Exfoliative Keratolysis

[Okie55]

I have suffered with Exfoliative Keratolysis on my hands and feet for 27 years now.
In fact it was only by going online recently that I finally learned the exact name of this condition. No doctor I saw ever put a name to it other than "It's some type of dematitis or exzema (eczema)." As like many others, I went through all the standard treatments including topical steroids. The ONLY times it has completely cleared was when I would get a cortizone injection in my bad shoulder as well as the one time I was put on a Prednisone treatment for an eye infection. That's it. I live with it. But I would like to know if anyone has an idea as to what brings it on in the first place. Why, out of the blue, does it appear? I have no allergies nor exposures past or present to chemicals or the like. Any ideas? Any treatments that work?

Thanks!

[Moraia]

I had just written a 5 line comment and my registration did not allow me to post it. After I got a new password the comment had been errased. I am trying to see what happens this time. This forum web is pretty uncertain.

[Moraia]

Well, it seems to have worked. I have a comments earlier on under "thumb peeling". I don't know if you have seen it. My condition seems a lower intensity than yours but could have the same cause. I was following the reports from someone under the name bbally who was having his skin cultured to check for possible fungus or bacteria. The comment thread was unexpectedly closed and I have not seen any comment from him since. Myself I am trying an antibiotic cream and see if it works. I know that water makes it worse, but not so sure about sea water.

[Okie55]

I had a biopsy done years ago with no results.
I have used over the counter anti-biotic ointments but it hasn't helped other than to act as a lubricant, much like Vaseline. Everything seems to aggravate it including stress.
I was told that much like any other exczema (eczema) or dermatitis, no known causes or cures.

[Moraia]

Thanks for the info, although sounds very hopeless. A biopsy is different from a culture in an apropriate media. For myself, It's hard to believe that after 50 yrs of having no skin problems something just shows up due to ? and because of being in a particular area and spreading down the thumb slowly I tend to think is some bug rather than stress. I am trying and learning whatever I can.

[Okie55]

As I mentioned before, steroids cleared it up but obviously that could never be a long term solution. I also had allergy patch testing done but no reactions to anything.
Every explanation I've read has been vague at best. But let me know how the culture thing goes. Even if I never get rid of it I'd find some consolation in knowing the cause!

[Okie55]

Also forgot to mention that I have read that a lot of these types of skin disorders can be a reaction to stress / nerves possibly from a critical life event. Don't know if there's any truth to that possibility but something to think about. I do know that my condition worsened recently after my best friend died suddenly in April. Within a week I noticed a marked increase in peeling and cracking and it hasn't gotten any better. My original outbreak with this came at the same time I was going through a divorce in 1982.
Connections?

[Moraia]

I had never thought about possible connections to stressful periods, but it may be. The first time it happened to me I was organizing an exhibit and having a lot of stress because of family matters. Later it has shown up at different times, and since I have been stressed or depresed often, it hard to say. This last time occurred after a very stressful period as well and it has not dissapeared yet but it's better now. I will pay more attention to it from now on.  

[geoffrey2]

i have had for 15 yrs  tried lots of therapy  have lived in tropics  and high desert...no stress  then high stress  doesnt seem to make a difference  it only gets worse month by month   waiting for someone to find a remedy  

[geoffrey2]

i have had for 15 yrs  tried lots of therapy  have lived in tropics  and high desert...no stress  then high stress  doesnt seem to make a difference  it only gets worse month by month   waiting for someone to find a remedy  

[geoffrey2]

dont waste your money on dermitologists they are no help  and yes the creams only act as a moistener to help with cracking   i actually find relief with gloves to keep the air off
has anyone noticed their fingernails grow really fast with an outbreak?

i have never had an outbreak on the outer side of hands..only where the sun doesnt fully reach..on the palms and inside of fingers   i was thinking light therapy may help  a uv light? anyone tried?

[fazant]

I suffer from Exfoliative Keratolysis now about 10 years...
Tried everything...biopsie, test of allergies, bloodtest, etc...
Every doctor and dermatologist in Belgium I have visited.
No doc ever called it that whay.
Till one... he knew directly a cure: he prescribeded me Prednisolone, corticosteroids and I was treated by that doctor 3 times a week with UV-radiation. I had to put a verry fat layer of cream with lots of ureum (urea) I guess in it on my handpalms and foot soles and then take place in a UV cabine for a few minutes. This was the only method that had result. But I stopped with it because due of the cortico's my haire felt out...etc.
I lived with it for so many years now... I don't want to poison my body all the time taking cortico's etc... and now my hand are back peeling all the time...!!! frustrating!!! (sorry for the spelling mistakes) greeting to all

[scala500]

Exfoliative Keratolysis


Please note that any medically related information provided in this report/advice is not intended as a substitute for advice from any registered physician or other healthcare professional.  Whilst I have endeavored to ensure that all information provided in this report/advice is accurate and up to date, I take no responsibility for any error or omission relating to this information, nor any responsibility for what any person may or may not do as a result of reading this report/advice.

I am a 50+ year old male and have had the condition Exfoliative Keratolysis (EK) for over 35 years, and have tried most if not all (cures) – Doctors, Dermatologists, Naturopaths, Herbalists and several ‘Theorists’.  Have been researching and experimenting with my EK for over 30 years. My parents were in medicine, and so I had some inside knowledge and access to research, although a lot of it (some unqualified) is now available on the net. I don't know everything, but I do know what works for my EK.  I believe that EK 'management' is really a matter of trial and error – unlike some medical conditions there is no ‘penicillin’ type cure (yet).

The following is a brief summary of what works and doesn't work for me, and my thoughts on EK.  I am providing this in the hope it may help some others.  

The first step I had to make was to accept that my EK condition will not kill me, but it is something I have to live with and have to manage myself.  In my experience there is no miracle pill/lotion/cream I can get that will cure it, and there is no plant growing on Mount Himalaya or in the Amazon Jungle that will either.  Some things make it better for a while, but there is no permanent cure - although it does run its course and 'go away' in some people. My advice to others is to accept this, then you can find out what works for you and then implement a management regime (and change if needed, and try new things sometimes).  Maybe this will result in a cure, and maybe it may last a lifetime.

My hands do not blister - they used to, but they have not done so since the condition started many many years ago.  I believe that this lack of blistering and some associated problem with the natural healing processes in the particular skin type that EK affects, is the core of the issue.

At its worst my hands would be completely 'stripped' of 'good' skin - the fact that I used to play so many bat and ball sports did not help (life is too short).  I wish I had learned my management regime a lot earlier - but that's how it goes.

My EK gets worse when the weather is hot or after periods of excessive hand contact activity (eg hammering nails, fixing cars).  In winter where I live now, it gets down to -10C (15F) and my EK all but disappears.  If someone was to go somewhere really cold for 2-3 days and expose their hands to the cold, and if they get better and the EK dissipates, then they on the same page as myself. I believe the cold helping is due to the healing process working better when the skin temperature is lower and less moisture is lost than when the skin temperature is high.

EK is not due to stress - but stress can initially bring it on (it would come sooner or later anyway) and stress can make it worse.

Topical steroids/cortisone and injections are not the answer for me - they 'repair' the damage, but EK always comes back (sometimes worse).  There are many other prescription drugs and natural options/cure available, and for me they all do the same.  Going down this path lead to a cycle of repair and damage, but no cure.  However, I have learned that EK may 'burn out' for some people who take this  course of action.

The EK condition is somehow related to moisture loss in the specific epidermis layer of skin that is only on two parts of the body and the natural healing mechanism of the skin.  I believe that this is why EK is only on the hands and sometimes on the feet.  The skin on the hands and feet is unique and is designed to be damaged and to heal quickly.  To counter the problem, I keep my hands moisturised, avoid damaging my hands (eg do not hammer nails), and keep those things away from my hands that make EK worse.  These are some of the things I do and that work for me, and maybe for others.

Wear light cotton gloves when doing light work with hands at home/work (am doing so now as typing can affect the finger ends), and wear heavy gloves over them when needing to do hard work (gardening, lifting furniture, etc).  Do not wear the cotton gloves for too long as they will after 20-30 mins start to dry out the skin.  Use a Urea based ‘repair’ cream 4-6 times daily when the condition flares, and 2 times a day when it has abated (after a shower/bath is best absorption time).  

Get a non-greasy quick absorbing hand moisturiser (for when greasy hands are a problem eg meeting people) - make sure it has no added chemicals or perfumes. Keep a clean dry cloth in car/desk (you never know when you need to quickly dry the greasy hands).  Sometimes I wear the cotton gloves when driving long distances – cream underneath and re-apply at least every hour.

Never let any ‘normal’ soaps, chemicals or solvents touch the hands - wear elastic/rubber gloves when in shower/bath (seal with tape around wrists), when applying things like hair products or after shave, and when doing the washing/cleaning.  Wash hands in a dermatological chemical free handwash, and/or use special non-soap soaps.

When seriously bad (usually due to being slack with my management regime) I smother  the hands thickly with the Urea based cream before going to bed and cover hands with a new unwashed pair of cotton socks (gives a quick repair) – this aids the healing processes and makes it better.  If desperate for a serious ‘makeover’ (job interview, wedding, etc), I use a steroid/cortisone ointment (not cream) and apply (not thickly) to hands at night and cover with non-allergenic medical gloves (very thin plastic type material specifically for the application of creams/ointments to the hands – not the rubber gloves).  This usually ‘fixes up‘ the hands for a day or two, but I know the condition will flare again later (has to be worth it to do it).

Basically, the key for me is to manage the condition by avoiding as much as possible anything that makes it worse, and to provide the skin with the right assistance to help it heal. Hopefully, like for some others, the condition will run its course and go away.  Until then I use my management regime to minimise the negative affects EK can have (has had in the past) on my day to day life.

PS - Photochemotherapy is an option I have not tried (yet).  It is a new treatment and new treatments always have their bugs - the technicians and doctors need experience to work out what works best (and more importantly what doesn't).  I have decided to wait a few years for the technique to become more 'mainstream' and will be keeping my eye on it.

[jphjones]

that guy hit the EK nail on the head.

I'm only 21, my grandmother had this problem and so does her brother.

I worked as a sumer student in an assemby plant, throwing batteries into trucks, wow did it ever get bad. Lucky I live in canada, b/c the post above me is right about the temp. effects

[Victory101]

I'm a 45 yr female and I feel so bad for you all. But glad I stumbled onto this Forum. I've only been suffering from this "EK" contidion on palms of hands for just over 3 yrs. But you mention everything that I have done to make this condition bearable to include prayer. However I have only thought about showering with gloves on and I think I will go ahead and do that regimine too because every type of cleaner causes pain and you gotta shower and wash your hair!

Other skin and life conditions could be & are worse and so I count my blessings.

I too researched every avenue and talked to all kinds of doctors and no one could tell me what is wrong with my hands and/or what has caused this condition. But they stated that because it is not anywhere else on my body, they were all 110% certain that it is NOT contagious. That is a plus!!

As you stated the steroids; (I used the dosepak 4 times in a 10 mth period) help temporarly but the side effects to the rest of your body are not worth it to use of steroid based drugs on a long term basis and the EK comes back. I've found that it isn't stress that triggers  my outbreaks as is the things I do or eat that may cause inflammation in my body; to include my hands, that I have to monitor.

After 3+ yrs I found a New Zealand website that put a name on this condition and for the first time I heard of the treatment called 'Photochemotherapy'. I'm with you; wait and see before trying this procedure. I haven't been able to log on again since that first time after finding site just a week ago...but I printed out the "authoritative facts" that stated other hand creams containing lactic acid or silicone my be helpful in releaving condition; so I'm going back to the nutrition center were I found out about Urea  and see what else they have available with all these ingredients. Could you name the Urea based cream you are using?

I've found that an aloe vera extract with colloidal silver helps in healing the deep lesions and cuts and if bad enough anti-biotic oinment and bandaid to help with the really deep, bleeding, painful cuts.

Typing is one thing, but I enjoy working in the yard/vegitable garden and my husband and I are building our house with our own 4 hands so I (with gloves) hammer and saw and haul heavy stuff frequently as well as all the other things associated with building a house: caulk, silicone, paint, plaster, and though painful I don't and can't let it stop me from living.

The peeling is not as bad as it used to be, but the superficial air-filled skin that callouses and then cracks and peels leaving new raw skin that is painful for couple of days gives me a sign of a break before the whole cycle starts again. Lately however, most of what I suffer from is the superficial air-filled skin that callouses and then cracks leaving cuts and lesions that come and go over and over and over again.

My Thanks goes out to you all for posting your pain, thoughts and suggestions.

[ben301]

i have just noticed the peeling away and air bubbles on my palms, ive never had it before now (16 yrs )

i hope it goes away but your comments about stress not being the cause is the complete antithesis of me,

i have just completed my GCSEs which are big exams in england (is this an english forrum) and yeh the Ek started about 2 weeks into 5 weeks of exams, coincidence...i think not.

dan its annoying, i always have played loads of sports such as golf tennis hockey which are all hand/fingr based doubt they helped.

i also have seeveral allergies, nuts pollun (horses dunno y?)


and yeh if there is ever a complete remedy or maybe a cream which i can pick up plesae email me

***@****

many thanks

[ben301]

wtf?


G S T 5 @ H O T M A I L .C O . U K

[saeria]

Does anyone know any online resources about EK with a good gallery. I've been trying to figure out what has been going on with my skin for a very long time now but i just keep running into dead ends. My palms and soles look alot like the pictures i've seen of EK but my major issue is all the peeling that happens on the tops of my hands, feet lower arms and legs. Could this somehow be related to EK or is this condition centralized only on the palms and soles? I'm not looking for a cure or tips on keeping the peeling at bay, i just want to know what it is so i know what to do when i have an especially bad outbreak.  

[Jimph]

Hello fellow EK sufferers.  I'm a 48 year old male and have suffered from EK for approx. 10 years.  I too had to self diagnose as no doctor ever offered.  I've been to countless doctors, dermatologists including the Mayo Clinic.  Needless to say "no help" any where.  I've also tried countless prescription ointments , etc.

Mine starts up in late winter (Minnesota) or early spring every year.  Then by late October clears up, and I mean clears up to the point where all winter you'd never guess I had the condition.  I always just thought it was seasonal and that's the way it is.  Then it dawned on me that every August and late September I get an injection of Depo Medrol for severe fall hayfever allergies.

I am convinced that this injection, which is a form of steroid gets in my system, clears up my EK and then by late winter begins wearing off and condition returns.  Depo Medrol is, as my doctor tells me also available in a topical ointmnent, which I have not yet tried.

Please, if anyone else has had the same injection I'd like to hear from you.

[Carrie789]

Great information.  I have been trying to figure out what is going on with my son's fingertips for a few years now.  It seems to happen during the summer months and last summer my husband and I thought it was from the swimming lessons he was taking (the Chlorine) but this year he isn't taking swimming lessons and again his fingers are peeling.  It seems to clear up as soon as summer is over.  One comment above (from geofrey2) caught my eye - he mentioned that it seemed his fingernails grew faster during the outbreak.  I swear my older sons finger nails grow twice as fast as his younger brother.  Does anyone else notice that?  I am also very thankful for the information from Scala500 was awesome.  Have any of you been diagnosed with EK from a doctor - or just self diagnosed (like I too have done)?  I would love to know the name of the Urea based handcream you are using too.  I am going to take my son back to the doctor next week and ask about EK and see what they say.  They haven't ever diagnosed my son either.  Again, thank you for the info.

[Jimph]

I am seeing my doctor again this week and am also going to inquire about the Urea based creams.  I've tried countless creams but not sure if any were ever Urea based?  Isn't it crazy that I keep going to doctors and why because nothing but the Dep Medrol steroid injections help.  I guess I keep trying because it is so miserable having this condition, especially over the active summer months.  It affects so many activities from typing on the keyboard to opening a can of pop, which becomes terribly painful.

I know what you mean about the finger nails.  I'm not sure if they are actually growing that much faster or if it's because when the finger tip skin keeps peeling the connected area kind of works back further on the finger tip.

Scala500 did offer some great and extensive advice but holy cow following that regime wouldn't be easy.

[Dr_Aparna]

Hi,
Exfoliative keratolysis is a common skin condition in which there is focal peeling of the palms and less often the soles. It is also known as ‘keratolysis exfoliativa’, and ‘focal palmar peeling’.

The first sign is one or more superficial air-filled blisters on the fingers or palms. The blisters burst to leave expanding collarettes of scale and circular or oval, tender, peeled areas. These peeled areas lack a normal barrier function and may become red, dry and cracked. However, they are not generally itchy.

The symptoms are aggravated by exposure to irritants including water, soap, detergents and solvents. Eventually normal skin forms, but frequently exfoliative keratolysis recurs within a few weeks.

Emollient hand creams especially those containing urea, lactic acid, or silicone and Photochemotherapy may be helpful.
The exact cause is not known but it could be some allergy, which is why it can start at any time in one's life.
ref: http://dermnetnz.org/dermatitis/exfoliative-keratolysis.html

[juliedd]

I'll so happy to have found this thread and will continue to watch for updates. I'm still waiting to find out the name of the urea-based hand creams that seem to help!

Does this condition seem to occur with other skin conditions such as hives and/or dandruff? My son has to use several different dandruff shampoos in the shower, which could be contributing to his EK. I will encourage him to use gloves when shampooing.

Also, is there anyone who is willing to post photos of their condition?

Thanks.

[Pmobs]

I've had EK on my feet since I was a little kid and then it started on my hands as a teenager, now 24.  Doctors always said it was excema and lots of creams didn't help until I found Augmented Betamethasone Dipropionate ointment.  I call it my miracle cream.  I just realized that I have EK and not excema, so I haven't tried these urea based creams, but will look into it.  I thought that if it worked for me, it might help someone else too.  It's prescription so you can ask your dermatologist for it.  

I use it only as treatment once my hands start peeling, or as a precaution the day before or the day of doing something physical that stresses my hands or having them wet for a long time or wet, dry, wet, dry, since that is when mine acts up.  

[steelrover]

My peeling first started in last summer on my hands and lasted about 6 weeks before it is gone. Then I had another breakout in last fall. Today, it just started again. I just feel bad and I've went to two doctors and none of them offered any help. I am praying it won't last that long this time.

[Jimph]

I've posted some comments earlier and must comment on the Augmented Betamethasone Dipropionate ointment.  Out of frustration form my EK this summer I consulted with my doctor once again where he prescribed this ointment. WOW!  What a great thing it has turned out to be.  In just one week of use my hands and fingers went from being to sore and tender to button pants, open pop cans, etc. to just about completely healed!

As prescribed I apply ointment 2 - 3 times a day and put on a pair of disposable latex gloves.  One application is just before bed so I wear gloves all night.  The golves force all the ointment to soak into the skin and is also practical because this ointment is very, very greasy.  I'm not kidding that in just one week my hands are 95% healed and normal looking.  This is remarkable because I've suffered for at least 10 years, from early spring through October before I'm usually healed (and that's because I receive steriod injections in Aug. and late Sept for hayfever).

I am in full agreement that this ointment is a miracle!  I additionally I use a 40% urea based cream as moisturizer between applications of Augmented Betamethasone Dipropionate.  I feel this also contributes to my remarkable healing but the Augmented Betamethasone Dipropionate ointment is the main cure.

Ask your doctors for a prescription!

[Bustin]

I am 50 years old and have had EK ever since I remember. I have tried various medicated creams and other prescriptions to no avail. As one of the posts mentioned, it is a matter of managing the disease and learn to leave with it. I do not know of any permenint cure to date and if anyone has been cured please share your experience with us.

[valld]

I have had EK for ten years now. I am a 47 year old female. In my case it started off on one thumb only and then over the years has spread to several fingers. It was diagnosed by a dermatologist about 3 years into the outbreak.She said it is very common and some people find relief from urea based creams. Any pharmacist will give you these, Eucerin is a common over the counter one, though I never found any of them any good. This summer for the first time my feet are affected. Both soles and the toes front and back are peeling. I went to a chiropodist today just to check that it wasn't something else starting. He had never come accross anything like it before, but reckons it is the same as the fingers. His advice is not to soak my feet in water and to use plenty of emollient creams. Is this condition progressive, and are any other parts of my anatomy going to start peeling!! As for nails growing quicker, I agree with the writer who said that its the skin under the nail coming away that makes the white part move back down the nail.

[vp123]

like most of you, I had to look it up myself, the doc thought it was psoriasis. I will try the A.B.D.  I have used sea salt from the dead sea and that works very well.  

[loki980]

I just figured out the name to this aggravating condition after finding photos that are *identical* to what I have.  It started about 5 months ago immediately after my first liquid nitrogen treatment for warts around my fingernails (you do not know pain until you've done this.)  Thank god those are gone!  The derm said it was hand dermatitis, but didn't go so far as to say it was EK.

Photos:
http://dermnetnz.org/dermatitis/exfoliative-keratolysis.html

The middle photo looked exactly like my fingers.  My palms were pretty much in a constant state of shedding skin, but my fingers were somewhat normal in some places.  I'd imagine if you left your hands alone (who could when there's dead skin hanging off) it'd look more like the left photo.  Real hot weather makes the condition worse for sure.

What worked for me was a steroid cream (Clobetasol propionate) 2x a day (1st thing in morning and right before bed,) with a thick hand cream to supplement it probably 2 more times a day.  It slowly improved over the course of about 2-3 weeks.  I can see a little bit of peeling still, but I'm sure it'll go away.  I just hope I don't have to keep using this steroid to keep it away...

So, it's not all roses yet.  Look at that page with the photos again.  See the bit about "Exfoliative keratolysis may precede pompholyx"?  They're right. I have that now.  EK never made my hands itch.  Now they itch like crazy.  Hopefully it'll clear up in 1-3 weeks like they say.  The treatment is the same, so I'm on top of it already.

[loki980]

An update...

The itchy stage of pompholyx is over.  It appears I'm in the 2nd stage of it, as indicated most everywhere you read about it.  My hands are dry, peeling, and cracked.  I'm continuing to put cream/steroid medication on it.  Hopefully the itchy stage won't recur...

[scala500]

Hi all - have not logged on for a while - EK has been dormat in Aus winter and system problems.

The Urea cream I have used successfully for a while now is called DU’IT Tough Hands.  It is made by a company called Orbis Australasia Pty Ltd – www.duit.com.au    The product has 15% Urea cream plus Vitamin E and several other ingredients that seem to combine well. I apply it every night and after showering in the morning (both when EK is dormant and also when it is active).  

Because it is greasy and therefore can’t be applied all the time (and I don’t want to over use it), during the day when the hands get dry, I apply products called NS-7 and NS-21 by Plunkett Pharmaceuticals - http://www.sunspot.com.au/pages/nutrisynergy/pages/index.html

The only thing I have found that ‘cures’ EK – not really cures it though, more puts it into a dormant state. I moved some years ago from a city in a hot/humid climate area, to a much colder place and that has been a great help.  Now I only have the EK 3-4 months of the year, instead of 9-10 months where I lived before (sub-tropical).  I am aware of people who have moved to much colder climates (Canada, London, etc.) and the EK has all but disappeared.  By the way, since moving here I have gone on holidays to hot/humid places (like Fiji) in our winter.  Although the EK starts to show itself after a week or so, it quickly dies down when I return from the holiday.  For those going through extreme problems with EK, I strongly recommend moving to a colder climate - life is too short.

Basically, the key is to manage the condition by avoiding as much as possible anything that makes it worse, and to provide the skin with the right assistance to help it heal. Hopefully, the condition will run its course and go away – and/or the medical profession will find a cure.

[dcmix]

For me here, it's been 7 months of
peeling on the finger tips.
All tips from left hand and
only the index and thum from
the right hand are affected.
It started with ski gloves
sweating, at first i thought
it was fungus but no, it
really looks like what
you describe,
Exfoliative keratolysis
I will keep following this post...

[Tampanuts]

Hello all.  After reading your posts, I have now self-diagnosed as having EK.  I am 39 years old and my hands haven't peeled in quite a few years.  No doctors that I saw offered any treatment or diagnosis, so I just lived with it.  I do remember my palms itching a lot right before the blisters and peeling would begin.  Now my issue is that I have acute pain in the tips of my pointer fingers (on both hands) and on the thumb points (on both hands.)  THe pain comes and goes for weeks at a time.  Sometimes, it relieves the pain to soak the affected tips in water, squeeze the tips of my fingers, or pull the finger tips back a little from the nail.  Has anyone else experienced any of these symptoms?  I don't know if it has anything to do with EK.  Please let me know...***@****.  Thanks.

[jaredls]

Hi
Thanks to this forum I think I have figured out I have EK.
I have bought a urea cream - it's called "urix 40". I have been using that as well as not using the same soap ( i was using irish spring and dove) now am using liquid soap. I have also not tried to use shampoo as much. This has all helped tremendously. I can go about a week without using the cream - until slight peeling cracking occurs on the tops of my fingers. I don't know what is the "cure" for my results...in fact it could just be that in the past month - about the time i started using the treatment I was just getting done with a lot of stress in my life (law school exams) - hopefully the EK will not get worse as a new semester starts for me. I will report back if it does.

[pinksheep0710]

You lot are a life line for me! I have suffered from EK since I was 18 (am now 25) and like all of you have never got anywhere with doctors who simply tell me I have excema and cannot explain why it never gets better or why it's better in summer.

I hate it when I have an outbreak and often feel obliged to wear plasters (bandaids for you Americans) on my fingers as they are sore and look horrible. Does anyone know whether this will be making it worse?

I'm going to go tonight to a Pharmacy and get some urea based cream. Here starts my informed battle against my peeling hands!

[dcmix]

So, it's been a year now and the dermatalogist
that i saw told me there was nothing he knows
to cure it.
He says that if no water was in contact for a
month or so it would probably go away.
The problem seems to be the first layers
of skin not retaining the right level of
moisture, go figure why...
Himuno deficiency alike but in my case
on fingers tips only.
That's it for now, i'll keep
on using the urea cream and cotton gloves at night...

[jsybean]

With regard to EK being linked to stress, I think that it may be as
I have had this condition for about 15 years, and it started when I was diagnosed with an overactive thyroid, my hands used to get very sweaty, 18 months later I had a partial thyroid removal and still the condition persisted. Sometimes in the winter it does improve for a week or two, but as I am now prone to feeling the cold, I tend to wear gloves which keep my hands warm and so it starts up again. At the time I didn't consider myself  "under stress" as I tend to be very level headed although to my body it obviously was a stressful time. I would agree totally with the gentleman who said that you have to just learn to get on with it and it's not going to kill you, and always keep hand cream everywhere for the times when your hands are on show!

[kc935]

hi. i'm sixteen and just about two days ago i was walking outside with my dad and he was kicking around dirt and stuff and then i was standing in grass and my leftleg started to inch, i thought is was nothing but when i got home i looked at my leg and there are little really little dots, it looks like its in my pores or something.my parents are in the medical field and they both say that it just might be a weed scratched me. and as i am thinking about it my whole body is starting to itch.

what do you think it is?

[kc935]

just to add on i'm putting a pixture on my profile so you can see

[jpok]

I have had a problem with peeling hands for years now, but I'm not sure what it is.  Like many of you I've asked doctors but none of them seemed to know either, and said it was probably some form of excema. For years I thought a hot shower (the moisture) would help......omg.... I wish I knew  that I was making it worse.  Now I alwyas wear gloves when around soaps or hot water.  I even rubberbanded trash bags to my arms in the shower during a bad episode to cover my arms as well. It always seems to be the worst in the fall but this year its already happened once, (just starting the peeling process).  I have a question.  I usually get a tingling feeling on my hands (and sometimes my feet if its going to be a bad episode) a couple of days before any other signs, then my palms turn red, and my hands begin to itch.  After that in a couple of days my hands (sometimes feet) turn leathery and hard before peeling (sometimes in sheets) for about a week.  The new skin is always sensitive.  I didn't see anyone mention the tinglling feeling prior to an outbreak/episode, anyone else have that sensation?   On the bright side, it (the tingling) does alert me to the coming outbreak so I can start the moisturizing process in earnest.

[billmorrisnz]

I get this EK nonsense with exposure to salt water. Even minor exposure is enough to set it off. This is a major problem, especially since I started working as a commercial diver (that's when I first became aware of it) These days it keeps me out of the sea, something that really bothers me - I live to be in and around  the ocean, but the reaction is too severe and disruptive to the rest of my dry-land life. Like everyone else here, I've been to a number of dermatologists all of which have charged me hundreds of dollars and provided no answers, just more expensive prescriptions for things that don't work. The only real answer I've found is to avoid the thing that sets it off.
I live in hope that I'll grow out of it one day.

[craggie]

Hi guys and omg thank you all very much. my father suffers from this and it is driving himi crazy and he cant even do every day things such as eat or drive his van as he cant bend his fingers because the skin is so taught it rips and bleeds causing severe pain. he has been in and out of hospital for months now and it looked like we were getting nowhere but i have found so much information on this page more than i got at the hospital over the past few months just goes to show you dont need a doctorate to find out whats with you. What i found most interesting is the humidity affecting the condition as my father works is extremly hot and humid conditions (well we are british so anything more than 15 degrees is shorts and t-shirt weather haha) but yes his work is very warm and thats why i think his hands are so bad because even tho he is in extreme pain he still finds strenght to work weird i know? he is crazy. The amount of information of this page alone i think will help alot i have a list of creams and ointments and some injections for my dad to test at the hospital now see if we can make it the slightest bit easier for him. So i just want to say thank you everyone and i will keep you updated with how my father gets on.

[iain1969]

Thanks to everyone that has replied. My EK started 10 years ago and like with most of you, the various medical opinions that I have sought from GP's and specialists were inconclusive.

My skin peeling gets worse around change of seasons. I am a recreational fisherman and I find the drying effect of salt water is terrible. As mentioned - working on cars, boats or in the garden makes the skin sensitive and makes the peeling worse.

I find a homeopathic product called Cutis Compositum helps contain my EK. I still have the symptoms but not as bad as when I stop taking it. You can buy this product online.

At least I now know what the problem is now and I will try Urea cream.

Thanks again everyone.

[markNZ23]

Hi,I am 23 and about 3 weeks ago I noticed my fingertips were getting harder, I awoke the next morning to find that they and the palms of my hands had started peeling,I have seen several doctors(there is a HUGE wait for a dermatologist in the part of NZ I live in at present) all to no avail-they don't have any idea what it is,I've tried steroid based creams but after a week of use I found the peeling skin on my Knees also! I jumped on the net and came across the dermnet website which helped me to figure out that it's EK I've got but nobody else seems to have had it on their knees.I'm using LOTS of emollient cream and a silicon cream over the top to try and protect it which seems to sort of keep it at bay-well stops it from peeling more but doesn't clear it up at all.I have no idea what I've come into contact with or whats caused it but I'm busily trying to figure out how to get my normal skin back as I'm sure the rest of you are! I'm going to go back to the chemist that sold me the silicon cream on Friday when I get back(I'm away atm)because he has apparently seen it before but didn't know what it was called(I was on my way to the GP when I spoke to him so didn't pay too much attention).I will keep you all updated with what he says because he did seem really switched on and hopefully he can help us. Mark H NZ

[xrayface]

i also have peeling on my knees it started on fingertip spread to palms, knees and feet. Its really annoying my fingernails are also changing colour and seem to be infected im seeing a dermatologist in 2 weeks hopefully he can fix it. ive had it for a yaer and a half just trying to not let it affect me to much its just a really frustrating disorder iv tried numerous creams and iv strangely found that vicks has worked the best for me so far.

[dippin]

My 4 year old son has sheets of skin that can be peeled off his hands without pain.  The skin underneath is left to look pink.  On his feet, the dry skin looks more scaly, but he can't peel it the way he does his hands.  
Dermatologists, as many of you have mentioned, have been baffled etc.,  I feel the need to be more proactive, because I can't rely on just their expertise anymore.  

Could someone please post more specific symptoms and detailed descriptions of how their Exfoliative Keratolysis looks.  I am trying to find his diagnosis myself at this point.

I would really appreciate the help.
Thanks in advance.

[markNZ23]

So I couldn't get hold of the chemist I spoke to that day but I I have however spoken to another chemist who said to try an Australian product called Eulactol. It claims to be nutrition for your skin and after using it for a week I can see why. Almost immediately the peeling started to recede and it is now almost gone(it's no longer on my knees but I am continuing to apply it). I'm not sure if it's going to completely cure the problem or not but my god it makes a difference - my hands look and feel so much better, I'm using the "hand balm for very dry skin" with no urea content, but they do also make a "hand cream for very dry skin" with a 10% urea content which I haven't tried it yet and this stuff seems to be working. If anyone tries this cream make sure that you're not shy with it - especially at night I find that the more I can coat it on the better my hands are. I work with my hands so it's hard not to abuse them during the day so I put as much as I possibly can on afterwards.

[cheesequeen]

It is incredibly helpful to read about others who are dealing with this frustrating situation.   I have had peeling hands for about 2 years and it all started during a time of stress when my Mom was ill and passed away.  I also developed 2 staph infections in that time period as well so I think it has to all be related and trigged by the two.  Some of the other things I seem to have in common with some of you are ...peeling knees and elbows and yes my nails do seem to grow much faster than before.   I have been to the dermatologist several times and most recent about a year ago, she gave me a variety of ointments to try including cold tar....nothing was significant.   I am considering going back with my self diagnosis of EK to see if she has any new treatments.

I have used a number of over the counter creams to no avail....Eucerin and Aquaphor seem to help the most.   My husband is a chiropractor and religiously pumps me full of fish oil and most recently some new probiotics thinking it could be fungus related...I have only been taking them consistently for a week and will let you know.   I have used Cold Laser Therapy which helps speed cell repair and previously it seemed to help but most recently had little response excelpt to make it peel more.  
Through reading I have picked up two suggestions Eulactol and Argumented Bethamethosone Dipropionate???   anybody having good results with these?  

[jamfol]

My hands have been peeling for a little over 2 years now... mainly on my fingers, sometimes on the palms.  Some doctors have diagnosed it as an infection, some as eczema or a dermatitis, and another recently said it is dyshidrotic eczema.  But the little blisters that form on my hands and eventually peel are not filled with a fluid and my hands have NEVER itched or scabbed over, so I highly doubt it is dyshidrosis.  Sometimes the skin peels where there are no blisters... its just like the skin is dead almost.  So I have recently self-diagnosed myself with EK.  

Things that have given some or very little relief for me are vaseline (acts as a greasy barrier), clobetasol propionate cream, augmentin antibiotic (possibly a secondary infection at the time, as it does not always work), and oral prednisone, which works pretty well, but is a hazard to take frequently.  

This problem occurs mostly during the spring, summer, and fall.  Suprisingly enough, it is better in the summer than in the spring and fall, but conditions still vary from week to week.  I play college basketball at the time, so it can be very difficult for training and practice.  I will follow the post.

I just got done with prednisone, so my hands are pretty clear right now, but I am sure they will act up again sooner or later.  I got some Augmented Betamethasone Diproprionate ointment today, so the next break out I have, I will try it out and post the results.  Two others on this post have claimed that it works extremely well, so hopefully I will be a third.  

Also, I have heard that shampoos, soaps, detergents, and chemicals can be irritants as well.  I plan on trying a natural line of soap and shampoo to see if it will help the conditions any at all.  I have heard good things about Siena Soap. They have 100% natural soaps and etc. that have no added synthetic fragrences, preservatives, or colorants, and all of the ingredients are natural.  If anthying, I think switching over to such prodects would atleast help some, seeing that my conditions worsen after a shower or when my hands are washed.  

[NZpam]

Great to find this site. I've had EK since I was a teenager (now mid-forties). I'm lucky it is mainly my feet (easier to hide). I get occasional small blisters on my hands, but can have one large blister over half the foot. Never any fluid underneath, just powdered skin. I was misdiagnosed for years - doctors sneered at me for not getting rid of athletes foot (I have probably used every tinea product known to science).

Exfoliative Keratolysis is just one name, and doesn't appear in many skin textbooks. One skin specialist told me it was dermatitis - so generic it was not helpful. Exfoliative is a good word, as I can peel off the blisters like an orange.

Digital photography is great - I just take photos along (after I found the Dermnet NZ website to compare it). I don't associate this with stress - I do get unexplained outbreaks, but also after I've been travelling. I don't know if it's temperature changes, humidity, soft or hard water, but you can almost guarantee it will happen a couple of weeks after I get back.  

Related conditions: I have seborrheic dermatitis, and haven't used a regular shampoo in decades. Now I use T/Gel - in rotation. The menthol one is great for itchy scalps, which leads me to problem number 3:

I get unidentified bumps on my skin, particularly on my scalp and neck, which are incredibly itchy. I call this my "heat rash", as it's often associated with a hot day, or when I'm bundled up against the cold, but I can get this any time on my scalp, neck and back. They look like nothing - slightly red and raised, but are so hard to live with. I resort to steroid lotions when I can't stand it any longer (currently Betamethasone valerate).

Other treatments: here are my life-savers. Skin dryness is a real problem. I use lanolin cream on my feet. If I don't use a lanolin lip balm every night and morning my lip splits and bleeds when I smile (or eat frenchbread...).

Vegetable-based soaps with natural scents (lemon, coconut, rose). I can't wear make-up or creams, but aloe vera at night helps keep my face smooth.

Oh yes, one last thing, my face is allergic to any sun block (no such thing as hypoallergenic for me). My skin turns to concrete and dies - after a few weeks I can scratch off the whole layer. Hats are essential.

My Dad had Psoriasis, but no other family connection. Would be interested to know if anyone has the same combination of symptoms.  

[jamfol]

AUGMENTED BETAMETHASONE DIPROPRIONATE DOES IN FACT WORK.  I had another bad breakout with my peeling hands (its summer, so its pretty common) and have been using the ABD ointment for about a week and they are almost completely clear.  The prescribed dosage is use 2x a day for 2 weeks.  I have been using it 2-3 times daily (mostly 3) and have seen steady improvement over the last week.  After the second week of using it, im hoping to be completely clear (im nearly there).  Then it says to take a week off and use it accordingly afterwards.  It really is a miracle cream, as stated before.  I am also not seeing any real skin thinning as most other steroidal creams cause, atleast after the first week.  

[juliedd]

Thanks, Jamfol. I'm making yet another phone call to my son's dermatologist tomorrow to request ABD.

For the past 6 weeks my son has been using clobetasol propionate cream for his yearly spring/summer outbreak of EK. There's even a new foam formulation of clobetasol propionate that's called "Olux E." Neither has worked well. In fact, peeling seems to be worse, although clobetasol propionate does seem to lessen the severity of the the red/cracking skin under the peeled areas, but that's it. It has NOT stopped the peeling.

Will report back. Thanks for your recommendation.

[jamfol]

I would use the ABD for about two weeks, then use an antifungal cream like ketoconozole for a week or so after.  Because steroids weaken the immune system, and I had a little bit of infection after using the ABD, but the anti-fungal cream helped in a couple of days.  Something that also has given the skin on my hands a lot of strength is fish oil capsules.  Ive been taking around 4,000 mg a day for the past week and have noticed the skin on my hands has become more hydrated.  The oil moisturizes from the inside out and the EFA's help with overall skin health.  Good luck to your son, its such a difficult condittion to live with.  

[juliedd]

I called my son's dermatologist to get a prescription for augmented betamethasone deproprionate....which he declined. Evidently ABD is not as strong a cortisteriod as the one that he was already using, clobetasol proprionate (in either the cream form or the foam "Olux E"). Thus, he is already using the strongest topical for EK that is available. There is no reason to switch to ABD...despite your success with it.

I wish I knew more about these formulations....is it possible that there is something about ABD which makes it more effective than CP, despite CP being the "stronger" topical?

Are there others of you out there who have tried both?? with what kind of results?

I am very happy to try jamfol's recommendation about the fish oil tabs....that's easy enough to do, and plenty of benefits whether it helps the EK or not....

I'll report back.

[cheesequeen]

Let me join the team here ....I visit my dermatologist on Thursday and I am going to request  ABD and see if she will prescribe.   I also have used CP and truly I don't feel it helps any more than just using Eucerin for keeping my hands lubricated.   Hopefully she will allow me to try and I will let you know the results.  I am curious too that maybe there is something different in ABD that is NOT in other creams and especially CP.   I can vouch for the fish oil....it does benefit in so many ways it is certainly worth adding to your supplement list.  

[mrskeafer]

Hello my 15 month old son has this I think we go to the dermotologist tomorrow so hopefully we will have some answers.  He was admitted to the hospital over the weekend for what they thought was a toxic staph infection it wasnt.  The palms of his hands an soles of his feet just started to peel.  Thick large pieces im no sure if this is what it is but ive printed all the info to take with me to the doc.  The poor kid it doesnt hurt him at all, he just hates to have it touched cause he is ticklish and with that top layer gone he is soooo much more sensitve.  Ive got some pics on my profile if anyone wants to take a look and see if it resembles theirs I would really appriciate it and any advice for him.  I dont think the gloves would work after all he is 15 months and i cant even get him to leave his clothes on all the time.  Thanks in advance and thank you for all the great information.  All the doctors at the childrens hospital were dumbfounded THANK YOU!!!!!!!

[pinksheep0710]

I FINALLY have been officially diagnosed with EK by my private dermatologist (at a cost of £150 I shoul add!).

It's such a relief just to have an actual diagnosis. He confirmed that there is no wonder-pill / cream, but that we should just try some things to see what might work. I've got another steroid to try as well as some tape impregnated with steroids to put onto the deep cracks overnight.

If this is not sucessful then we're going to try light treatment (UVA) - I'll let you know how it all pans out.

[H_Lenz]

I've done it. I've succesfully treated my Keratolysis.
The illness is genetic, and will always be part of my life, but it turns out that it was triggered by food intolerance issues.

Since I've been diagnosed with intolerance towards malt, apple, pork, onion, etc., I've change my diet, and my hands have healed to almost completely normal.

Get an ALCAT test done, and chances are, your immune system calms down, and your keratolysis does as well

[jamfol]

TO H_LENZ: Where can you get this ALCAT test done?

TO ALL:  I recently posted on the Augmented Betamethasone Ointment... It helped clear up my hands 60-70% over a 2 wk period, but the condition only came back within a week of stopping use.  I went to my derm last week and he gave me something called Epiceram.  It just came out this year and is  generally new method of treatment, so I dont think it is that popular yet.  The creator of the formula did a study on eczema patients skin and found that the ceramide levels (a natural lipid that acts as a moisturizor in our skin) are significantly lower than that of a normal skin cell.  Epiceram is a lipid based cream that mostly contains ceramide combined with fat and cholesterol.  Unlike most lotions, it enhances our bodies natural moisture function rather than adding moisture through chemically derived lotions.  In a clinical study, Epiceram was found to be as effective as a mid-strength steroid when compared to reducing inflammation and stimulating healing.  The great part about it though is that it can be used longterm and does not thin out the skin as does steroid creams.  So I would think it would be pretty effective in actually preventing breakouts if used daily.  If you are interested, just google "Epiceram" and read up on it.  
I had another breakout and went to my Derm and he gave me this stuff and it has cleared up my hands just as well as the ABD did, but the good thing is that i dont have to discontinue its use.  I have only used it for a week and my hands are cleared up 60%.  I will post back if they clear up completely and how the longterm effects play out...
I also posted on the fish oil... I started hhaving bad chest pain after taking them, so I had to discontinue use...  
Like I said, the ABD did work for me but I broke out again within a week after stopping its use.  Im hoping that Epiceram will keep them calmed down because it can be used long-term.  

[dippin]

I had posted several months ago, thinking that my son's condition could possibly be EK.  None of the dermatologists had answers, and numerous ointments were tried, without having the skin look normal.

More recently, the past about 2 months, his dermatologist finally diagnosed him with pityriasis rubras pilaris.  I actually took it upon myself to urge her to email the photos of his hands/feet (and even face which began peeling at the end of May), to all the pediatric dermatologists in the Nation.  Finally his condition was diagnosed.  It is extremely rare, and as you can read in the post from several months ago, many of his symptoms are similar to those of you who think you have EK.  The ointment that I am finally pleased with, because it has stopped the peeling, and returned his skin to normal color and texture (his hands are soft and so are his toes!) is Protopic .1%.  

I hope that this will help those of you who are looking for solutions.  Though you may not have Pityriasis Rubra Pilaris as he apparently does, the ointment may enable your skin to go back to normal too.  Best of luck.

[crom1987]

I've had problems with skin peeling for about 5 years now, and I've been misdiagnosed with regular eczema countless times. The docs took the easy path with that diagnosis since I've struggled with ezcema (eczema) since birth. I addition, I have food intolerance (egg, fish, etc).

After reading this, and watching the images posted, I've now self-diagnosed myself with Keratolysis exfoliativa. Going to try out the products mentioned in this thread, as well as continuing with my regular "treatments". Urea cream, A-vitamine cream, etc.

Lastly, I would like to say that my worst enemy is water. Salt or not, hot or cold, or just some liquid in whatever form, just kills my hands.

From Norway,
Håvard

[cheesequeen]

I did get my derma to prescribe ABD and here I am almost a month later and my hands are the best they have been in nearly 2 years.   I am using morning and eve but will be cutting back to just one time per day next week.  What has been remarkable is that I have also for the last week had a bad case of poison ivy.on my leg and arm..never fails to be something....I have used many drying things for the ivy including a Dr. prescribed oitment, alcohol baths and constant hand washing....I was so afraid that it would flare up my EK but it is still doing very well.  Both my hands and the blasted poison ivy.   I truly think it must be something in the formula or the fact that ABD is not as strong as other prescripts.  She told me to come back in 4 months...Will keep you posted as I lessen the dosage and will also be anxious to hear how the Epiceram continues to work.  

[H_Lenz]

Get the ALCAT test done.
Again, for me, it turns out that KE was triggered by food intolerance issues. Now it's gone.

I live in Denmark, and here it's done by a doctor called Lene Høj. But it's an American test so you should be able to locate it in the US as well

Best wishes.

[zuclinator]

My 'breakouts' of EK seem to be triggered by having an infection-like a sinus infection or upper respiratory. I also have asthma, food and environmental allergies. It makes complete sense to me that it is triggered by an over active immune system.

The cream I use daily to help keep it at a reasonable level is made by Eurcerin:  http://www.eucerinus.com/products.html and  it is their Plus line that helps. It contains urea. It doesn't cure but rather prevents the peeling from being deep. The deeper the peeling is the more painful it can be.

I currently get it on my bottoms and toes of my feet, my hands; palms  and fingers, and elbows. Right now I am getting over a sinus infection and I am on antibiotics. Only my feet and elbows are peeling right now-my hand have not started. However my hands had just recently healed from the last outbreak in August when I had another sinus infection.

I am going to seek out a dermatologist in the next few weeks and see what advice they have. I am also going to ask for the ALCAT test.

Thanks for you advice and information guys.

[crom1987]

Hello again.

I think i have found a "cure" for my EK - at least how to reduce it too a minimal amount. In August I reported in this thread that I had self-diagnosed myself with EK, and that  I'd had severe skin peeling inside my hands. Since that, I have used cortisone regularly inside my hands, and my condition has not not been this good in 3-4 years.

I started with 5 days (applied before bed) with Elocon, a group B corticosteroid (mometasone). After that i used Hydrocortisone 1% corticosteroid from group D every day in 10 days. I also used thin cotton gloves in bed, because of my eczema. After that I used the Hydro just twice a week or so.

This treatment gave me great results, and I've not seen any signs of heavier outbursts when stepping down the cortisone treatment as mentioned by others before me in this thread.

[jamfol]

I posted back in August... It is now October 13, and my hands have not been "peeling" since late July.  Wow.  And usually the fall is the worst time for me.  Let me share my routine with everyone and maybe it will give others success.

I saw my dermatologist back in late july and he prescribed me some Epiceram, as I posted earlier.  It is a lipid-based cream that supplies the skin with ceramide, which is a natural mosture lipid that does not "substitute" the skin with moisture as most lotions do.  Ceramides are actually a natural lipid that are in our bodies that hold moisture in our skin, and studies have show that people with eczema lack this lipid.  So, I have been applying this cream twice a day, sometimes 3x a day.  It has completely stopped the peeling and my hands have had hydration.  LET ME POINT OUT THOUGH, that it has not cured me of my EK condition.  In most EK conditions, people get tiny white blisters that erupt and cause peeling.  In the past ten weeks, I have had two breakouts of these blisters, but I have been successful in halting both of them.  I bought a pumice stone (used for callouses) at a local drug store, and at the first site of blister formation, I have wet both my hands and the stone and simply scrubbed the blisters off.  Though I have done this, the Epiceram has kept the skin from peeling.  I just scrubbed the blisters off and the hands were still hydrated.  During both breakouts of the blisters that I had, I used clobetasol propionate twice a day for five days to help halt blister formation, then tapered off with hydrocortisone for 4-5 days afterwards.  This stops the blister formation.  So, I have basically found a very successful treatment for my condition.

Conclusion:  I apply Epiceram twice a day to keep the skin hydrated which prevents peeling, and at the site of blister formation, I get rid of the blisters with the pumice stone and halt the breakout with a short course of clobetasol propionate followed by hydrocortisone to taper the skin off the steroid.  

Hopefully this will help many of you who suffer from the same problem I have dealth with for 3 years now.  

[cookeville]

I am so thankful to have found this site.  When I was a child I suffered from 'dandruff'.  Lately more skin probelms have risen.  

My index finger had a small bump rise, it was itchy.  More bumps appeared.  The bumps dried up, and the skin became sorta lethery with a hard crust like exterior.  This hard crust then cracked and exposed very pink, tender, sensitive smooth skin.  Then the peeling and cracking begins.

Went to a family practitioner, they gave me a step down pack of steroids and a cream called Fluocinonide .05%.  After about 3 days my hands began to improve.  There were no bumps, no itching and the skin began to heal.  However 3 days post treatment, the skin erupted again and more severe then the pervious episode.  

My pinky finger is so sore I can no longer bend or type with it.  I type all day long at work, as I am a professional.  Also, this is embarrasing as I am always interacting with other professionals, and shaking hands.  

Things that irritate hands:
Water, seems to speed up and worsen the peeling phase.  The peeling is deeper and the skin shed is thicker.  The skin remaing is more sore, tender and sensitive.  
Hand soaps, shampoo, hair products, hand santizers, shaking hands, handling large amounts of paper.

I am getting the allergy patch test on Tuesday, I followup 2 days post and 3 days post, and then 7 days post to have the patch removed.  I hope that I can at a minimum I find some possible triggers.  

I cannot take any treatments to improve my situation until the testing is completed as it could interfere with the test results.  I will ask for the Epiceram for post testing, since there is no cure.  I am about to begin working some massive overtime and I type and handle paper all day long.  I cannot afford for my hands to be in this condition at this time.

Praying for some relief.  

[lorikitty]

I've had this for years on my fingertips, and never knew what it was. Hydrocortizone didn't work, most lotions just make it worse, and it goes away seemingly as quickly as it comes (out of the blue). It's only been recently that the occurrences have gotten worse and more frequent. Out of habit, I bite the peeling skin off (I'm not sure why, I've always done that), and eventually it would go away. Enzymes in the mouth or something? In any case. I was given a bottle of Aloe Vera by a co-worker for a particularly bad sunburn, and one day I smeared some (100% pure btw) all over my fingers and thumbs (index fingers and thumbs of both hands are affected first, after which my other fingers follow suit, unless I catch it in time). I re-applied the Aloe Vera many times in the proceeding hour, and by the time I went home for the day the skin had sealed up and stopped peeling. I kept this up for a few days until the skin was completely healed. I now do this every time I get a flare up, and it really makes a difference. Aloe Vera is fairly quick to dry, blow on your fingers or wave your hands around to help it dry more quickly. It is both an Anti-Bacterial and Anti-Fungal, as well as promoting faster healing. I have no idea which properties help, but I thought I'd get my two cents in in case other people have a milder form like I do.

[jva]

Thank you everyone for your posts. Here is my experience:

My dermatologist nailed it, I for sure have EK. He "prescribed" (these are all over the counter treatments) Gloves in a Bottle (twice a day), Cerave (to wash hands as a substitute for soap), Amlactin (twice a day) and Vaseline to go to sleep. His plan is to keep my natural moisture in by occlusion.

I figured I would mention these since they haven't been mentioned before in the forum. I'm starting treatment tomorrow, so I'll inform you of the progress.