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Exfoliative Keratolysis
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." 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!
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I'm sorry.

It didn't work. The blisters came back with a vengeance and this time they look 'infected' and for the first time they are painful. I think using the pumice stone irritated my skin.

I'm still applying papaw and coconut oil. It does work on reducing the peeling.

Some days I feel like giving up but then I remember I did try to ignore the EK once and it got worse.



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I've been trying everything like most of us sufferers for 5 years, including drastic diet changes, avoiding water altogether, every cream known to mankind, just as many useless docters, and I am pretty sure this is an auto immune disorder, exacerbated by stress and has to do with the state of the "gut flora and fauna"
I have tried using probiotics and apple cider vinegar (organic with the Mother)
and so far I have gotten some relief. I'd be interested to hear if anyone else has tried this approach. Thank you all for this thread
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Oh I thought I would also mention that I have had comprehensive blood analysis, hair analysis, and allergy tests, and have eliminated all the suspected foods. Have seen several naturopaths.
I avoid the night shade group, no longer eat dairy, am gluten free, have been a vegetarian for 40 years, don't drink, don't smoke, eliminated coffee for a year made no difference so I'm enjoying that again, exercise, am not overweight, use natural non scented products, eat organic, drink filtered water. To sum it up, I am at a loss as to where to go from here. Not a very positive prognosis for us sufferers.
As always thank you everyone for any helpful input
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I'm back! I've had EK off and on for my entire life (and for sure it's hereditary because my youngest child has it too - he's 26 now). I've been working with the current flare up for 4.5 years now.

HOWEVER, I'm back with NEWS. I have it under control! I am absolutely NOT peeling and no blisters have formed in over 3 months. I treat my hands and feet.

There is this recipe going around the internet now for dry skin so I thought I'd give it a whirl. I soak every Sunday while watching an hour long TV show. I double it and this is what I use:

1 cup apple cider vinegar
1 cup Listerine
2 cups water

It says soak for 10 minutes but I've worked up to an hour. I use a firm heel brush after that and rub the dead skin off.

Also, every night, I just started using any ole lotion... I got tired of buying expensive stuff. It seems just putting something on my feet and hands is enough to keep it from getting dry. I also put socks on every night. I've been doing this for a year.

Now? Other than a tiny amount of peeling around the nails, my feet look GREAT! Even my hands are wonderful.

I think what is happening is mostly mechanical -- not a cure -- since this seems to be an auto-immune disorder. But a weekly soak makes it worth it to me. My skin is soft and supple. I love how it feels after all of these years. Good luck!!
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I'm back. I have vowed to keep trying everything and when I have found something that works or seems to be working I'll post it here.

I injured my wrist, the one with the EK and have had to wear a wrist brace. "Luckily" my EK is on the bottom of my palm. I noticed after a few days of wearing the brace (it's like a compression and it generates a lot of heat "thermoskin") my EK patch of skin got really red and manky smelling. Oh great I thought!  Yet another problem to have to deal with.

Someone suggested soaking my hand in Pinetarsol Oil. It's an Aussie product but it's active ingredient is coal tar. I know it's also used in dandruff shampoo's. I've been soaking my hand in that, a cupful in 2 litres of warm water, every night for the last 3 nights then putting my wrist brace back on. My skin is finally healing! It looks so much better. I still get the odd blister but I think because of the compression and heat of the wrist brace they don't reach the peeling stage which in turn is giving my poor skin a chance to heal.

Beth is correct, I think, when she said any ole cream will do. It's the mechanics of soaking, exfoliating and in my case compression that seems to work for some.

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I am also suffering from this. I got this in the summer of 2010. I stopped wasting my money on Lotrimin and got better results from all of your helpful advice. I use Goldbond with the urea ingredient. It's helps but is no cure.

I have noticed that my ring finger suffers the least as it gets the least contact. The more pressure and friction my skin gets, the thicker and scalier the skin becomes. It's almost impossible for my fingers NOT to have contact with anything so I have to use the pumice stone to keep the amount of loose thick skin down. Its much more sensitive to touch after I've removed the extra thick layer of dead skin. Maybe this is what is causing our skin to create calluses. It's becoming hyper sensitive in the affected areas. Just my theory.
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I'm inclined to try the vinegar and probiotics and maybe gold bond...I also think a new lotion I got may have exacerbated it.  I would never use Listerene -- for some worrisome ingredients.  But maybe check what else is in it and try whatever the healer is in that product.

Thought I'd post something related: I've controlled eczema for 20 or more years now by taking fish oil capsules, up to 6 a day (which may help some on this list).  Before I had to use RXd hydrocortisone which was thinning my skin and I think is really bad news.  I was "addicted," but the fish oil works.  Weening from the hydrocortisone was hard at first, but only took a few days of living with a little pain and itching. It's almost completely gone or completely gone 100% of the time for years now.  Diet and exercise are much more important than any topical.

It has not worked, however, for this new patch of dry peeling skin (and I'm past spring chicken time now, so I'm sure that's related).  So I'll try some of these things.  
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Too bad you aren't comfortable with the white vinegar and Listerine treatment- it's safe enough to put in your mouth and I am pretty sure my feet are tougher than that. I do the treatment every 2 weeks and I've finally KNOCKED THIS OUT OF THE PARK after a decade. I've been peel-free for six months now. I'm sure, since this is an auto-immune disorder, that I'm not cured, but HECK YEAH I'm happy! It's gone! And I'm wearing sandals and pedicured toes this summer. YAY!!!
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I've had EK for 8 years now.  My skin bubbles/blisters (clear, air blisters) and then will peel over 7-10 days until my finger pads are raw and pink.  

I've been able to control this condition for the last 4 years, and have only had 1 "peeling" breakout over the last 17 months.  I went to the dermatologist back in 2010 and showed him what my condition was.  He diagnosed it as dyshydrosis / dyshydrotic eczema (haha).  I wasn't going to argue with him, because I know that I have EK based on the symptoms described on the internet, which are different than dyshydrosis.  Nonetheless, he prescribed me 4 different medications.  Solodyn (an oral acne medication that has anti-inflammatory properties), Clobetosal Proprionate (steroid cream), Halobetasal Proprionate (steroid cream), and Epiceram (a lipid based prescription lotion for psoriasis).  

My treatment regimen is as follows:
At the VERY first sign of a blister appearing on my fingers, I'll start taking 1 Solodyn tablet each day for the next 7-8 days.  I'll also use a steroid cream 2x per day.  And this will halt the breakout in it's path before it ever reaches the peeling stage.  The combo of the anti-inflammatory effects of the Solodyn and the steroid cream stop the breakout altogether.  I use the steroid cream for only 5-6 days, and then take Solodyn for a couple of days longer.  For each breakout, I will rotate steroid cream.  So if I use Clobetasol this time, I will use the Halobetasol for the next breakout.  I've found that rotating them helps the skin to not get "used" to a certain cream.  I know a lot of people say that steroid creams don't work cause they thin the skin, but I've found if I only use them for 5-6 days, my skin is fine.  Especially if the skin is already healthy and is not "peely" and raw.

Keep in mind that this is my regimen for preventing a breakout to the peeling stage.  In order to heal currently peeling skin, do the same process but take the Solodyn a little longer and use the Epiceram after you are done with your round of steroid cream.  You may find that you need to use the steroid cream longer also.  I know that your skin will get really thin, but I've found that if this happens, when I come off the steroid cream my fingers go into a rapid healing race.

The only breakout I've had recently is because I ran out of Solodyn and had trouble getting more.  It is a really expensive medicine - $1,000 per prescription because it is a new med and they have exclusive rights to it for a few years where they can't make a generic version yet.  But ask your dermatologist about the coupon savings program.  You can get a coupon to get 3 fillings of the medicine for only $35 a pop.  That would be 90 pills, which should last a long time if you only take 7-8 per breakout.  I just got a new prescription with the savings, so I'll be stocking up.  90 pills should last me 2-3 years.

Hope this helps.  Feel free to ask any questions.  This condition sucked while I struggled with peely finger pads.  It makes simple things in lift miserable, like putting on clothes, taking a shower, going for a swim, working outside.  But over the past 17 months, I've only had peely skin for about 3 weeks.  Having healthy skin right now is great!  Give this a try.  Hopefully it will work for others as it did me.
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Just wanted to add to the thread - lots of great ideas here, some that I will try.  I've had this condition for almost 20 years, started with one thumb (my friend called it my "scratchy thumb" - now I know what it's actually called!  
Anyway, I live in the Pacific Northwest, so I don't have much trouble in the winter because of all the humidity in the air - as soon as the sun comes out, I start peeling (mostly on my fingers and palms).  I found one cream that has really helped - it's called Impruv, I buy it at London Drugs here in Canada.  Of all the dozens of creams I've tried, this is the only one that actually seems to help my skin heal.
Here's a link:
http://well.ca/products/impruv-cream_1765.html
Best wishes to all in finding some relief, it's nice to know I'm not the only one, as I have never met anybody else who had the same thing....
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My ek started 7 mos ago and have just cleared it up on my own, dr's as you know are useless when it comes to ek. I made several changes at about the same time so could have been a combination of some of the different treatments I instituted or maybe just one. About 3 months into the ek, seeing that it wasn't going away I decided to take action. I did some research and decided to try the following: I first removed almost all gluten from my diet which I know helped alot, I backed way off of tomatoes and potatoes and started drinking a mix of apple cider vinegar, honey(to make it palatable) and water 3x per day. Also sprayed the vinegar on my hands several times day. I started eating way more fruits & vegetables and what I think helped the most was taking a super multi-vitamin from xtendlife, very expensive($100 mo) but very good. There are minerals and vitamins in there that are great for the skin. At the same time I started on the vitamins I greatly increased my fish oil supplement intake.The gluten free regimen probably cleared up 50% of it but I think the vitamins and fish oil finished it off. Also, the best moisturizers I've found, w/o a doubt are jojoba oil and Tea tree oil and they both helped greatly. Hope this helps you all.
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I have had this for 34 years. I have spent thousands of dollars on everything imaginable, but here I am with band aids on my feet. MDs, podiatrists , and dermatologists have no idea what this is. Only from the internet, have I found that I am not the only one in the world to have this. I will continue to try new suggestions.  I don't think there is any research going on, because it isn't dangerous, or contagious , and only painful if you peel too much skin. The biggest problem is embarrassment !
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FINALLY!  –  20% PROPYLENE GLYCOL

I found something that works for me. I have tried most things, but finally by chance tried something that works for my hands when it starts with this annoying shedding, during the summer.

Propylene glycol 20%, there are different kinds of brands that has this, doesn't need any prescription and is to be found in the pharmacy.

Dunno what it is or if it has some other bad effects but it seems to do the job. It  was better even after a day. I have tried it of a week now. Try and see if it works for you.

/Robert
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9644738 tn?1405023859
I have been experiencing this skin disorder for as long as I can remember. Like clockwork, every summer my hands (and sometimes feet) develop air filled bubbles that have a slight itch. After a couple days the bubbles spread due to skin flaking off (and my peeling at them..oops) this lasts until the weather changes to cooler temperatures. After the top layer of skin flakes off, the skin below becomes tuff, tender and numb and is often associated with cracking and bleeding in the folds.

I live in California so the weather is always nice but only the summer time is when I get EK. When I visited the Dermatologist as a child they summed my peeling hands and feet to a general eczema and prescribed me topical steroid ointments. I don't know if this helped or hindered, I continued to have the peeling of the hands and feet until the first few weeks of school began.

Here is something interesting: When I was 28 I became pregnant and I breastfed for 2.5 years and In that time I did not get the EK as bad, almost not at all. Hmmm... Wonder why?  

My friend is an Holistic Chinese Medicine Acupuncturist and he believes that it is heat trying to escape the body. He told be to eat foods that are cooling and to stay away from the ones that heat up the body. For instance

Cooling foods are:

Apple, banana, pear, persimmon, cantaloupe, watermelon, tomato, all citrus, lettuce, radish, cucumber, celery, button mushrooms, asparagus, Swiss chard, eggplant, spinach, summer squash, Chinese cabbage, bock choy, broccoli, cauliflower, sweet corn, zucchini, soy milk, soy sprouts, tofu, tempeh, mung beans and their sprouts, alfalfa sprouts, millet, barley, wheat and its products, amaranth, kelp and all seaweed, spirulina, wild blue-green, oyster-shell calcium, wheat and barley grass, kudzu, yogurt, crab, clam.

Heating foods are:

Ginger root, black beans, aduki beans, lentils, cinnamon bark and twig, cloves, basil, rosemary, oats, spelt, quinoa, sunflower seed, sesame seed, walnuts, pine nuts, chestnuts, fennel, dill, anise, carraway, carob pod, cumin, sweet brown rice, parsnip, parsley, mustard greens, winter squash, cabbage, kale, onion, leek, chives, garlic, scallions, cherry, citrus deal, date, hot peppers, butter, and anchovy, mussel, trout, chicken, beef, lamb.

Worth trying...

I have heard of using Urea, a moisturizing and softening dry, cracked, calloused, rough, and hardened skin of feet, hands, cream.
I have used Vanos, which is a Steroid cream. It is basically just masking your symptoms which I believe are here to tell us something. When I  discontinue Vanos, my conditions worsened and I developed a candida outbreak. Candida is a yeast that lives in the body and is regulated by good bacteria, a steroid tells your body to ignore the Candida and because of this it gets out of control. Keep in mind that I used this on a patch of dry skin on my face and maybe the effect wont happen when only applied to hands and feet but beware to never touch face, if that is the case.

I am still looking into Prednisone and UV radiation and would be delighted by any and all information on the matter..

Keeping my hands moistened and not doing any outside work without gloves seems to help a little.

Sorry for my rant, this in my first attempt of putting my business out there.

Blessings to all!

~Brandi
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Thanks for your post. I enjoy finding others that believe that food is medicine!
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Hi Brandigirrl
Thanks for your input, every little bit of info and experimental outcome helps.
I keep hoping to read this thread one day and someone will have the definitive cure, at least for the symptoms. I've just had the worst outbreak I've ever had, which is strange because the one previously was one of the lightest, and I was thinking perhaps all my efforts were paying off in slowing this EK nightmare down to a manageable level. Went to the Derm doc just to ask her opinion of Prednisone for times like this when I have to get this under control and she said "it doesn't help". Not that I take her word for gospel for sure, but I'd like to hear anyone else's experience with Prednisone ??
I have just started to see another Traditional Chinese Doc who only does Dermatology, so I will let everyone know if I have any luck.
Once again, Thanks everyone for the input.
Peelyguy108108  
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I find it interesting that your problem subsided when you were pregnant- because mine began when I was pregnant! Maybe there is a hormonal component to this. I also get it in the summer months- and it is identical to what you describe. I don't know if it's related, but I have vasomotor rhinitis- basically that all things in the air irritate me but I don't test positive for being allergic to anything. Maybe we can get all of these pieces of this crazy puzzle put together~
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My 16 year old son has been dealing with the peeling and cracking (which can bleed) fingertips and toes for three years now.  His is seasonal (starts in late spring/early summer till first frost.  We have been to derm doc after derm doc for over three years.  They have never mentioned exfoliative keratolysis.  Only after reading and some have said seasonal and just on first digits of hands did I feel like I hit pay dirt.  We are going to another derm doc that will talk to us about excimer laser.  Don't know if it will but at this point worth a try.    At this point we are praying for a miracle.
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What in the brand name?  Can you name the store?
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I have followed this board, off and on, for several years.  Around 20 years ago my feet and palms started peeling and cracking, just like most of you describe.  Embarrassing dry blister looking spots that would eventually open up and peel.  My hands and feet were so rough and terrible looking.  I went to several dermatologists, was tested for athletes foot, exema, etc.  I've tried more prescription creams and lotions, as well as over the counter ones, than you can shake a stick at.  I've tried soaking my hands and feet in tea, vinegar, hydrogen peroxide.  I've slept with socks and gloves on.  My hands and feet would clear up a bit every now and then, but it would always come back just as badly.  I gave up and thought I was domed to have this condition for life.
Then a miracle happened!  I had a medical procedure that required that I take a steroid pack and an antibiotic for a week.  A week or so afterwards, I noticed that my hands and feet were getting better.  After around three weeks there were no traces of EK.  It's been 6 weeks now and my hands and feet are still perfect!  I can't believe it and am constantly checking to make sure that it hasn't come back.  I can't remember the last time I had normal hands and feet and wasn't embarrassed by them.  I don't know what exactly happened or which of the meds did the trick, or maybe it was a combination of the two, but I am so happy that I had to share this with all of you.  I know how you're suffering and if I can pass along something that can help you, I'm happy to do so.  The meds my doctor prescribed before my surgery were-METHYLPREDNISOLONE Dosepak 21'S 4MG  and CEPHALEXIN CAPS 500MG.  Good luck to all of you!
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I just posted for the first time today.  Before having a surgical procedure my doctor prescribed METHYLPREDNISOLONE Dosepak 21'S 4MG  and CEPHALEXIN CAPS 500MG.  My hands and feet have been perfect!  I don't know if it was the methylprednisolone or the cephalexin caps, or the combination of the two, but I feel like a miracle has happened.  I'm not sure if cortisone works the same way, but it's worth a try.  Best of Luck!
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Hello to all, I'm back. I haven't posted since Nov 2014. I have the EK under complete control. As of now, I have none. It's summer time here in Los Angeles and no outbreaks. I used to live in Maryland where it started in 2010.

What I found most effective was the abrasion method of a pumice stone. Others here have used fine grit sand paper, I used pumice stone to abrade the thick calloused spots. I noticed that if I use the pumice stone, the calluse  stops spreading and in a week or two, the callus is gone. Now I have none.

Remember to use lotion after you've sanded down the callus. Don't over do it. Be patient, it takes time for really bad spots. Before, my fingers were cracked and dry and it would catch fabric. I hope this works for all of you. And no, I stopped using medicated lotion: the steroids made my mucus lining swell up and I ended up with a stuffy nose for several months. But that's me.
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Hello, I have suffered with EK for about 5 years now. On and off with very bad episodes. Right now it is the worst it has ever been. Really bringing me down and I am finding it very hard to carry out day to day tasks.

Below is an album of pictures I have taken over the last 5 years

http://imgur.com/a/GO641
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Do what I did. Get a fine grit sandpaper or a two sided pumice stone. here's a link: http://www.tweezerman.com/store/product/2-sided-pumice-stone/

Mine wasn't as bad as yours but it got pretty bad on all my fingers. I spent an hour every other night working down the callus. After 6 months, it was all gone. I hope this works for you. Remember to use lotion after each session.
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Great information. I love all the posts, I really enjoyed, I would like more information about this, because it is very nice, Thanks for sharing. I like the site best.  Silicone grill Gloves
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I couldnt agree with you more!  Thanks for sharing.
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I've also had EK for 20 years & never knew the name until i saw photos online that look exactly like my condition.  I've tried so many things with no results but would like to share this information that may have a connection to the condition.  i started a diet that i bought on line where you don't eat wheat, dairy or anything with sugar for 6 weeks.  i only ate whole foods, vegetables, fruit, chicken & turkey breast, & eggs.  i lost 20 lbs in 6 weeks & followed the diet to the T.  i did the diet another 6 weeks and lost another 15 lbs but in addition to weight loss, my hands were clear.  I'm thinking that there is something in the foods we eat that causing the condition.  I mentioned it to my doctor & he agreed & said it may be an additive to food that causes the condition.  i haven't had the right mindset to try this diet again but hope to soon.
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So glad you all took the time to share, my 5 year old has had exactly what you are all describing since about a month after she was born. It appears worse after time in swimming pools, but honestly it's an everyday annoyance for her. It's "summer like" here in California most months of the year, so perhaps that is why we never see it subside like many of you during your cooler winter months. The only thing I would add since her feet are worse than her palms is that shoes made from100% leather are best to minimize the number of affected areas on the soles of the feet. You are right on about the dermatologists though, we've also had the condition misdiagnosed a few times as well. Thank you again for all suggestions and ideas, finding comfort in knowing she is not alone.
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i have the same symptoms as everyone here, however mine happen in the winter. i work outside during the summer and am home and off work in the winter, i think there just might be an issue with the water will look into that. i use bag balm on my hands at night and it keep the peeling down to a minimum, i use the lotion with urea during the day but it does not do much, would love a cure.
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I realize that your original post was from last summer.  That said, I just wanted to tell you thanks for the great post!! I too suffer from EK.  And I agree with you wholeheartedly Brandi, that these symptoms we have are our bodies way of telling us something is amiss internally.  

I typically don't post a lot online, but after reading your post I had to thank you.  Thank you for taking the time to share the lists of hot and cold foods you got from your holistic Chinese medicine friend.  I found it very helpful.  I am going to take a serious look at my diet in my ongoing quest get rid of my EK.

Nancy
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I'm having a bit of a problem with this for the first time and really appreciate this forum.

A couple of suggestions to some:  we have an adopted son who has an inherited form of eczema and, for him, peanut butter is the answer.  It has a fatty acid in it that his body is evidently short of.  Cheap try if that is part of the problem for some.

However, after reading some of the posts, I want to add that there is a fairly rare condition some of you who get to the point of bleeding in the sun might want to check:  porphyria.  My husband is a porphyriac and one of the problems is a severe form of photosensitivity and his fingers, especially around his nails, will break open and bleed within hours of being in the sun.  This has only been happening in the last few years (he will be 73 this year) and did not happen before, so for us it is a sign that things are getting worse.  Nevertheless, for those of you with bleeding after being in the sun, the problem may be something you want to check a little more closely for.

In the meantime, thanks for all the tips.  Has anyone tried tamanu oil?  It's expensive but it did get rid of toenail fungus beautifully and only a drop or two is enough each time.  That's going to be my first try since I already have some on hand.

thanks again.
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I started taking Magnesium Citrate for a different reason (muscle cramps, recommended by nutritionist.) I have only had a few minor problems with my skin since (11 months), which have been related to not taking the Magnesium.
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I am having this similar issue since 4 years ago. The first time it was really bad since it got secondary infection. After seeing the specialist, he has advised that there is the secondary infection and on top of it, there is actually allergy reaction to the ointment given by the family doctor. Things he suggest to avoid are following:
*Soap and perfume, this is related to the summer time sweat and acidic reaction.
*Stress is probably the trigger.
*Chemicals in general, such as the Head and Shoulder shampoo, which he mentioned it is too strong.

Clearly, things he suggested would cost a bit more, such as those organic allergy free perfume free option, in comparison to those artificial/chemical products like soap. But isnt this is true for every other healthier products nowaday? Cost a bit more? Glove would be a good and cost effective method to have your hands protected.
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I have had to have a steroid shot and a prednisone pack in Winter of 2013 and have just had to have another round of prednisone, finished in December 2014, for Bronchitis. Both times that I have taken the Prednisone. My feet have cleared up. The peeling came back ofcourse after a few months, so it seems a temporary fix, and not worth the side effects of Prednisone.
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I also have vasamotor rhinitis and exfoliative keratolysis. I don't believe the EK is due to anything you come in contact with, but from within, some sort of auto-immune problem. The deep peeling can't possibly be just a skin surface problem. No answers after having it for 35 years though, sorry.
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First of all I want to thank everyone for the insights. This thread was more useful than any doctor I've been to. Allow me to #1 share my story and #2 propose a solution to the problem.

MY STORY:
I have started having EK sometime around the age of 6. Some people here have described having EK breakouts once a year, every summer. In my case I had a breakout once a year, only on my palms, but strangely always in the winter. Am I the only one? This could indicate that the condition is not weather-related (to clarify, I live in the northern hemisphere so winters are indeed cold). I was tested me for allergies and it turned out I'm not allergic to many things, so that was probably not the issue. I was always picky about my food, so my mom insisted that it has to do with my diet. Yet, without significantly altering my diet, sometime (can't remember the exact year) around the age of 16 the breakouts gradually faded away to the point where my hands were completely fine all throughout the year, every year. Right up until this year (I am now 26). My EK suddenly came back about a month ago. Personally I believe it is somehow related to stress, as this was the same time when I was under of stress. I am now trying a bunch of different creams, among them a dexpanthenol cream (has anyone tried it before?). I will report if it makes any difference.

SOLUTION:
I am very worried my EK is back permanently. I do not want to spend another 10 or more years dealing with it. The worst thing about it is not the annoying sensitivity it causes, but the blow on one's self-confidence it deals.
I thus propose a solution: CROWD FUNDING OF EK RESEARCH
I don't know about the rest of you, but I would be willing to donate a large sum to help get to the bottom of this. There are a bunch of websites around the web dedicated to crowd funding of research. We just need to provide an expert or a team of experts who would be willing to do this research. Personally I don't know anyone like that, but I am hoping someone here will be able to step in contact with a professional or an institute and perhaps bring them to this forum.
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I'm just curious if anyone has had any luck with either coconut oil or Shea butter, and using them before the peeling starts?
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Hello, I have had EK for the past few years and I have had the results with any lotion or cream that has petroleum product in it like what's out there from Vasoline. Also I use vick's 44 which is a petroleum with eucalyptus when the cracking becomes painful. Its not necessary to purchase name brands, either. The cheap ones from the dollar stores work just as well. These creams just take care of the symptoms, but I've had true success when I control my stress levels through acupuncture.    
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Has anybody had any issues with EK stemming from fishing? I go down to Florida every year and like clockwork 4-5 days after I first touch a fish my hands break out in the blisters, crack, peel etc.

I know it is not saltwater or tropics (spend plenty of time in those not fishing and as long as I don't touch fish my hands don't peel) or anything else really. 15+ years of process of elimination have it down to fish. I am not going to stop fishing so I am hoping someone has a prevention. I have used the urea creams and they seem to help the healing but thus far nothing I have done PREVENTS it from breaking out.

Any thoughts would be hugely appreciated!
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This EK began for me in Fall 2014. I've gone down many of the same paths you all have kindly shared. If anyone has recommendation for summer gloves, that would be most helpful and appreciated! I never knew how self-conscious one can feel with this until walking the dog in a pair of black gloves in 85-plus weather.
After getting thru winter with lots of greasy and heavy ointments that didn't help, here is my current regimen:
•Urea 40% (prescription name X-Viate in the US) - twice a day.
•Halobetosol- sparingly and with on one-week "steroid breaks."  
•CereVe cream as needed.
•Compound topical containing "PracaSil-Plus," which is somewhat like  Mederma. I find the product soothing and protective of my fingertips. Products with the PracaSil are found through independent compounding pharmacies I have no conflict of interest here, just passing along and hope it helps; caveat: these can be expensive and insurance doesn't usually pay. Ask for a wee sample if you find a friendly pharmacist and a compounding pharmacy.
•Link to find a compounding pharmacy: http://www.pccarx.com/about-pcca
•Link to info about PracaSil: http://beta.pccarx.com/pdf_files/98534_SkinBases_10-12Apoth.pdf
•Of course, avoiding irritants and also water, most challenging as a healthcare professional!
•Gloves, gloves, gloves. Cotton gloves at night, latex-free vinyl for all day-to-day chores, and of course while working in a hospital--I go through a box per shift. And for now winter cotton-knit gloves for driving, walking, shopping.
My perspective on this condition is that it is difficult to be patient, but I tell myself it will pass. I do believe stress aggravates it. And when tissue is injured it takes longer to heal==>more inflammation, more excess skin buildup and more aggravation. Patience and persistence don't come naturally for me when I am the "patient." My heart goes out to all!
As for one of the latest posts regarding magnesium, I can't say personally but there is a lot of literature about magnesium and skin benefits. Many sources cite this journal article or mention the published study: http://ajcn.nutrition.org/content/85/4/1068
Here is the PDF: http://ajcn.nutrition.org/content/85/4/1068.full.pdf+html
Thank you to whomever started this thread. I found it through Wikipedia, pretty cool.
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I make a lotion bar that contains bees wax, coconut oil, coco butter, and almond oil. If I use it multiple times a day--especially after I wash my hands--it helps with the peeling, and seems to help my skin get back to normal faster after an outbreak. Can't say yet whether or not it will help prevent or lessen my outbreaks, because I've only been doing this for a few months, and warmer weather is a trigger. But it smells very nice and is soothing. Just do a search on DIY lotion bars. You can make them yourself for a whole lot less than buying them.
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I am 30,Asian and new to US. I am first time getting Exfoliative keratolysis.. My hands and my feet were bad with blisters and peeling..

Tried Moisturizers like st.Ives on Hand . It didnt work. First i thought this is Acne and applied cortisone cream.. no effect... Waste of Money and time... Googling  helped me to identify the disease.. Later I found Goldbond healing handcream in Walmart and it works like a magic on my hand.. It locks moisture and keeping my hand far better and 95% recovered.

But with feet, no luck.. still peeling , applying moisturizers...  Anyways for Hands, i suggest to try Goldband Healing hand cream-costs just ~4$.
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It has been more than 10 years since I started having EK. I, like many of you here, diagnosed myself since my 2 dematologists I had visited had given me only 'put some hand cream on' type of solution without anything more for me to go on with. Pretty much the same way they dealt with my eczema, 'put cortisone on' .  I suspected that EK might have some common causes as my eczema. Then good news came 3 years ago when I saw the documentary 'forks over knives'. Skin conditions were not mentioned on the film; it mostly dealt with preventing and in some cases reversing cancers ,heart disease, and diabetes by changing diet to whole-food plant-based diet. That was my AHA moment. I had to give my body a chance to heal itself. I gave the dietary change a try. Guess what, in 3 weeks my 17-year old problem of eczema was just GONE really GONE no more cortisone. Then when summer came that year, the 10-year old skin peeling EK that used to ravage my whole hands, fingers and the palms and all, scaring people, was limited to only the tips of 4-5 fingers! And it didn't peel so deeply, and didn't make the new skin feel too sensitive any more. And it has been getting less severe every year (3 pealing finger tips this year and I'm expecting it to stop there). And I can just go about my day putting shear butter on after washing my hand and nobody really notice the slight peeling unless they look really closely.  The peeling happens only one round and doesn't last more than 2 weeks. This is a huge improvement. I'm not completely 'cured' from EK but I would consider it a 90% improvement and I'm hopeful that soon enough it, too, like my eczema, will be GONE. Check out FORKS OVER KNIVES and Give the WHOLE-FOOD PLANT-BASED DIET a try. It's worth it.
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Just wanted to add my feedback on this --

I have suffered from dry skin problems for years and years. After much research I am coming to the conclusion that it is an auto immune condition caused by intestinal permeability. I have had a lot of testing done and confirmed my gut is semi-permeable and contains and overgrowth of fungus (unknown species).

Recently I have come in contact with some fungus/mold while working with some mulch and developed this EK condition the next day. I had never had it before in my life. This correlation further strengthens my suspicious of a sensitivity to fungus and gut dysbiosis. I am pursuing an anti-fungal diet, anti-fungal herbs, intensive therapeutic pro-biotic treatments and the GAPS diet to heal my gut. This won't be easy but I have decent evidence it is the source of the problem. I'm not interested in temporary fixes but want to get to the root cause.

This may not be the case with everyone (fungal overgrowth) but I suspect that guy dysbiosis is the root for many sufferers of EK and I believe GAPS is the most effective way of healing for this. It is worth looking into.
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Try Vasoline.  Works great, softens hands, hides blisters, and cures problem in a could weeks.
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Hello all

I have come to this board and also posted in regards to my exfoliative keratolysis. To summarize, I am a Registered Nurse, and always thought it was related to my frequent glove use and hand washing. It turned out I was allergic to the dye in the gloves at work (blue dye), so they switched me to clear gloves. After 4 years, I still have the same cycling of peeling and rehealing, hardened skin, all painless.  

I started a new diet 2 months ago, and I have eliminated all WHEAT products from my diet. So no bread, pizza, flour, cakes, cookies, pastries, etc.  In just 1 month, my skin stopped peeling. I was really shocked. It turns out the gluten or other component of wheat was causing an inflammatory / allergic process on my hands.

I hope this helps anyone else looking to try something out. The side effect is you will also lose a lot of fat (because wheat spikes insulin which then promotes fat storage). Even if you don't need to lose fat, I suggest trying this.
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I have suffered EK for 40 years.  What greatly helps for me is simply soaking my hands in hot water for about an hour.  Hot bath or hot tub makes it easy.  Soak until skin is "pruny".  Takes a few times, once a day, pretty much until your skin doesn't prune anymore (maybe related). For me, much better results than tons of other nasty treatments from dermatologist (drugs, lotions, tar, etc etc).
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Is the gluten free diet still working for you and your EK?
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PART 2:

This was my management plan that worked in 2012:  Pinetarsol – about 30ml per 2 litres of water – soak hands at 4-5 times a day (sometimes more) for 2 minutes, and occasionally for 5-10 minutes (in front of TV) – always after a shower/bath and after washing hands (not using soap).  Because it is not cheap I used a water container (2 litre) and kept the same solution for a week – remember to wash/rinse hands first before placing in solution.  
I would also still apply a small amount of the Du’it Foot and Heel Balm each night (very greasy) – it has 25% Urea Cream.
And I had a hand cream that I would apply when needed (hands would still dry out) and which would not be greasy on the hands – Vaseline Intensive Care.  
I would also not use soap – only Dove Exfoliating Soap (non-soap) and Dove Shampoo.
Surgical Gloves – Nitrile and Powder Free Examination Gloves. For when appplying any gels/sprays/etc to the body/hair.

Now it is 2016 and things have changed dramatcially – both with the EK and my life.  In late 2012 I met my now wife, a lovely Thai lady and in 2014 I retired and we moved to Thailand. This was an issue for me because of the hot climate, but with my new EK treatment I was confident that I would be OK. The disaster that later arrived was caused by the over-zealous customs nazis who refused to allow me to enter Thailand with the pinetarsol (even with a Docs letter).  A month later my hands were an EK disaster zone – creams etc not enough.  Pinetarsol not sold in Thailand, and nothng in the Chemists would work.  A friend sent some Pinetarsol over a few weeks later (illegal but who cares) and I started the treatment again. But the EK was not responding and although there was a slight improvement, after a month we were looking at other options (including going back to Aust).  

My wife convinced me to try a skin clinic – and after researchiong things I ascertained that Thais are particularly suseptible to skin issues and that young Thai ladies are extremely conscious of their skin. This meant that the ‘skin clinic’ that I had pictured as a single Dermatologist and receptionist, was in fact as big as a Hospital in Australia.  And they had extremely well qualified Thai Dermatoligists who trained in USA and UK.  My research also located the most recommended Thai Dermatologist who spoke English.  So what I did was ‘summarise’ my medical history in writing – all the treatments and all the medications etc, and old the old photos of my hands.  I made and appointment and the Dermatologist read the ‘report’ and looked at the photos and examined my hands, and then said ............... you have Exfoliative Keratolytis (with a Thai accent). I was stunned – this was the first medical professional to ever say those words, but did I really hear them, was I wrong because of the accent. I said ............. “what”.  She replied – ‘you have focal palmer peeling’(in a funny Thai accent).  I was so happy and I took out the printed pages from the NZ website that details EK and showed it to her. She looked at it and said “Yes, that is what you have”.  

After she realised I was well versed in EK, we talked further and she confirmed that there is no cure, but she said she can provide something ‘stronger’ that will make it dormant again. She explained that pinetarsol (or any other similar treatment) will not last long in Thailand – too hot and humid.  She advised she can provide me with something very strong but with side affects - but maybe I could give it a try. I was ready to try anything, and agreed.  She pointed out that it would mean I cannot give blood for 3-4 years (never again at my age), should not drink alcohol, should not go out into direct sunlight, and that I will lose some hair (probably come back if stop) and I might get headaches, nausea and my eyesight maybe affected – and that if I was a female I should not have a baby for many years.  I am now thinking ‘Wow this IS serious’. OK tell me more I said.  

You must have blood tests after 2 weeks, after 1 month, and then again every 3 months – you may get Liver damage and it needs to be monitored closely.  She normaly only prescribed this when all other methods had failed, but she said I had clearly tried everything else (except phototherapy which she said was very expensive and not effective most of the time for EK).  I decide that I will be 60 in a few years and have had a gutful of EK, I dont drink much anyway, the hair is going anyway, so lets see what happens.

The treatment is/was a combination of several things. Firstly it was a ‘trial’ for two weeks – and then a return visit and a blood test.  Take one 25mg tablet each morning of Neotigason (Acitretin). Apply Salicylic Acid cream to hands once a day for two weeks (in mornings). Apply Dermovate Cream to hands once a day for 2 weeks (at night). And apply ‘Gloves in a Bottle’ 3-4 times a day – both to the hands and feet and also to the skin that is exposed to sun/air (face, neck, legs, arms).  And dont drink any alcohol at all – and avoid direct sun on the skin at all costs – for two weeks. And if the eysight gets bad to stop and come back.

After two weeks the hands had been through the strip and heal process and are starting to look good. But I am having headaches and the eyesight is blurry for a few hours after taking the pill in the mornings, plus feeling nasuea now and then, and the hair has started to fall a little.  After seeing the doctor and the blood test for liver (all good) the treatment changes to the following for the next 2 weeks.   One 10mg tablet each morning of Neotigason and one 10mg tablet at night.  No more Salicylic Acid cream – it has done it job (stripped away bad skin).  Dermovate Cream to hands very thinly every second-third day. And apply ‘Gloves in a Bottle’ 3-4 times a day. And still dont drink any alcohol at all – and avoid direct sun on the skin.

After the next two weeks (1 month) the hands were great - absolutely no EK.  After 3-4 days the headaches had gone, and the eyesight is only a little blurry at night when driving (more sensitive to headlights than before but AOK). No more feelings of nasuea after 2-3 days. The 2 x 10mg was the trick.  But the hair is continuing to fall a little – who cares.   I again then see the Doctor and have another blood test for liver (all good).  The treatment now changes to the following for the next month.   One 10mg tablet each morning of Neotigason and one 10mg tablet at night.  No more Salicylic Acid cream. Dermovate Cream for 2-3 nights only if/when EK breaks out (does a little now and then). Apply ‘Gloves in a Bottle’ 3-4 times a day.  And I get blood tests every 3-4 months to make sure Liver OK – clearly people drinking too much in their lives (or who have had any Liver diseases/problems) should not take Neotigason.

(see part 3)
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Hi all – I first posted about EK on this forum in 2008 (twice), and again in 2012, and am now posting an update again in 2016.  I am going to have to do 3 posts by the look of it – keep exceeding the limit.

PART 1:

I am now an almost 60 year old male and have had the condition Exfoliative Keratolysis (EK) for over 40 years.  Up until 2010, I was in a regime of ‘damage limitation’ trying to manage the situation, after many many years of Doctors, Dermatologists, Naturopaths, Herbalists and ‘Theorists’.  Some things worked, most things didn’t, some made it worse, some made it better. Then in 2010 I stumbled upon a treatment that worked – which I passed on in 2012. In 2014 I found something that works even in a very hot climate and I am now passing that on for others to look at.

Background (mainly from previous posts):   I believe that the EK condition is related to a ‘fault’ in the epidermis layers of the type of skin that is only on two parts of the body (the palms of hands, and soles of the feet).  After many years of ‘research’ and trial and error (my parents were medical professionals), and also some related personal medical issues, I am convinced that it is related (directly or indirectly) to auto-immune diseases.  In 2012 I was diagniosed with Sjrogens syndrome and I also had one espisode of DVT – there is a link between these internal ‘blood disorders’ and some skin conditions like EK (much research is being done - maybe one day they will cure it).

Many years ago I lived in a warm/temperate climate and it was only after some years that I noticed that the EK got worse when the weather was hot, especially after periods of hand contact activity (eg hammering nails, fixing cars). Actually I noticed how the EK was much better in the 2-3 months of cool weather.  We once went on a 3 week holiday to the snow /skiing – and the EK was better almost immediately and then went away after 1 week – but it came back a few weeks after we returning to the hot weather at home.

I moved (about 20 years ago) from that temperate city to a much cooler mountain city (Australia).  There I would only have bad EK for 4-6 months of the warmer summer, and it would go almost dormant for the 6-9 months of autumn/winter/spring.  It was clearly all dependent on the weather.  In winter the temperature got down close to 0C (32F) each night and usually only got up to +15C (60F).  In summer it was from 15C up to 30C. However, it was a catch 22 situation – I didn’t like the cold much, but loved what it did to the EK.  I believe the cold weather makes the EK go dormant because it helps the normal healing process of the skin. I think that is because of the change in blood/fluid flow caused in the hands and feet in cold weather, and also because less moisture is lost through the skin naturally.  I am aware of people who have moved to much colder climates year round (Canada, London, etc.) and the EK has all but disappeared.  For those going through extreme problems with EK in a hot climate area, I still strongly recommend moving to a colder climate - life is too short.

As many have found out themselves, all the topical steroids/cortisone and injections and all those other remedies (both natural and ‘modern’) that I have tried are not the answer. They only 'repair' the damage and assist damage limitation, but the EK always comes back (sometimes worse).  There are many prescription drugs and natural options/cures available - and I have tried most of them. Going down this path lead to a cycle of repair and damage – and it was always a matter of ‘damage limitation’.  Living in a cold climate was a big help – but unless I was prepared to live in an arctic climate, then it would always come back whenever the weather got warm.  Once I did look into getting an invitation to spend a year on the antarctic research station and see if that would make the EK ‘burn itself out’ – but family and work excluded that option.

Then in 2010 I achieved some success for nearly 2 years in making EK dormant for most of the year and I passed that on in this forum in 2012.  In summary:  In 2010 I had the misfortune of putting a knife through my left hand.  After surgery I had my left hand in a hand/wrist cast for over 3 weeks. After removal of the cast all the skin on my left palm completely peeled off in a couple of days. What happened next was very surprising. Whilst my right hand was already starting to go through the usual summer weather problems with EK, my left hand was completely EK free for quite a while after the skin had peeled off.  Slowly over the next month or so, the left hand slowly caught up with the right, and both hands were again EK prone (but the left one was always a little better).  

This caused me to think about why peeling the skin of the left hand made it so much better.  Then I remembered that many years ago one of the attempted treatment that a Dermatologist had me do for a while, had resulted in the skin on the palms of my hand going yellow and peeling off a lot – and the stuff smelled bad (tar).  This treatment involved soaking my hands in a Pinetarsol solution 4-5 times a day.  At the time I thought this was a disaster and didnt go back to him, because the treatment made going to work and social situations somewhat embassing. But after the knife experience, I started thinking again about removing the ‘bad’ skin and therefore allowing the ‘good’ skin to heal and come through.  So I decided to undertake the same process with Pinetarsol, and this time I committed to keep going with it no matter what (or whatever comments are made by others).  I will tell you young people now, one the best advantages of getting old(er) is that you will start to care less and less about whatever negative things other people may say or think about you.  Keeping going with the pinetarsol treatment was not an easy option for a 30 year old, but as a 50 year old I genuinely didnt care a ‘rats rear’ about what others may think/say.

For the next few weeks I undertook the process and much of the skin on my palms peeled off – after going ‘yellow’ in colour (and my hands smelled).  In the first week it was the same slow and ‘messy’ peeling of the skin as before (20 years previous), but then it was less and less - and more and more ‘healed’ patches were evident.  I kept it going and slowly over another week or so I could see that the skin was definitely getting better, and that there was no more new EK developing. I kept this up for the rest of that summer and it worked.  And once the bad skin was gone, my hands didnt smell as much and they looked normal (not yellow).

Before the next summer (2011-2012) I decided to try it again, so a month beforehand I started soaking my hands in Pinetarsol about 4-5 times a day.  At the end of summer in 2012 my hands had been great – there had been only one bad EK outbreak, and a few small ones here and there.  The bad EK outbreak happened when I went to India for 2 weeks (didn’t take Pinetarsol with me), but after a few weeks back home and the treatment, the hands were OK again. The little outbreaks happened when I was slack in the management routine and the weather was particularly hot for a few days. That was when I posted my ‘treatment’ on this forum (see below). IMO the reason the treatment worked (like the hand in a cast for 3 weeks) was because it completely stripped off all the bad skin.  As you know, EK does not occur ‘evenly’ – some parts of hands are good, others developing, and others bad. The pinetarsol strips all the bad skin off at the same time allowing the good skin to develop – and the good skin last longer and stays good, as long as the bad skin is stripped away (using the pinetarsol).  

(see part 2)
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PART 3:

I have been on this treatment regime for  nearly 1.5 years now, and the hands are great. The headaches and nausea never came back – for me 2 x 10mg did the trick.  The eyesight is more sensitive to other lights than before – but I can see fine (used to be 20/20 – but after 45 it slowly declines anyway).  The hair stopped falling out after about 3-4 months – not much net change really – I have far more hair than most 60 year olds.  

As far as alcohol goes (this one is for the blokes), I found that drinking 2 glasses of beer/wine makes me feel sick – but 1 is usually fine.  I also found that a couple of small glasses of spirts/liqour are fine (but no more than 2).  How I got to this point is that after 2 months I decided ‘surely’ I can have a beer or two – WRONG.  After trial and error over the first year I found that beer and some wine makes me sick – but a little brandy/scotch/vodka is OK – but only 1-2 times a week – and only after 3 months.  

The Doctor tells me that although my Liver is good (in fact the numbers are better than at the start) as the body has now adjusted to the Neotigason, that she recommends that I should only take it for up to 3 years. But that is a year and a half away, so we will cross that bridge when we come to it.  One thing the wife and I are looking into is travelling between Australia and Thailand – that way I can get some weather relief and stop taking the Neotigason for 3-6 months at a time – the Doctor liked that idea.

And interesting point is that two of my kids had severa acne when teenagers, and both were given a retinoid treatment that ‘killed off’ the acne. Basically Neotigason (Acitrite) is a modern/refined form of a retinoid, which is a Vitamin A derivative.  Luckily neither has EK – and hopefully they never do.  I got it in my late teens – probably something I did back then (or someone or something I met) triggered it off.  

So there it is – the ‘cure’ for EK.  Unfortunately there are serious side effects and the condition is only dormant. But it works and works well – I can now play golf and not suffer for days afterwards.

MY RECOMMENDATIONS:

There is no cure for EK – it has been known to ‘burn out’ and sometimes that is because of treatments, and sometimes it just runs its own course.

For anyone with EK, I would firstly look into using the normal medications/treatments to see if any of them make your EK manageable.  If you can manage the situation, then I would live with that before trying anything ‘serious’.

If that is not successful/possible, then I would look at moving to a cool/cold climate location – and again trying to establish a management regime that is liveable with. I found one in 2010 that may work for you.

If that is not successful, then and only then, would I consider using Neotigason/Acitrite or similar very serious retinoid medications. And if I was a young woman who may give birth one day, then I would not recommend using Acitrite at all – and I doubt any medical professional would prescribe it.  I guess what I am saying is that I have found something that will take EK away – but it has very serious saide affects that must be monitored – and it should only be used as a last resort.  IMO never for a young person (under 40) – unless absolutely no other option – and in that case I would recommend a vasectomy/multiple pregnancy prevention.  I say vasectomy (for men), because the biggest problem for others from taking Acitrite is that your blood remains highly teratogenic for years (causes birth defects) – that is why you must not donate blood.  But there is no research on what may/can be transmitted via male sperm after months/years of taking Acitrite – so I would take the assumption that it is possible and therefore make it not possible (until research clearly shows it is not).

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