use Dove soap and a mild shampoo but that doesn't seem to make any difference.  Help!

[margaret]

Ron,
I had severe dry skin mostly on the fingertips of my right hand, esp the index, thumb and middle finger.  A dermatologist diagnosed me with eczema and dermatitis.  I was given steroid cream, pills and a shot which cleared it up for three days.  My doctor suggested that nickel allergy could be a contributing factor.  Interesting to note that the fingertips involved were the ones most in contact with keys, which contain nickel.  I covered my keys with plastic and the problem started to improve, it's almost completely gone now.  I've also found Aveeno lotion and soap very helpful, they're excellent products.  You may not have a contributing nickel allergy of course, but you could maybe cover some things and see if it helped, just in case.  I hope you'll find this useful.

Margaret

[Jim]

I have had the same problem with fingertips.  Since nothing seemed to relieve or cure it, I have been using a liquid bandage called "New Skin" which does no more than form a "skin" over the split part of the finger.  This alleviates some of the pain and allows me to use the finger (or thumb).

New Skin seems to be available at many drug stores, and offers no cure, just relief.  

Thanks for the suggestion to use 1% cortisone cream.

[Lynne]

I have been having the same problems with fingertips, palms, feet, and mildly on knees and elbows for six months. Oral prednisone, ointments, diet, and everything else I've tried has either not worked at all or was only temporary. My Dr. calls it excema, dermatitis, proriasis or some combination thereof. After much time online I am leaning toward something called keratolysis exfoliativa. The nickel allergy is also interesting and I have seen reference to it online. It is worth getting tested but be sure you have the patch test, not the stick test. Gooping up with Dovonex ointment has helped soften the skin somewhat but is not a cureall. If you find it, please let me know!!! Good luck!

[Michael Newcombe]

I have had the same symptoms as above. It started when I was working for the US Fish and wildlife Service in New Hampshire about 5 years ago. My hands were in icy water for long periods at a time.
It initially appeared on both thumbs which was quite incapacitating. It has recently gone without explanation, from my right thumb and is now affecting my secomd left fingertip as well as my left thumb.
I have tried cortizone, antifungal and anti biotics all to no avail. I have found the best treatment to be a cream made from 6% AC SAL (some form of acid) in a strong tar based cream. I apply at night time covered in the cut off fingers of surgical gloves. This seems to work by removing the dead skin.

It is not a cure but helps. If only someone could come up with something permanent. As you all know it gets so saw that it is sometimes impossible to use your hand especially when on a thumb.  

Mike  Newcombe Australia