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Exfoliative Keratolysis
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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 (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!
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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.
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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.
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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.
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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.
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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!
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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?
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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.  
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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  
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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  
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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?

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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
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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.






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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
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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.
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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
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wtf?


G S T 5 @ H O T M A I L .C O . U K
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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.  
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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.
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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.
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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.
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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
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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.
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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.  
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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.
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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!
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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.
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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.
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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.  
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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.
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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...
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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.
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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...
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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.
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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.
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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!
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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...
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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!
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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?
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just to add on i'm putting a pixture on my profile so you can see
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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.
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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.
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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.
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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.
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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
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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.
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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.
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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.
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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?  
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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.  
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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.  
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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.  
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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.
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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.  
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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.

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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.  
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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!!!!!!!
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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.
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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
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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.  
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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.
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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
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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.  
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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.
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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.
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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.

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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.  
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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.  
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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.
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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.
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its been more than a month now. What's the progress?
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So far so good! Yesterday was the first time that I forgot to apply everything (I was very busy) and today for the first time after the treatment started I had two very little blisters. Not sure if it's related but I'd love to depend less on creams. I might try fish oil pills, which seem to work for some people and they're good for you too.
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Hi,

I am a 45 year old male and having this problem since more than 10 years. I came to know of the name only now while browsing the net for more info. My problem has been increasing year after year and now it has come to a stage that I have to do something about it. The peeling is quite severe and it affects my normal life in many ways. When the tender layer of the skin is exposed, the hands and fingers become extremely sensitive. It is frustrating when simple activities like writing, turning a door knob, driving, etc. become difficult tasks.

I have done a lot of work on this and I thought of sharing it here as I find many people in this message thread are suffering from this problem. My apologies for this long post.

Problem:

It affects me every year. It starts by the middle of February and it will last till May end. It begins to disappear by June and will be completely gone by the end of June. So far I never had it in any other time of the year. It coincides with the onset of summer and the changes in the humidity of the air. Right now I am affected by this problem.

When it appeared for the first time some 10 years ago, I just noticed it. It was a few blisters and some skin peeling and that’s it. It had been an ignorable issue for many years. It never affected me as such. But slowly it started to increase its effect. The peeling became prominent and affected areas of the hands increased. Last few years it was very severe and I suffered a lot.

Over the years I have done many things to control this problem. I went to a doctor only once but that was of no help. I have learnt much about the problem on my own by trial and error. Since last year I am determined to tackle it and win over. This year my determination is at its highest. It is like a war now for me.

Treatment:

I am tackling the problem aggressively. This problem needs to be managed that way only. The procedure I am following is based on my past experience.

Water/Soap:

I do not know whether it is either or both, but water and soap for sure will make the problem worse. So I avoid contact with both. I started this last year near the end of the cycle. I use latex gloves and seal them with rubber bands while brushing, washing and during bath. This controls the spread of the problem. I found this out by chance. The irony is, earlier when the problem was full blown, I used have an urge to rinse my hands in water frequently. This used to give temporary relief. Two years ago, during this problem, I washed my hands frequently to get some relief with devastating result. I think this is one of the reasons for the increase in its severity.

Cream:

I use a cream, which has urea and lactic acid. I apply it almost every hour. I even wake up many times at night to apply the cream. I have tried so many other creams but this seems to be the best. I stock enough of the cream and make sure it is there everywhere like my house, work table, car and one small pack even in my pocket.

Humidity:

I read all the posts in this forum. I was surprised, actually shocked, not find any mention of humidity. I find this problem is just related to humidity. In my city, humidity falls below 20% in February. It stays low for a few months till it starts to rain in May/June. I have many reasons to believe that this problem is caused by low humidity. When I travel to places where humidity is high the problem comes under control on its own. I have experienced it many times. If nothing works my last resort is to shift to a humid place during the dry season.

Since last year I tried to include humidity control in my treatment. Last year I had tried avoiding exposure to dry air by covering my hands with cotton gloves at day and night. This year I am avoiding exposure to low humidity as much as possible. I test humidity with a hygrometer wherever I go. I maintain over 60%  humidity in my room. I feel much better in a humid room than when I am exposed to dry air.

Infection:

When the peeling is severe, the area is prone to infection. I use an anti-bacterial and anti-fungal ointment once a week to prevent any infection. The problem gets worse and the healing can be delayed if the infection is not treated earlier. Itching is s sign of infection.

With these methods I am able to handle the problem much better this year compared to last year. I hope it will be so till the end of the season. I have 2 more months to go. But I am determined like a general fighting a war. I WILL WIN.

Causes/Prevention:

My approach from now on will be to prevent the attack. If things go well this season, I am planning to advance some of the actions next year to January itself to see whether I can prevent the attack. I am doing water/soap and humidity management as a reaction. I waited for the problem to show up. Pre-empting it may be better next year.

I have another idea that the problem affects when the season is right if the skin of the palms is weak. Repeated attacks over the years have made my skin soft and thin. I can feel the change. I can also relate it to the change in my work/life style. I believe lack of physical activity of the hand like gripping made my skin soft in the first place. I plan to start some exercise regimen after July.

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I was so relieved to find this forum!  

About 3 weeks ago, I woke up with tingly, sensitive fingertips one morning.  I play guitar and it felt just like when I'd been playing a bit too much (pressing on the strings hurts my fingers quite a bit).  The next day I woke up and my palms and soles of my feet were bright red and warm to touch.  They didn't look it but I could feel they were swollen. By that afternoon I started losing feeling in my fingertips so went to a doctor immediately who had no answers - not carpel tunnel, not circulation or nerve related, probably just an allergy.  He recommended an over-the-counter 1% hydrocortisone cream and a visit to my usual family GP.  Over the next couple of days it continued to get worse; the cortisone cream had no effect at all.  I experienced no itching, burning, pain or discomfort or any sort other than the numbness in my fingertips and unusual sensation from the swelling.

I went to another doctor who postulated auto-immune disease to contact dermatitis to food allergies.  He wrote me a referral to a neurologist for the numbness and took some blood for basic biochem work.

A week after my fingertips had first started tingling, my elbows started peeling and a dark bruise-like lesion appeared on the flat of my left arm just above my elbow.  Two days later an identical lesion appeared in exactly the same spot on my right arm.  Again, no itching, no peeling, no crusting, oozing, nothing.  Just a slightly raised lesion.  

The following day, my fingertips started peeling.  It started underneath the nail and though I picked at some fingers, the fingers that I didn't pick just peeled anyway.  I trimmed it all back to try and stop it from peeling but the skin would loosen anyway, especially after extended contact with water (i.e. showers).  The redness was very slowly subsiding and the swelling was improving during the day but flaring up again while I slept.

I am now just about at the end of my third week.  Two days ago my soles started peeling too.  They have been a bit tender to stand on for extended periods of time and also red (except for the arch).  Also a little swollen but not as bad as my hands.

I went to my family GP today and after reading through this forum yesterday, suggested EK.  He Googled it and tended to agree though he wasn't sure that the swelling fit.  He also suspects my elbows are psoriasis so he prescribed a stronger corticosteroid cream.

I now have an appointment with a dermatologist in 7 weeks time, 3 pairs of cotton gloves and a tube of Calmurid which is a urea (10%) and lactic acid (5%) cream.  So far it seems to be working really well and it's not a heavy greasy cream like some others I have used - perfect for my day at work.  At night time I used Body Shop hemp oil cream or paw paw ointment which are much heavier and I sleep with gloves and socks on.  

I didn't see anything in this thread about swelling - does anyone else experience swelling overnight?  It's the only thing that doesn't seem to fit.  In the meantime I will persevere with this Calmurid and hope it starts to settle down before I see the derm.

Good luck to everyone else, hope my story helps xxx
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I enjoyed your thorough accounting of your battle with peeling hands. Just wondering....how is your condition right now? I'm asking because my son (age 19) suffers a great deal at this time of year, usually April through late summer. Were you able to head off a full-blown peeling attack with your preventive measures???

I've followed all the advice in this forum (countless creams and ointments, prescription and otherwise) to help the condition, but it seems to progress NO MATTER WHAT at this time of year. It starts with just a little peeling, but eventually he'll lose the entire surface of his hands and fingers to blistering and peeling. Right now they look very unsightly...much blistering and much peeling. Worse on his right hand. I'm guessing because it's his dominate hand, there's more trauma to it.

He infrequently will slather on Clobetasol Propionate....insists that the peeling will progress no matter what he puts on it. Also insists that further appointments with the dermatologist are a waste of time.

I found your theory that its onset is related to LOW humidity conditions to be interesting....I would say that my son's peeling begins with the onset of HIGH humidity conditions in mid-spring (April)...we live in the Northeast US. It does not plague him during the winter months.

Also...he suffers somewhat from dandruff and has very thick calluses on the feet (he's an athlete). Some peeling on the feet as well. Does this sound familiar?

Any further insight/updates would be much appreciated.

--jdd

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Ive had this problem with my hands and sometimes my feet for over a year now, everytime i seem to have any contact with water whatsoever or anything that is moist my hands start to peel and same with feet. I think how I got the problem was to do with a very strong cleaning soluvent which sadly got on my feet and hands when cleaning a shower, to make things worse the next morning I went into the room and the glass I had used the soluvent on had cracked in the form of a mosaic which made me worry greatly. I am very interested however to hear anyone who has had any success on treating their individual problems because Id like to get rid of this sooner rather than later...
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Ive had this problem with my hands and sometimes my feet for over a year now, everytime i seem to have any contact with water whatsoever or anything that is moist my hands start to peel and same with feet. I think how I got the problem was to do with a very strong cleaning soluvent which sadly got on my feet and hands when cleaning a shower, to make things worse the next morning I went into the room and the glass I had used the soluvent on had cracked in the form of a mosaic which made me worry greatly. I am very interested however to hear anyone who has had any success on treating their individual problems because Id like to get rid of this sooner rather than later...
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This forum is really great!  I have just started my journey with this condition about 3 weeks ago when the peeling started.  There are so many theories of what causes it that I dont even know where to begin.  Lots of different treatments too, some work for some people and not for others.  Kind of frustrating, but at least it gives us options to try. I can handle the peeling by keeping my hands slathered with lotion, and I'll be trying some of the potions mentioned-thank-you!  The receeding nail beds and nail sensitivity is what really bothers me. Ive read that this is another symptom so I am assuming it's all related.  It feels like a fungal infection.  I'd like to pose a question-how many of you out there have foot/toenail fungus?  I'd like to see if it's related.   Also, has anyone tried some sort of laser treatment?
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Im sure I have EK. Strangely it only manifests itself on my right palm and base of my right foot. Makes you wonder what is causing it, and how it is contracted, such that its restricted to my right side.
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Sorry, I had not logged in to see your post earlier. Here is my observation. As I had mentioned in my post, my problem occurs when the humidity falls to very low level and it goes away when the weather changes. My problem is over for this year now. My hands have become normal and I have stopped all the precautions by the middle of June.

As I followed the strict regimen mentioned in my post throughout the season. I am very happy to state that I could control the issue far better this year. In fact this is the first year since the problem started more than 10 years ago, I could reduce its impact compared to the previous year. I am very happy about that. I have succeeded. I could limit the severe peeling to only the tip of fingers, that is, the third of the finger length. My right palm was peeled only for a couple of weeks. My left palm was not much affected at all. Last year both the palms and all the fingers were affected in full for the entire season. I also had no problem of infection at all this year.

I strongly feel that the strict precautions taken this year have helped tremendously. I hope I will be able to make further improvement next season.

Now to your particular query on humidity, I am unable to explain. My problem has direct, 100% co-relation to fall in humidity. This has been the case every year. I have met many people who have similar problem in the low humidity season here, but their severity is not as much as that of mine. But the trigger seems to be low humidity. It may be the other way in your case. I do not know.

Thanks for reading my post.
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Hi, I'm new here. It's so good to find persons to share this problem, that of course it has been a self diagnose..... I want to share with you the things I believe could be triggering it.

First of all I thought stress was the worst cause, rigt know i'm going through high level of stress and it's beginning

But Reading Sub100 has opened my mind to new possible reasons... that's the humidity (also connected to someone that said in colder climates it was better) Thank you sub100! In fact right now were i live we are having 25% of humidity, that is really low, this would explain why I'm having outbreaks since 3 years (time that i've been living here)
Last year I've been in another country were humidity is higher, and no symptoms in all that time.

I just bought an urea cream 30%, but can't give you results yet. Has anybody tried urea?

Thank you all, keep posting!
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I've had EK for 5 years now, and I've learned to live with it. I even stopped complaining about it to the people around me. I keep reminding myself that it does not kill or turn into something malignant. What works best for me is to apply some moisturizing cream before going to bed and to wear socks ( I have EK on my feet). When I have severe peeling I blame myself for missing the last night cream dose. Unfortunately I live in a very hot country (It goes up to 52 degrees in the summer) so I can't wear socks all the time. This is why in winter things get much better.
I tried a Urea-based cream for two months, and it worked beautifully but not to the extent of curing EK. And I believed it worked because it provided regular moisture, not because of the Urea.  
So I'll continue misturizing and covering my feet until they have done enough experiments on their new cure.
Finally, thanks to everybody .. I feel much better by knowing I'm not the only sufferer of EK.
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Thank you for helping me in my quest for answers about my swollen,/calloused/splitting/peeling/raw/ red nightmare.  My condition is similar to most of yours but there are a few variations so I am hesitant to self-diagnose.  That said, EK descriptions and the pictures (2 and 3 but not 1) on Dermnet NZ lead me to believe I may have EK.

Similarities:

**I too suffer a 2-3 week cycle of skin on fingers, thumbs and wrists, toes and ankle that feels at best like it has lost its natural moisture barrier and at worst feels spongy and foreign like I have to getit off!!  It swells, becomes discolored and thickly calloused on print side, then cracks and peels (I admit to picking / pulling / clipping it with clippers, ugh) in thick chunks revealing too-fresh, too-tender skin that heals over in about two days.  Fingers end up looking multi-layered.  I have 4 or 5 days of freedom, though skin hardly ever feels normal in spots, then cycle repeats.  In between, I get papery pieces that flake off on the knuckle side of my fingers and in between fingers and along the fleshy parts of my thumb and at the inner wrist.  Toes and top of right foot look more red and papery and discolored than calloused, peeling here is more superficial.

Prednisone works to clear, but doc won't give it preventatively

been to 5 derms and one allergist - no one really "questing" with me, appointments are like 15 mins. then a new steroidal or anti bacterial ointment is prescribed. Protopic is the latest recommendation but I havent filled the scrip yet - insurance questioning need.   UGH!  

PUVA treatments may have eventually been helpful, BUT could not afford the time requirement, travel, or co-pays to keep up with that.

Differences / variations:

It IS itchy a lot of the time, esp. the more superficially-peeling spots
Clobetasol does nothing for it
no blisters - this is a big mystery
palms and soles clear but fingers, wrist and top of toes and right foot horrible
red silvery knuckles
Better not worse in summer - salt water and sun seem to help
This thing knows no season - relentless for 2 years
I have had Psoriasis 10 years, tho the P is under control & the EK is not - anyone else have this dual diagnosis?

Here's a theory - do you think that my 10 year use of potent topical steroids for the psoriasis - applied by gloveless hands to affected areas - has caused skin atrohy and invited infection???

Any advice or ideas will be MUCH appreciated.  Thanks evry1.  I am praying for all of us.
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Hello,

I would like to share a thought.
I had this condition for up until 9 months ago. It lasted for approximately 1,5 years. Then it started to disappear and is now gone. Ive been trying to recollect the period of when it started disapperaing and rememered that I started taking the mineral supplement Magnesium during this time period, rather low daily dosages, I think it was approx 100-200 mg / day (i took them in the evening since Magnesium makes you calm / almost abit sleepy), it didnt happen at once, it happened gradually.

I am not stating that this is the reason it disappeared, simply that it happened in the same time period. Just wanted to share this with you guys.

Take care
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Just wanted to say a big thanks to you all for this great page.
I like most of you could not get this problem diagnosed - but when i looked at the photos on the site supplied, the middle picture looks exactly like my hands!

It seems to me that its quite diffrent for all, lots of people saying that it gets better in winter, mine seems to agravate over winter.

I connect mine with stress, i first delveloped it when i was working a very stressfull job & then suffred a nervous breakdown, took about a year to go away that time.
Then fine for years, only to falre up again this year after the death of my husband, which happend just before winter, & it seems to be getting worse over the course of winter.
I too use the dead sea salts, i bought a hand & foot wash from a health fair & it works great.
For me when i go on holiday to a warmer climate & am swimming in the sea, not waering shoes etc, it clears right up on both my hands & feet.

whic is contradictory to what a lot of you are saying. perhaps its just a stange "disease" that nobody has bothered to reasearch properly yet!

But thanks so much, at least now i have a name for it & dont feel like such a weirdo!
I'll be keeping an eye on this site to see if there are any new breakthoughs.

Kindest Rebecca
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I have had this for 11 years, but it began small & has exploded. It's horrible in the summer months- currently 8 of my fingers are peeling severely. I think there is a hormone relationship for me because it began when I was pregnant with my first child. I have a doctor trying to get to the root of the cause and the speculation at this time is possibly metal toxicity. I'll post if anything comes of that. I've seen 6 or 7 dermatologists that said it's just eczema & gave me topical lotions that have never helped. Fish oil hasn't seemed to help either. I have NO allergies but do have Non Allergic Vaso Rhinitis which makes me sensitive to just about everything that people with allergies would suffer from.
I'm going to try everything I found on this blog-
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Well, I finally know what it is.....Exfoliative Keratolysis! Something to pick at besides my nose! This hideousness has been going on now for ten years or so. One doctor suggested I use the moisturizer Cetaphil...it's overpriced garbage that actually seemed to make it worse. Aveeno works best in my opinion, especially the "Skin Relief" variety. I think I'm just going to learn to live with it...all this taping gloves on in the shower nonsence is never going to happen. Besides, my partner has OCD, and hopping into bed without washing ones hands is a titanic no no. Maybe I'll try the ABD ointment mentioned above (Augmented Betamethasone Dipropionate) if I get another breakout like 2008's.

Thank you everyone for all of this info! Chalk another one up to genetics. I'm curious...do any of you get really bad heat rash on your lower legs too? This is yet another gem I get to enjoy during our hot, dry summers.  
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Hi all,

I have reading all of your posts and like many of you have been frustrated.  My son is 13 and has had this hand peeling for a couple of years now.  Some times is better and as of now it is completely horrible.  Has has to put band aids all over his fingers becuase he picks at it.  Was going to go to the dermatologist, but now I wonder if I should even bother.

Am I better off going to an allergist to see if this is caused by some sort of reaction to food???
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My daughter was just diagnosed with EK... She is 22 months old.. Her hands and feet started peeling at 4 months old and haven't stopped since. Sometimes it's painful for her, and she love the water which makes it 100 times worse.  I took her to 3 family doctors, 2 allergists, 2 dermatologist, and finally a team of 10 dermatologists and their med students diagnosed her. I feel so bad for her and I have read every post here and will try whatever I can to keep this under control. I know that steroid creams have not helped as we tried them before. I do know she doesn't complain about the peeling when I use aquaphor cream daily... No that I have this diagnosis I will try some of the things everyone here has suggested... The water thing is going to be the hardest... She loves her bubble bath and swimming...  I can actually see the blisters forming minutes after the exposure to water, soap, and especially any chemical with chlorine... If anyone comes up with a cure please post it ASAP.. I hate to see my baby suffering. She's not even 2 yet and we've been dealing with it since 4 months old...
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When I was a child, I used to have this skin condition every fall and spring. Then, I lived in Florida for several years, and I had no peeling at all. Note that Florida has very humid and hot climate. I moved to Wisconsin 3 month ago. It is fall and the problem with my skin is back again. So, its definitely climate and season related for me. Some say vitamin A helps, but I am not sure.
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My husband has this condition. After trying all sorts of things, he eventually just gave up and had been living with it.  I learned a bit about traditional medicines in South Africa, and decided to attempt my own remedy. I mixed equal parts of beeswax, raw honey, olive oil, coconut oil, water and oat bran, and had him massage his hands with this preparation for 10 minutes and then rinse it off (no soap).  It worked immediately. The dead, dry skin was removed, and although still red and inflamed, his hands were soft and pliable.  After using the preparation twice a day for 4 days, the condition disappeared.  This preparation did not make the condition go away permanently, but with regular use, has brought permanent control for his problem.  Hope this helps.
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My husband has this condition. After trying all sorts of things, he eventually just gave up and had been living with it.  I learned a bit about traditional medicines in South Africa, and decided to attempt my own remedy. I mixed equal parts of beeswax, raw honey, olive oil, coconut oil, water and oat bran, and had him massage his hands with this preparation for 10 minutes and then rinse it off (no soap).  It worked immediately. The dead, dry skin was removed, and although still red and inflamed, his hands were soft and pliable.  After using the preparation twice a day for 4 days, the condition disappeared.  This preparation did not make the condition go away permanently, but with regular use, has brought permanent control for his problem.  Hope this helps.
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Has anyone tried this South African remedy?
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Not sure what I have yet.  It started as a young child, would notice small patch of loose unattached skin under a fingernail and before I knew it, my whole palm would peel in a whole piece, like a snake shedding its skin.  Dermatologist took pictures of my palms and soles
but no diagnosis given nor any treatment.  My grandmother's "face peeled".  This continued for most of my growing years, it never hurt and
skin revealed underneath was pink and healthy.  My hair is healthy and
thick-even now at 58.  I've had occ. bouts of nonpainful pealing, until this
last year.  As an RN I do wash my hands alot.  I never used creams.
I did experience PICA during pregnancy.  Within the last 6 months, I have been stressed and noticed my nail chewing has extended to the
edges of my fingers where the skin feels more like callus. After biting off
the thicker skin, the skin will peel and the tips of my fingers are now red
and painful, but it heals quickly.  However, Illinois weather turned cold &
windy, now my face is fire-engine red, painful, my lips have cracked, bled, and peeled twice in a week and has a white sheen to them and are painful.  In the evenings, my forehead and cheeks start to itch severely.  It looks awful, almost like a burn.  My mom had an auto-immune disease at her death.  Any suggestions?  ***@****
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LOOK NO FUTHER!!!  Someone way up in this thread recommended AUGMENTED BETAMETHASONE DIPROPIONATE CREAM (.05%) ...saying it has been the only thing that has worked!! I asked my doctor for some and she was right .. it WORKS!!!  I have been using it for almost a week, and it is almost gone. It'a a miracle.  If you have EK, get this stuff. It is the cure.  I understand EK can re-occur so I am assuming I will have a tube on hand forever. But right now after trying steriod creams, cortaids, and various fungle creams .. it is EXCITING to have found something that really actually works!!  Go get some!!
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you can't use AUGMENTED BETAMETHASONE DIPROPIONATE CREAM (.05%) as a long term solution, it is still a steroidal cream and has long term side effects. I have been on oral prednisone for over a year now and it worked fantastic, but i cannot continue use because my blood pressure has become dangerously high, but i definately recommend prednisone out there to anyone suffering a horrible breakout and needs emergency relief, take 15mg for 3-4 days then 10mg for 1-2 weeks and you'll be all cleared up. I've been suffering from this condition since 4th grade, im currently 19 years old. I just paid for my ALCAT test, pretty expensive ($850 U.S) so i'm blessed to be in the financial situation to pay for it, but i'll keep all of you posted as to how it works for me, If it doesnt then i'm trying PUVA therapy and let you all know how that pans out, but i'm confident this is a food sensitivity as i have tried every ointment out there already. Epicerum has worked fairly well, my skin hasn't cleared entirely but it makes them stronger, i recommend that as well. Good luck to everyone i should be posting again in about 2 weeks as to my ALCAT results.
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i have been told it is an issue with the adrenal glands (responsible for making your adrenaline) and so worse in times of stress or dietary - too much sugars, caffiene, ect.  that through our body out of whack.  i am going to do a blood hormone panel test to see on that level how my body is doing.  there are supplements you can take to improve adrenal function.  i'm hoping this helps
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i don't beleive it is an adrenal issue, prednisone has been an effective treatment for me and some others on this forum, and prednisone is ineffective against adrenal problems. never the less i would like to know about your blood results, that is something i have not tried yet. my ALCAT results should be in any day now. also, a new hand cream called Elidel 1% seems to be doing well, its stronger than steroidal creams and you can use it for life.
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I have had this for about 6 years now. Started when I foolishly exposed my hands to some strong pool chemicals and hasn't ever completely disappeared since. I will say that the Hemp hand cream from the Body Shop is a great option. Its a super strong moisturizer and is one of the few that are pretty waterproof, enough to last the length of a shower or 3 or 4 handwashes. This past summer a girl gave me a tube of silicon gel. It dries to what almost feels like fine sand after being applied but that inside a pair of gloves while I slept really had me waking up with the hands slightly better. Anyone also have flakey scalp and itchy inner ears? I know that a dermatologist recently said on the phone she suspected a mild form of Psoriasis aggravated especially by a natural skin fungus that feeds off of fat. Another nurse told me that she thinks a strong dose of oral antibiotics would remove it. Anyone tried any of these?
I'll keep searching and keep posting, I'm glad I found this page.
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i've just about ruled out the possibility of fungus. I've been an a powerful anti-fungal for over a week now and its not changed a thing. I also tried Zovirax just out of curiosity to see if it was viral, but neither helped at all. My Alcat test results came back and showed sensitivities to some foods i eat often (pork, wheat, tomatoes, chicken, cocoa, and orange). So i'll avoid all of those for a few weeks to rule out the possibility of food sensitivity. and if that doesn't work i'm finally going to try PUVA treatment. good luck everyone.
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I have suffered with this for 18 yrs.  I have seen 6 different doctors in 4 different states.  They always put me on steroids, which didn't really help.  Finally, a had a dermatologist that gave me the correct diagnoses, and said there was no cure.  So, I tried the natural route, and finally, I have found something that controls it.  It is not cured, but I haven't had a major break-out in 3 months.  This is a miracle for me, considering the doctors said I had a "text book" case.

The products are from a company called IsXperia.  They are all natural.  I take isGrape and isLife.  Both have high levels of Fucoidan, a seaweed extract.  IT HAS CHANGED MY LIFE.  I have never been into "natural remedies", because, married to a doctor, I didn't put stock in it.  Now, I have him believing in these products because he has seen such wonderful results..

If anyone is interested, I can tell you how to get these products.  They aren't cheep, (about $50-70), but it is the first thing that has helped control it for me.
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elta skin creme

http://www.elta.net/ProductDetail.aspx?p=13

THIS WILL HELP!!

20 yr old male with EK for a few years... finally found a perfect skin creme
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Hi,

I'm a mother of 3 and started having peeling fingertips since my first baby was born.  I believe it was all the dishwashing by hand, harsh laundry detergent (again, no gloves), all the diaper changes and subsequent hand washings, and dry winter air.

I had over 4 years of painful cycles of flaking, peeling fingertips down to raw sore cracked and bleeding fingers (not to mention a whole bunch of creams and soaps and different doctors and steroidal creams that did not help).

Then 2 years ago, I finally found a cream that worked for me.  It is UREMOL 10.  The magic ingredient is "urea cream".  There are other more expensive creams with urea in them - just find one in your Walmart or drugstore.  I noticed a huge difference in 1 day and in 3 days my fingertips were as smooth as before.  I was so happy.  It doesn't have any smell and doesn't feel greasy.  Now I only use a few drops at night before going to bed and my hands feel great.  Also, I make sure to use a few drops before putting on my gloves in the winter.

I still have very minor peeling (only I notice) on my index finger which I think is from my computer mouse and some pens.  I have tried to eliminate all LATEX and it has really helped (even using non-latex dishwashing gloves).

I hope this helps everyone out there.

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Urea cream works but it has not totally solved the problem for me.
Avoid water as much as possible and put the urea cream at night with cotton
gloves.
Hope we find a cure oneday!
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I've had this problem for many years and what works for me is DERMAN'S ANTIFUNGAL CREAM. It's sold as an athlete's foot treatment (active ingredients are zinc undecylenate and undecylenate acid). It's inexpensive and is available without a presciption at many drugstores including Wal-Mart. Rub a dab into your palms and fingers twice a day until the condition goes away (probably in a week or two), and thereafter every night. The only problem is that if I stop using it, the condition comes back, but it works great for me.    
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I am 17 years old. I don't remember when i started to have it all i can remember it was before i was 3 years old. I hated it. it ruined my life in high school and middle. I was picked on, made jokes about all the time and  mean things they found they would use. it happen almost every week for me. I am embrassed. I have it on my feel and hands so I hate to swim. Any advice or info. Please because i Need every bite. Thank you!!
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I'm 33 and had this condition all my life.  When I was young it was quite bad..my hands would crack and bleed.  The skin was hardened on my fingertips and, being a kid, I would bite at the skin to tear it off and pick at it often making it worst.  Dermatologists would just give me creme and call it eczema and send me on my way.. but I always knew it wasn't eczema.

Over the years I have found nothing that works as far as cremes or lotions go.. they help a bit..two things I have discovered though, that work a bit for me--  

Drinking a lot of water.. I noticed around the holiday season when I am drinking more alcohol, my hands would become worst. Ever since I have noticed there seems to be some sort of relationship between being dehydrated and my hands being "bad". staying hydrated helps me a bit.

Pumice stone-  being frustrated with the dried and hardened skin on my hands and not wanting to peel it off (causing sores)  one day I thought I'd buy a pumice stone and after a long hot shower I would "sand" the dead skin off of my hands.. I've been doing this of a year now and so far it's worked quite well for me... whenever they get bad and I have a hot date... I use the pumice stone and it's been awesome.

Just thought I would share.
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TREATMENT!! I found something that works. I've been using it for 2 months now and have had EK for 6 years (I'm 20).  I've been to a dermatologist they couldn't help me at all. So I took it upon myself to find treatment.

Just to give a little background Info first:

Prior to discovering my treatment, my hands - particularly my fingertips - would have frequent 'outbreaks' which consisted of little white circles that eventually broke, spread out up and down my fingers, and revealed the 2nd layer of skin. The circles started out very small but gradually increased in size due to aggravation from normal daily usage of my hands, and when coming into contact with water. shower = enemy

My guess regarding EK is that our hands create an environment which is harboring a bacteria that basically "eats" our skin. In other words, our hands are unable to provide an adequate balance of moisture and dryness - and my reasoning for this is that when I kept my hands cold (I used to work in a fish market) - the circles would seem to fade, telling me that my hands were too moist (the cold air dried the moisture). When I got my hands wet, the circles would come back. ANNOYING.

My Treatment:

After searching around one day, I found something that promised to "tighten the skin" which caught my attention, so I bought it.

DMAE capsules (also comes in cream). DMAE = Dimethylaminoethanol, found naturally in fish.

"Studies suggest that DMAE can play a role in making skin firmer, smoother, and brighter, while also reducing the appearance of lines and wrinkles."

It took about 3 days before I started to notice the change. EK is NOT cured, but the circles don't open, and when they do, they don't spread, even if i provoke the skin by trying to remove it, it doesnt spread. In other words, my skin is more reluctant to peel, even when I get it wet.

DMAE capsules seem to be advertised to people looking to increase their concentration and improve their memory (I noticed no change in either) whereas DMAE cream is advertised (as quoted above) as a skin healer. I bought the pills because lotion was another enemy of mine.

My Regimen:

DMAE CAPSULES 100 mg. I usually take 1 pill every 2 days, sometimes 1 pill every 3 days depending on if I feel my skin change again. If I start to notice that my skin wants to peel when I get it wet, then I usually take another pill. I really never had to take more than 1 every 2-3 days thus far, and I haven't noticed my body building a tolerance to DMAE which would cause me to have to up my dosage.

I can't tell you exactly what it does, but what I know from experience is that it slightly changes the consistency of your skin somehow. The drug is SAFE with no known overdose or harmful side effects ( I did my research). The only side effect I experienced was a headache, but that was because I was bumped up my regimen to TWO pills per day to see if it was curing the condition or treating it - it was treating it. When I cut back to 1 pill a day, no more headaches :-)

You can buy DMAE caps online for only $5 a bottle. Ill post the link below, I personally use Twinlabs100mg. I wouldn't buy the 350 mg, you don't need that high of a dosage. Let me know if it works for you, I hope it does!!!

http://www.google.com/products/catalog?hl=en&biw=1280&bih=619&q=DMAE+caps&um=1&ie=UTF-8&cid=1032478454655871637&sa=X&ei=O-uTTaPLDNC4tgeX3fiSDA&ved=0CDgQ8wIwAg#
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Hello i too have had a similar problem for over 10 yrs however i cant remember when it started but i do know my life has always had much stress in it. The peeling is on my right hand and on three fingers front and back, however it is not on my palms but my palms do itch at times also i do feel funny tingling sensations on my fingers where the skin is peeling. I did notice when i got bronchitis last summer i was put on steroids for my asmah and it almost went away completely once i stopped taking the steroids it came bk with a vengance. The doc took a sample and tested it and ruled out fungus he said it could be some type of eczema? But it sound like EK to me except my palms do not peel??? i am going to try some of the ointments suggested and i will get back to u, on how they work. Everyone Hang in there your not alone!!!  
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this is the last post i'm going to make because almost everyone who posts on this is being ridiculous. most of you are just repeating the same things and not even taking advice from each other, except for the people who posted earliest in this post you are all a bunch of idiots. I've posted three times, and documented everything i've found, and nobody wants to know my success, your just using this as a blog to complain. stop feeling sorry for yourselves and get a friggin alcat test done. It's expensive but it's easy, and in the long run your going to save a lot of money by not taking any more pills or creams. I avoided the foods and i haven't had a single out break since. I even tested it and binged on the foods and sure enough the EK came back within 24 hours. So stop complaining, stop saying the same things, stop saying I HOPE WE FIND A CURE SOMEDAY like your dying of cancer, and get the test done. you'll be EK free within a week. Promise :)
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I have had EK for 18 years, and didn't know it...doctors were no help, as many can relate!  By accident, I found a cure!!!!  Desitin ointment!  You know.....for baby diaper rash!  My EK started with exposure to Simple Green cleaning solution which was undiluted, I thought the peeling was due to a chemical burn at first.  I have gone through all the steriods, anti-fungals, antibiotic creams, etc.,  but these only set it back to return later with vengence!  In a moment of pain with hands bleeding, I tried what had given my babies relief from their inflammed skin and it worked!!!  Praise the Lord!!!  Iam finally seeing healthy skin growing where it used to peel (after about 3 monthes of use).  I can even skip use for awhile with no return of symptoms.  As to the many posts, yes, I believe stress is a factor.  Also, hard work with the hands, strong chemical contact, seasonality, and hands in a moist environment.  Funny how others have found that fish oil helped them, as this is the main ingredient in Desitin Ointment!  Hope this helps you all!
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I have had many of the symptoms of EK on my hands and feet, and I also wondered about the underlying cause.  Various treatments sometimes helped the symptoms, but didn't remove the cause.

A friend suggested a workup at a local chiropractic college, which taught their students to take a holistic approach to medicine.  My whole back was out of alignment, so they recommended chiropractic adjustments.  (Now I get adjustments from our family physician, a Doctor of Osteopathic Medicine, D.O. or DO.)  Apparently vertebrae in my upper and lower back were pinching and irritating the nerves going to my hands and feet.  EK symptoms were a result of this nerve irritation.

After several weeks of 3-a-week chiropractic adjustments, I could feel my fingers and toes beginning to heal.  Adjustments went down to twice a week, once a week, etc., until I'd get a "tune-up" about once a year, longer now.  My hands are still somewhat sensitive to detergents and solvents, and I notice an increased sensitivity when the weather gets warmer.  However, I am nowhere near going back to wearing vinyl gloves to keep the blood (from my fingertips) off the organ keys when I practice.
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I have never heard of this condition,EK, but it sounds alot like my problem that I  have had for about 10 years. Six years ago after my colon cancer I was told to go on a gluten free diet b/c of daily diareaha,etc. I had relief w/in a day or two but this skin problem on my left palm and the back of my neck at the hair line and parts of my ears have not gone away. The palm has gradually gotten worse and continues to spread out at a very slow pace but the itching thickening and cracking skin is driving me crazy. I`ve tried tons of creams but the latest I`ve been using is cocoa butter combined w/vaseline and a cotton glove nightly and as often as I can. I agree w/Jpm that this is food related b/c I have celiac disease. I can`t have wheat,milk(cow`s), cheese,chocolate,oranges,and dislike most meats except chicken and fish. I don`t know if my symptons fit EK but the skin issues sound alot like what I`m going through. Does anyone else have celiac or other autoimmune diseases?
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So glad to find this!!!  My son is suffering from this.  At least is seems so.  I have a question though.  What kind of soap and shampoo are safe to use?  
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Hi all.

I've read this entire thread of comments several times after finding this link by googling the symptoms I'm having.

The pictures I have found of this condition seem to look exactly like what I'm experiencing.

Many say this condition can be caused or exacerbated by hot weather and humid temperatures. I found that my condition (which started about a week ago) coincided with a recent heatwave that pushed temperatures above 100 degrees for several days; this added to the already humid climate of the area.

One thing that I can't seem to figure out, and I hope someone could help me: this condition is known to cause peeling primarily in the palms and on the soles of the feet.

While this is true for me, it is not 100% true. Though there is a bit of air-filled, painless blistering and peeling on my palms, most of the peeling is on the 'touching surface' (not sure what to call it) of my fingers and along the sides. HOWEVER, I also get peeling on the back of my fingers near the knuckles of two fingers, and along the sides of my fingers.

On my feet, the peeling is mostly under and between my toes, but I'm also getting a light bit of peeling on the top of my toes and on the top of my foot.

Most strangely, I have noticed a bit of peeling on my elbows. In all of my readings, I have never heard of any involvement of the elbows.

So would this indicate that I do not have exfoliative keratolysis? The symptoms and physical presentation look almost identical except for the involvement of other areas that don't seem to be as common.

Any help would be appreciated. This is kinda freaking me out (though not too bad, I'm in no pain and its largely asymptomatic so I realize it could be worse).
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I have been using BAG BALM it works great.  This is not an ad.  It is utter cointment for cows but it work really great on humans.  I have had the same problem now for two months and this ointment really helps with the dry craked skin and itching. You can get this at any drug store.
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EXFOLIATIVE KERATOLYSIS - What really worked for me.

First, it's important to point out that I am not a doctor, so this is not intended as medical advice.  This is just the story of what I have gone through, and what finally worked.

I've had this for 8 years.  It took 6 different dermatologists before I even got a name for it.  I have waited so long to post, because I have now completed the first full summer without a single outbreak!  I hesitated to post until I was sure that I found something that worked.

When I was first diagnosed, I got the usual 3 weeks of steroids, which did nothing but make me gain weight.  Urea cream did very little, (and I was applying it 20 times per day).  My doctor said I had a very extreme case, but even sleeping with cream and cotton gloves on every night did nothing.  Staying away from chemicals, etc., did nothing as well, and the entire palms and fingers peeled off every time I had an outbreak, (constantly throughout the summer).

As I wasn't getting any help from dermatologists, I tried to investigate what was happening myself.  It seemed to me that once the peeling started, the skin was separated, and therefore dead, so nothing was going to make it heal, so it seems to me that the emphasis can't be on stopping it, but to prevent it from starting in the first place.

I finally found a doctor who did an allergy test......nothing.  I was allergic to absolutely nothing!  So......that theory flew out the window.  I did believe tho....that the problem is not on the outside, but on the inside.  As I get older, I have noticed other minor ailments that have been bothering me:  fatigue, headaches, etc.  

I came across a documentary on Netflix called, "fat, sick and nearly dead".  The guy who made it had a dermatologic condition that was pretty severe.  He went on a juice fast, (made with all vegetables) and within 60 days, it was gone.  Now, to be honest, I didn't do the juice fast.  I did become a vegan, cut out all processed foods, and drank the juice concoctions twice a day.  My diet consists of mostly raw fruits and vegetables, with a serving daily of vegan protein, (nut butter, quinoa, organic soy, etc.).  In addition, I take a multi-vitamin, vitamin C (double the dose), vitamin E, 3-6-9 Omega oil capsules, and a B vitamin that contains pantothenic acid and B12.  

I started doing this last December, (it's now September) and I lost 40lbs, my headaches are gone, and I am very happy to report that I have gone the entire summer without a single outbreak of exfoliative keratolysis.  I even do dishes without gloves, (I hate those darn things).  No dry skin, (and not using any moisturizers) and I have more energy than I have ever had.

This is just my 2 cents, and what worked for me, and I really believe this is an immune problem of some sort.  I highly recommend watching the movie, (google it for their website, which has the juice recipes).  Oh...and one more thing....you don't have to use the juicer that they show in the movie.  I got a 700 watt juicer for $70 which is a lot cheaper than the one they recommend.

Hope this helps someone.
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Greetings EKers -

I recently found this thread which finally named this hand problem I've had for 20+ years. Thanks all for posting.

So far, this thread has been the best resource I've found for EK advice. After many attempts with dermatologists I now just avoid them completely. I'm wondering if anyone has found any other resources either online or in print that discuss EK further?

Also, I'm curious if anyone else has tried the full fledged solutions that have been posted about here. First, following the results of an ALCAT test and now the "juice diet" posted by nomoresuffering. Does anyone else have any success stories to share with these remedies or others?


Some background on my EK for those that are interested....
It started when I was about 13, I'm 35 now. It happens due to friction + wet hands and is usually a direct result of pulling the lines on sailboats. This is mainly a summertime hobby and it completely goes away in the winter when I'm not on a sailboat. I wear 2 pairs of gloves when I sail but still the problem persists. I've tried lots of creams etc. etc. with no success and for the past 15 years I've put nothing on my hands at all. I know several other people that have the same problem from pulling on sailboat lines and we've all had similar experiences with finding a remedy.

Thanks for the help!
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I just went through puva hand light therapy for 8 weeks, 3x/week. It didn't help me at all, but my doctor said it can be very effective for some. Good Luck~
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HI ALL THIS IS LONG I KNOW BUT WORTH READING - I have just recently been diagnosed with EK but have suffered with other (what I believe to be related) issues for years. A little background: I was severly burned when I was 4 yrs old w/ boiling water on a large % of my body & between that & subsiquent surgeries (many times severing nerves that were still trying to heal) I now as an adult deal w/several conditions that I have put the puzzle peices together on being related to the nervous system and a breakdown in its communication in the body. I have gradually obtained one "condition" after the other some far apart and some rapidly in sucession -the first being Fibromyalgia. This past year I started experiencing the EK but only after having Nueropathy (deading of the nerve endings in the feet which ironically causes numbing to the surface of the skin but extreme stabbing pain on the inside) I have the advantage (if I dare call it that) of putting all the clues together because of how long and how many different nerve conditions I've had to deal with. Because of this I feel confident in saying that MANY OF YOU ARE RIGHT EVEN THOUGH YOU HAVE VERY SEEMINGLY DIFFERENT CAUSES FOR FLARE-UPS. The reason that heat/cold, dry/humid, stress/no stress, food intolerance/chemical exposure etc can all be related is because they ALL affect our bodies nervous system. I also see a huge difference w/changes in baromectric pressure when it comes to onset of nervous system conditions. I believe the best approach is a WHOLE BODY approach ie:nutrition,(also make sure to get a blood test to find out if you are deficient in any vitamins) maintaining a healthy weight (puts less stress on the body) low mental & emotional stress, know what foods to avoid-your body DOES tell you if you pay attention, (ie: I can no longer eat red meat not because I dont like it but because it upsets my stomach afterwards now) as well as hydration, hydration, hydration. Topical oitments can be great at relieving some of the symptoms but staying hydrated is the way to maintain the moisture of the skin from the inside out. I CANNOT STRESS ENOUGH HOW MUCH OUR MENTAL/EMOTIONAL HEALTH AFFECTS OUR BODY so if nothing else I urge you to pursue in this area (FYI I'm not a tree hugging yoga hippie haha but personally without Christ & supportive friends & family I could not deal with all these painful life altering conditions) and yes, "busy-ness" ='s stress too!
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I have had this same issue and I have gone through all you are talking about and more. I started taking this cactus juice in June and my hands have been cleared up ever since. It is truly amazing. It is a little pricey but when I add up all the dermo visit and creams that have not work it is well worth it. Here is their link www.nopalea.com.  
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my mom. my nephew and my grandson all have this, after decades my mom found that if she ate ice cream, bacon, sausage, or milk, anything that's high in animal fats it caused her to flare. She controlled her own diet and her condition. It would me nice if medical "experts" could catch up.
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I'm so glad to have found this information and have skimmed through most of your posts on exfoliative keratolysis, which, quite frankly, I had never heard of.

About a week ago, my right hand thumb started to look dry and peeled. I thought it was odd, but lotioned up. The next day, my index finger, same hand, started to do the same. I thought my hand lotion was the culprit. As the day wore on, I literally watched this peeling jump to the next finger and the next. My left hand was ok...until it started as well. I thought I was going crazy! Eventually, both hands were a mess of skin falling off my inside fingers and palms. I had no itch or bubbling red blisters, so I ruled out excema (my daughter has excema, so I ruled out the itch).

The situation was rapidly spreading and getting worse. I thought I'd ride it out for any improvement. My skin was falling off in chunks. Oh my! Did I have some travelling fungal disease?!

I did some internet research and found this condition, which matched my experience.

Scooted off  to the doctor today, after reading this thread. I've been fortunate in my life to not have had allergy problems or skin conditions. I started to think of anything different I had done or been through as of late. I had been prescribed Amoxicillin for a strep-type infection recently. I realized almost as soon as my 10 day run of the antibiotic was finished, my hands began this bizarre condition. I had not been under any stress (my life is pretty calm), nor had I changed my diet in any way, shape or form. I eat pretty clean.

After a thorough consultation with the GP and any different situations recently, he mentioned that EK can be a side effect with Amoxicillin. I have had Amoxicillin a few times before in my life, with no side effects. Since the doc was not my regular physician, he gave me some 1% Hydrocortisone cream for relief (no itch, but burning and tightness from the tenderness of the skin). I am to see how it works, and return to my regular Dr. if no improvement is happening. I checked on my own, and it's a side effect from this drug.

Thanks to good advice here, I purchased the highest over the counter % of urea cream I could find from my local pharmacy (Uremol 20% Intense Relief Moisturizing Cream). It has given me a bit of relief from the dry, tight feeling for now. It makes things less uncomfortable, although there is a wee burn initially that is better than the dry tightness.

There has been some interesting info on this thread for a condition I had never heard of before. What a situation  and I can't imagine what I'll do if it persists from here on in. I can't imagine being a long-time sufferer with this and I give so many of you credit for looking at the positive, as in 'It won't kill you, but is manageable'. I find that uplifting.

I live in a colder climate (Canada), and it seemed to feel worse outside with no gloves (snow now), but eventually maybe this might be an advantage.

In conclusion, being a person who has never been sensitive to reactions from anything, I do think in my case, with the timing of the initial breakout following antibiotics, there is some valid cause. How it can happen mid-life, is a mystery, but sometimes it feels like the old bod is falling apart! I have a warped sense of humour and told my young adult kids that I will be bringing them hand-rolled cookies with faux coconut flakes tomorrow. All in jest, of course, but they just said EWE! I can't even THINK about any food preparation, which is sad for me. :(

I may have skimmed over some posts in my haste to get to the Doc today, but I never saw anything about a possible Amoxicillin link to EK and I just wanted to share my thoughts.







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Has anyone ever suspected Clorox or other strong cleaning agents as the cause of the fingers/hands peeling? I recently came down with what sounds exactly like EK, and looking/hoping for other explanations before succumbing to a life of lotions and gloves. I recently used bare handed Clorox Clean-up with bleach and hope I'm simply having a prolonged reaction...  

There is a scarcity of posts by anyone who found something besides EK to be the problem or to have had their problem go away.

If anyone has had these symptoms and had them cease or knows someone who had them and then it went away, please share. Also, please share if another cause was found to be the problem (ie clorox, etc). Do these posts not exist because it is incurable or because the people who no longer have peeling hands stop posting??

I am very grateful for this site. Lets keep up the sharing of information.
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I have the same condition described by most of you:

-- A flare-up occurs every few months whereby the fingers lose some touch sensitivity and the skin begins to 'bubble up' into partially detached superficial lesions.
-- The lesions peel away naturally over the course of a week and leave behind new skin that is red and sensitive.
-- The lesions are most severe on the finger pads, but the lower parts of the fingers and even the palm can be affected also.
-- Sometimes a flare-up is severe enough that pain and some bleeding occur.
-- Bathing or washing exacerbates the condition by accelerating the exfoliation of the detaching skin.
-- Topical steroids were only mildly effective at best.

I came across the solution while working on a home carpentry project. I noticed that after a few days of spending many hours handling wood and roughing my hands up in the process, my condition improved. So I went a step further and began gently rubbing my fingers against sandpaper for a few minutes a day (you could also use another rough surface like an emery board or nail file). The trick is to do this at the first sign of a flare-up, before your fingers get raw and delicate. In my case, this simple treatment reduces the length and severity of the flare-up by about 90%.

This simple solution has really improved my life and I hope it works for some of you. Let me know if you have any questions and I'll share more.
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joeplex:

How does it reduce the length and severity?  Does it simply stop the blister formation?  Does it just combat the blister formation by popping them immediately?  (I have used a pummice stone which similarly just popps them earlier and they eventually peel).  Or does the sandpaper toughen your skin up and make it more resistant to peeling?  Like almost calloused?

Thanks for sharing.  Please provide more detail/observation.  It would be nice to find a cure other than steroid cream and medicinal "treatment"!
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Hi jamfol,

A little background first on my problem: it began after I started playing hockey when I was about 14 years old.  Hockey gloves tend to get full of sweat and I would wear them almost everyday and they would never get a chance to dry up.  After a few months of this foolish behavior I broke out with a terrible case of EK; my fingers were actually bleeding a little bit.  Dermatologist prescribed a corticosteroid, and it maybe helped somewhat, but I kept having a flare-up of EK about every two months for the next 3 years, and the steroid cream did not seem to help much.  That's when I stumbled upon the sandpaper solution that I described in my earlier post.

Now to answer your question, here are more details of how my disease was before and after using this treatment.

Before:
Flare-up begins with with blistering on two or three fingers.
Flare-up 'spreads' to the remaining fingers
Fingers feel weird and are not sensitive
Blisters enlarge and begin peeling, sometimes leaving behind painful red skin.
Hands are full of peeling-off white skin flakes
This last about 3 weeks until it finally clears up

After:
Flare-up begins with with blistering on two or three fingers.
That night I plug in my small electric circular sander and spend a few minutes abrading the focal and palmar surfaces of the fingers and hand.  It can hurt a small amount, but the discomfort is minor.  The hands throb when I'm done and this subsides gradually over the next hour.  The hands have been exfoliated and no longer are full of dead white flaky skin.
Over the next couple days the hands feel better, the blistering is mostly abated.  After 3 or 4 days, the hands and fingers look very healthy and peeling and blistering is absent.

After I did this treatment for each flare-up (about 6-10 times per year), the duration between the flare-ups started lengthening.  I don't know if this fortunate happening was the result of the treatment or not, but every year my condition has improved.  Now I only get a minor flare-up about once a year and it's super easy to knock it out with a minor use of the sander.

So I pretty much consider myself cured.  I'm only posting on this forum in hopes of helping other folks who are still struggling with this affliction.
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Hi jamfol, let me explicitly answer some of your questions here:

Q: How does it reduce the length and severity?
A: The flare-up duration was reduced from a few weeks to less than a week. The severity of the outbreak is limited in the sense that much less of the hand gets pealed off.  The treatment basically shortens the duration and greatly lowers the intensity of the outbreak.  And it seems to prevent the awful situation where a single location gets re-blistered twice during the same outbreak which for me was the source of pain and occasional bleeding.

Q: Does it simply stop the blister formation?
A: Yes it seems to prevent new blisters from popping up.

Q: Does it just combat the blister formation by popping them immediately?
A: It pops the existing blisters and somehow prevents new ones from coming in during this cycle.

Q: Does the sandpaper toughen your skin up and make it more resistant to peeling?  Like almost calloused?
A: After 3 or 4 days the hand is healthy, clear.  It may be slightly calloused but not in a real noticeable way.
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My son began to experience EK when he was a junior in high school during basketball season and he's now 25. He would get terrible outbreaks 3 - 4 times a year.   He went to at least 10 doctors and the steriods and creams they gave him didn't work.  We did do a ALCAT test and did find that he was allegric to grasses (wheat in food also) and dogs (yes, we've always had one, but he doesn't live at home now).   He doesn't follow a "proper" diet, does drink beer occasionally and is naturally a high stressed type A person, however, he has found one cream in the last 3 years that has kept his EK in check so he only gets a few bubbles now and then.    It's called AMLACTIN and you can buy it at Walgreens.  He uses the cream in the morning and at night, keeps his dish washing, house cleaning and showering to a minimum and has been able to put the gloves he wore to help protect his hands away.  Hope this helps.
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Thanks very much for posting lindawf! Can you tell us a little more about the ALCAT test and if you think it might help? Some others claimed it was able to cure their EK altogether.
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Hello,

This forum is the largest collection of fellow EK sufferers I've found on the web.  

This condition is painless.  So for those of you posting on here about how itchy or painful the condition is, sorry, you probably do not have EK.

For me EK runs in cycles.  In my case, EK is not seasonal.  It started 2 1/2 years ago and has continued year-round, with few breaks, since then.  

At the start of a "cycle" I usually notice flat, dead-feeling round and oval sections of my fingers (usually thumb and index).  These round flat spots usually start small (maybe about 1/2 a centimeter).  Eventually the flat round spots grow larger, and often times merge with nearby flat spots to form larger flat dead spots.  I have reduced feeling in these dead spots.

After the flat spots have been there for a while, they begin to split open and peel.  The following is a link to photos of my fingers.  These photos were taken after many of the flat spots began to peel, but before all of the flat spots had began to peel.  http://www.bigoperations.com/hands.html.
There are spots in these pictures that appear to be bleeding.  As I stated earlier, the condition itself is not painful.  I am compulsive about trying to remove the unsightly dead skin.  I also have a nervous habit of biting at and picking at the dead skin.  It's very satisfying to pull off large sections of dead skin, but I usually get greedy and pull off too much.  The result is the accidental exposure of unaffected skin, which causes cracking and bleeding.  On the occasion of a bad outbreak, my skin will sometimes crack and bleed on its own (which is also painful).

Eventually all of the dead sections peel off and my skin starts to return to normal.  The fresh skin after an outbreak is usually shiny and pink.  Eventually the skin returns to its normal pigment, and my "normal" skin will only last for a week or two until I notice the small circles popping up again.  When I see the circles pop up, I get very discouraged.  I am always so hopeful that maybe this time they "won't come back".  I am always wrong, and the process ALWAYS starts over again.

The following things seem to aggravate my condition:
1.  Friction on the hands (i.e. hard work and weightlifting)
2.  Shooting pool (perhaps the chalk)
3.  Washing my hands too often (again I am a bit compulsive and have a hard time letting my hands stay "dirty")
4.  Not drying my hands well after washing them
5.  Stress (maybe).  I can be a stressed out person, but it's not a new thing within the last 3 years, so I can't say that it's a cause of my condition.

The following things seem to help the RESULTS of the EK, but do not prevent the EK from happening:
1.  Wearing gloves with A&D ointment smeared on my hands at night
2.  Covering areas that have been peeled too far and/or cracked with a bandage and anti-bacterial and/or A&D ointment.

I am trying to find a common connection among EK sufferers.  Here are some things about me.  Please let me know if any of you share any of these traits.
1.  I am in my late 20s
2.  I work a desk job and am in constant contact w/ a keyboard and mouse.
3.  My car has a leather steering wheel.
4.  I have periods of high stress.
5.  I suffer from migraines a couple of times a year.
6.  I suffer from IBS (although it seems to get better as I get older)
7.  I struggle with acne on my face even as an adult
8.  I lift weights regularly
9.  I shoot pool regularly
10.  My home has a water-softening system
11.  My home has well water
        
Dermatologists haven't done anything for me.  The first problem with them is that when I'm having and EK outbreak, they make an appointment for me 2 months down the road.  When the appointment finally happens, the EK outbreak has subsided and I'm going through a "good phase".  Regardless, the creams and ointments that they give me never work.

That's about it for now.  Thanks everyone!

-Aaron  

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Hi Aaron,

I was in the same situation as you for many years.  Did you read my earlier comment about sandpaper?  I don't know if this will work for you but it really saved me.  Good luck to you!

--Joseph (joeplex)
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Joseph,

Thanks for your response.  I did read your sandpaper post.  It sounds the most promising of any of the treatments I've seen.  

I will share this too.  As of right now, I'm heading into a "good" phase.  Recently, I read that a surplus of vitamin A can cause skin problems, including peeling.  Almost every day with lunch, I would eat a small bag of baby carrots.  I would also have carrots in my salad with dinner, and sometimes even as a snack in the evening.  Carrots are very rich in vitamin A and supply 200% of your daily value in one serving.  I have since cut baby carrots out of my diet, except small amounts in a salad.  I am going too see if lessening my vitamin A intake will help with this condition.  I will post again once I'm further into this endeavor.  

-Aaron    
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I've followed this forum for years but rarely comment as most postings don't have much insight as to why this condition occurs. I think we can all agree that there plenty of postings that advocate the use of various lotions and ointments that can help, but not cure, the blistering and peeling. The recent postings are much more helpful. Let's try to figure out WHY this condition erupts and plagues the individuals that it does.

THANKS to cadge31 and joeplex for jump starting this!

An observation:  It would be helpful if EVERYONE who posts to this forum reports the sex and age of the person with EK.

It's hard to tell, but it does seem that most CHRONIC sufferers are MALE (in other words, when the condition erupts following the one-time use of harsh chemicals used for cleaning, etc., I would not consider this a chronic condition, but rather an acute condition). Has anyone else noticed this??

I am writing on behalf of my 20-year old son, who has suffered for the past 5 years with this condition.

Traits:

1) Condition used to occur seasonally during humid months of northeastern US; now occurs year-round (he attends college in the south)
2) Condition occurs on both hands and feet--EXACTLY as cadge31 described in his post above. Much worse on hands.
3) Water and water sports (water skiing) exacerbates the problem.
4) He limits hand-washing and showering...water definitely worsens peeling
5) He also has severe scalp flaking and itching, as well as chronic skin itching (hives), acne, and dry, sensitive skin. It is difficult to control these conditions since he must use harsh dandruff shampoos and acne face washes, which are probably bad for his hands. Will not use gloves.
6) Insists that lotions and ointments don't work and does not use them.
7) Any activity that involves hand friction (i.e, weight lifting) worsens the problem.
8) Stress probably adds to the problem.
9) The condition is improved slighty when he is at school and worse when he is home. We have well water at home without water softener.
10) Drinks alcohol...probably more than I want him to.

Cadge31--

I am intrigued by the sandpapering and I appreciate your detailed description of this. But I still don't fully understand the mechanics of its success....are you saying that it is the PHYSICAL abrasion of the surface of the skin that seems to PREVENT further blistering and peeling, or is it simply that the act of sandpapering your skin removes already dead and peeling skin, giving an improved appearance?? If it is the former, then you are really on to something....I mean, there must be something about the physical abrasion of the skin that promotes skin health. If it is the latter, I agree that it's a good solution to unsightly hands during a flare-up, but I doubt I can get my son to do this on a regular basis.

THANK YOU for the information you've given thus far. Let's get to the bottom of this!

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Thanks for your response.  It was actually joeplex who uses the sandpaper technique.  I haven't tried it yet, but will the next time my hands are at the appropriate stage  

Did you happen to see the photographs of my fingers I linked to in my first post?  Do your son's fingers and hands look similar to the photos I provided?  

Best,

Aaron
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Just something to ad.  Two things that occurred in my life prior to this problem were:

1.  I built a garden fence in my backyard.  To hammer in the fence posts, I used a sledgehammer with work gloves.  I live in New England w/ extremely rocky soil.  My hands took a beating.  I had blisters for weeks after.  I am wondering if I caused some soft of triggering trauma from that.

2.  At some point I also remember getting Gorilla Glue all over my hands.  The glue came off relatively easily, but it's still strong stuff.  I wonder it that may have caused some sort of triggering reaction.

Best,

Aaron
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I suspect this condition is genetic. My father had it. I have it (for as long as I can remember - I'm a 57 yr. old woman) My daughter has it. My son does not.
I also have mild hidradenitis suppurativa. My daughter does not and I my father did not.
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Hi juliedd,

For me the sandpaper treatment greatly lessens both the duration and severity of the flareup; that is, the effects are not just cosmetic/superficial.  Please see my earlier posts for more information.  As to the mechanism for how this might work, EK is probably an auto-immune disease, so abrading away the skin (and whatever is in it) might remove some of the fuel for the auto-immune response.  I'm quite satisfied with this simple treatment and hope that it works for others as well.

Regarding the comments about the condition being genetic, it seems to be very common for autoimmune diseases to have a strong genetic component.  I seem to have inherited a propensity for autoimmune diseases from my father and grandmother.

Best of luck to everyone!

--Joseph (joeplex)
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Hey Joseph,

Just wanted to let you know that I have begun filing down my dead skin with a nail file.  After just one treatment yesterday, I am very encouraged with the results.  I can deal with the hardened pink skin.  The pieces of dead skin is what annoys me.  I always get myself into trouble with peeling off the dead skin.  The nail file is a great alternative.  It files away the dead skin without removing the healthy skin.  I am hoping to get to the same point you are with the condition being well-controlled.  Thanks a million, and I will keep everyone on this forum updated.  Joseph is on to something here folks!

One other thing . . .  I seem to have less "breakout" spots occurring on my fingers.  In the past, I've had good stretches like this where I though I was "cured" only to have a breakout days later.  This, however, is the longest "breakout-free" period I've had since I started with this nonsense.  I've read about vitamin-A surpluses causing skin problems.  As I mentioned above, I usually had a bag of baby carrots with my lunch every day.  I would also have baby carrots in salad at dinner, and sometimes as an evening snack.  I am wondering if I was getting a bit too much vitamin-A.  My wife, who is a nurse practitioner, doubts that I was getting nearly enough vitamin-A to cause a surplus.  But since cutting out the baby carrots from my lunch, and as a snack, I've noticed an improvement in my skin.  I suggest everyone here look over their diet and see if they're eating foods that are rich in vitamin-A.  One serving of baby carrots provides 125% of your daily requirement of vitamin-A.  

Thanks and good luck to everyone here.

Aaron
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Hey Joseph,

If this sanding technique starts working for others as well as it has worked for me, I say we call your suggested routine the "Joeplex Protocol" in the treatment of EK!

-Aaron
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Hi Aaron,

I hope you continue to see results the way I do.  The funny thing is, I haven't had an outbreak in over a year, but I just got a flare-up beginning 3 days ago.  I pulled out the electric sander and have been treating myself once-per-day since then.  It looks like the outbreak is now under control and I'm hopeful it will be cleared up completely by tomorrow.  Crossing my (EK) fingers!

Btw, I don't think I eat an excess of vitamin A.

--Joseph (joeplex)
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I haven't posted to this list for a long time, as my skin doctor doubted my self-diagnosis of EK. She actually suggested I have a mild version of Dystrophic Epidermolysis Bullosa. I doubt that, although I do blister easily. My skin is very dry and splits - I once twisted a bunch of weeds to pull them out - my skin did not twist just ripped in a straight line from one side of my hand to the other. I didn't even bleed (hurt though). I have also been known to smile and split my lip from top to bottom (which does bleed).  

Some people posting do not have Exfoliative Keratolysis, they have a peel after a one-off exposure to a nasty substance. EEK is a recurring condition.

If that is what I have, it started around adolescence, but may have been triggered by excessive exposure to chlorine (I think that caused my sinus problems, anyway). My blistering is mainly on my feet - I only get tiny blisters on my fingers, but foot blisters can be 2 inches or more. I have a photo of a foot blister on my profile.  

Juliedd: Some similarities between your son and me, although humidity actually helps, and I generally don't react to water. I get severe scalp flaking and itching (hate that) and my skin is extremely dry. Your son does NOT have dandruff, probably seborrhoeic dermatitis, so anti-dandruff shampoos are making things worse. I recommend Neutrogena T/Gel therapeutic shampoos, particularly Stubborn itch control - used in rotation. I also limit showering as it takes so long to wash off soaps and shampoos - essential to reduce itching. I only wash thoroughly twice a week, but "top and tail" in between. Friction does increase hand blistering (I thought it was my bicycle handle-bars, but it appears even when I haven't riden a bike or driven for ages). Lotions - he is right, not many help and most cause itching. However, once a week I cover myself in cetamacrogol cream (a base for many skin products) to reduce dryness. It's messy but does not itch (much). I use 100% aloe vera on my face at night, and occassionally a coconut oil body mist, which dries quickly and doesn't itch.

Sandpaper (in my case emory boards) does help, although I think it just cleans up the dead skin.

You can share these details with him, but adult sons hate accepting advice from their mother, so he may not listen...  

Cadge31: I wash my hands too often too - I hate to be sticky and may wash 10 times while cooking a meal. I use a computer all day, but I've had this since I was about 12, when computers needed their own room and I'd never seen one. I have never noticed a direct connection with stress.

My skin just likes what it is used to - I usually get a peel about a month after travelling (I have one now from Christmas). Cream and gloves don't work for me, best to let the cream dry uncovered.

I feel this is genetic and yes there are auto-immune conditions in my family (MS, IBS, Crohn's, Endometriosis - shared amongst myself, siblings and cousins). Lucky us!
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Joeplex--

The improvement you've experienced with the sandpaper "joeplex protocol" has given me reason to rethink my son's condition. I'm anxious to see if it works for him...not only to remove dead skin, but to see if the actual physical skin abrasion somehow promotes skin healing and health. Thank you for the details regarding this.

cadge31...please keep us informed as to your success with sandpaper!

Here's my observation:  For years my son played varsity basketball, practicing hours on end, nearly every day of the week. During basketball season (fall through winter), his hands were cracked and dry, but very smooth and no signs of peeling.

Then basketball season would end. His hands would begin peeling in earnest in the spring and continue for months. I've always connected its onset to the increased humidity of spring/summer.

But now I'm wondering....was the constant contact with the basketball actually providing the same abrasive wear on his skin as sandpaper does?? And if so, maybe this is why the peeling began after basketball season ended? His activities following basketball season provide a much different kind of wear-and-tear on his hands....weightlifting, volleyball, swimming, frisbee, golf, water skiing....nothing really "abrasive" in nature, but activities that can be tough on skin.

By fall, when basketball would begin again, the peeling would completely clear up and stay that way for the entire winter.

Now that he's in college, the peeling continues year round. I would say he's very inactive now with his hands since he's a busy student...other than computer work.

SO....is this a skin condition that occurs BECAUSE THE SKIN OF EK SUFFERERS DOES NOT DO A GOOD JOB OF EXFOLIATING ITSELF NATURALLY??

If so, then it explains perfectly why the Joeplex Protocol works to promote healing and smoother skin. It removes the top layer of skin....preventing a build-up of skin layers...thus healthy skin is no longer topped by dead and dying skin.

Conversely, in the absence of physical abrasion to remove this dead-and-dying top layer, the skin eventually breaks out in flat, dry blisters that eventually peel. It's simply the body's reaction to getting rid of old skin that isn't exfoliating the way it's supposed to.

Comments, please??

It would explain a lot of my son's other skin conditions too....like the itchy, scaly skin, seborrhic dermatitis on the scalp, thick calluses on feet that also peel, acne, etc. His skin simply doesn't shed dead skin the way it's supposed to.


p.s. NZpam...you've got it SO right...my son does not appreciate unsolicited advice from his mother! =) And yes, he does use TGel Stubborn Itch, in rotation with a pyrithione zinc shampoo (like Head and Shoulders) and Nizoral shampoo (an anti fungal). The rotation of these three shampoos (about 1 week of each one at a time) is the only thing that keeps his dandruff/itching under control.






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Well Everyone,

It's been a week of the "Joplex Protocol" of filling the dead skin from my fingers.  I am currently using a nail file to do the job.  Any sections of dead or drying skin get filled down.  I don't know if I just happen to be going through a "good" phase right now, or if this filling is really working.  However, I can say that this is the longest "good phase" I've had since this condition began for me over 2 years ago.  In addition, this is by far the best my fingers have looked in 2 years.  Within the last 2 weeks, I've only had a couple of small flat dry blisters in isolated spots on a couple of fingers.  I immediately file away the flat dry blisters as soon as I see them.  Joplex is correct in that this seems to stop the "spread" of the blisters.  

One other thing I've been doing is moisturizing my hands EVERY TIME i wash them.  I have been using Gold Bond Ultimate Healing Skin Therapy Lotion.  After I wash my hands, I rub a small amount into my skin.  I rub the lotion in until the greasy feeling subsides.  At work, whenever I wash my hands, I moisturize with Vaseline Total Moisture Conditioning lotion.  I will post some pictures of my hands soon.  

Best,

Aaron  
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Hey Joeplex,

Just a few questions regarding your sandpaper treatment.  I am currently in a 'flare-up' stage with my hands.  I have been for about 5-6 days.  When I first had the flare-up, I used the sandpaper technique and it seemed to work with blisters that initially came-in.  2 days later, more blisters came along so I sand-papered again.  After the second sand-paper cycle, my finger pads are pretty raw and have yet to recover.  I am still getting some blisters but they are not peeling because my fingers are already raw and mostly 'peeled' because of the sandpaper.

My question is: when you said "gently rubbed your fingers against sandpaper", did you truly mean 'gently'?  When I did, I more-so 'scrubbed' my fingers pretty vigorously against the sandpaper.  This seemed like the only way to remove the top layers of my skin.  Also, do you do the sandpaper treatment daily during an outbreak?  I did it on the first day and then again on the 3rd or 4th day.  As stated before, my finger-tips are pretty raw right now.  They are basically at the peeled stage already.  Instead of me peeling-away the blisters over the course of 3-4 days, the sandpaper did it for me immediately.  Do you have any insight on the treatment?  Or maybe if you did anything differently that helped you?

Thanks!
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Hello jamfol,

Q: When you said "gently rubbed your fingers against sandpaper", did you truly mean 'gently'?
A: I used the word gently so as not to scare folks away from trying the approach.  In my personal experience, 'gentle' rubbing works, but 'vigorous' rubbing (until the skin is a bit red in some spots) works even better.  I generally use an electric sander and spend about five minutes total for the ten fingers, moving the sander from finger to finger and also hitting the palms for a bit.

Q: Do you do the sandpaper treatment daily during an outbreak?
A: Yes I do the sandpaper treatment daily, usually before bedtime.  This way the abraded fingers can recover during sleep.  When I was more 'messed up' I would sometimes sand twice a day.

Q: My finger-tips are pretty raw right now.  They are basically at the peeled stage already.  Instead of me peeling-away the blisters over the course of 3-4 days, the sandpaper did it for me immediately.  Do you have any insight on the treatment?
A: My hope is that since you are 'already peeled' then perhaps your outbreak will be shortened in duration.  My advice would be as follows:
-- Keep at it every night for a few days unless it's clear that the treatment is causing unacceptable or intolerable levels of abrasion, which only you can judge.
-- If you continue to try this treatment, make sure you begin it at the first signs of an outbreak.  As with all skin conditions, the time it takes for skin layers to elevate toward the top layer results in a time lag between superficial and underlying states of health, which means you're only hearing about the problem days after it may have begun.  The flip side of that coin is that if your fingers are raw and uncomfortable today but you have been consistent in treating them, then there is a good chance that the underlying cause of the flareup might be gone already.  I suffer from a separate skin condition called vitiligo which I have studied carefully, and in that case there is a 20-day lag between underlying disease (the destruction of melanocytes) and any discernible improvement in the symptoms (I am happy to report that I now have control over this disease after about a year of study).  With EK, the lag seems to be more around 4-5 days, which is why it usually takes about that long for an outbreak to subside even in the best of circumstances.  Your goal is to 'attack' the outbreak at the earliest possible moment, and then confidently sit back as the symptoms gradually subside on their own.  Of course I don't know if this treatment will actually work for you, but I pray that it does.

Best of luck to you regardless of which treatment you use!
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Joeplex,

Thanks for the prompt response and insight.  I scrubbed my fingers against sandpaper last night again.  This makes the 3rd round of scrubbing over the last 6 days.  This morning, the fingers are really raw again - I even have some little red spots where super-raw skin is exposed.  Other than the rawness, my fingertips are actually doing well.  Rather than being peeled where there are different levels/layers of skin all over my fingers which causes me to peel further at the skin, it is just one, raw layer.  I am hoping that this will allow an easier healing of my skin to a normal state.  They atleast look better than having several peeled blisters with different layers of skin all over my fingers!  And I am only in day 6 right now during the flare-up of noticable symptoms.  Flare-ups in the past usually lasted 3 or more weeks.  As said earlier, I am hoping that my skin will begin to heal over the next few days.

A little background on my experience with this condition:  I have had this condition for almost exactly 5 years now (it began in March 2007).  For the first 3 years, I did not have any 'good' method of treatment.  My skin stayed peeled most of the time.  Ocassionally the exposed skin would get infected and through a course of antibiotics and antibacterial cream, the skin would return to normal state.  (I think that once the skin got infected, the reason that it stayed peeled was because of the infection itself.  Once I treated the infection, the skin would clear up until the next flare-up of peeling blisters).  About 2 years ago, I saw a dermatologist who prescribed me oral Solodyn pills.  It is used to treat acne because of its anti-inflammatory properties.  It counter-acts certain inflamations with the skin.  He said that it may actually help with my condition (he called it dyshidrosis - I am convinced it is EK, but EK is a cousin of dyshidrosis anyway).  Well, the Solodyn SIGNIFICANTLY helps my EK.  For the past two years, I have only experienced one flare-up that has resulted in peeling besides the current one that I am experimenting with the sand-paper treatment.  I use the Solodyn in combination with a topical corticosteroid cream at the FIRST sign of an outbreak and the combination of medicine stops the breakout before it ever hits with peeling symptoms.  Basically, I have had normal hands for the past two years.  I usually take the Solodyn for 7-10 days after the sign of a flare-up and use steroid cream for 5-7 days.  If I average 6-7 flareups per year, that is almost 70 days per year I am taking an acne medication.  This is a problem because I am not fond of the thought of putting an oral medicine in my body that can have potential long-term side effects (high blood pressures, liver problems, etc.).  This is the reason that I am seeking an alternative treatment, such as your sand-paper regimen.  I would like a 'natural' treatment rather than using oral medicine and steroid creams throughout the year.  Hopefully I will find success with your treatment!

I got the ALCAT test done this past summer and after 3-4 weeks of being on the diet, I could not do it anymore.  There are two many things I am 'sensitive' to for me to live and eat normally (sugar, mustard, green beans, soybean, etc.).  Soybean and sugar are in tons of foods.  I just pretty much gave-up on a food-avoidance lifestyle.  I will say that during those weeks I avoided those foods, I did not have a flare-up.  Although sometimes I go 2 months without a flare-up, so I cannot confidently say that it was because of the ALCAT results.

One last thing - I posted earlier about Epiceram cream that helps moisturize your skin with lipids.  I still use it during peeling stages (although I do not have many at all).  It really helps moisturize and I am hoping will help my hands heal during this current peeling cycle.

Will keep everyone updated.  Thanks, joeplex, for all of your help.
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I am skeptical on the involvement of food choices in my EK. My skin problems started with adolescence as a 12 year old (what a time to have sheets of skin peeling from the soles of my feet!). Since then I have had random occurrences of both feet and hand peels (mainly feet). My diet has completely changed since my teen years (I became a complete vegetarian at 19 and ate a lot more vegetables than I had ever used to), but still the peeling continued. Environmental factors are more likely to be the cause. In my case hot dry climates are hard on my skin, but I often link a peel with temperature and humidity changes.    

My husband had an ALCAT test done at great expense a few years ago, as he has an intolerance for wheat. We sent the test to the US, and he was deemed allergic to all kinds of foods he has never eaten (lobsters, for example). We could not see any connection between his problems with wheat and the test results. He still avoids wheat, but not the rest of the long list of foods which we never felt were a part of the problem.

Excluding too many food types is nutritionally not a great idea, so unless you are conscious of a direct connection with a specific food (in which case it can be useful to exclude to see if it helps), I feel it is better to eat a varied diet involving all food groups.

I'm also worried about being too rough when removing flaking skin - EK skin is fragile, redness suggests you might be pushing it too hard. When I buff I just smooth out the edges - to avoid catching the skin on things and getting pulled off. Dead, peeling skin is white and I can't feel the abrasion. Redness suggests you might be involving "healthy" skin.      
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I've read this entire thread of course hoping to find "the silver bullet" and maybe one day there will be one, but not from the dematologist's corner, they seem to have less information than people here on this site.
I'm 57 and have had this condition about 8 years now. It never used to be bad enough to compromise my quality of life, but it has reached that level in the last 2 years. I'm a musician so when my skin goes away it takes my calouses off my fingers and leaves me in hell for 2 to 3 weeks. I had been trimming back the dead skin with cuticle scissors and liberally applying urea based creams. My last derm visit was for a prescription for epiceram cream, the derm said the same ingredients are available in lower concentration in an over the counter cream and lotion called "Cerave". It's good stuff at a 10th of the price of the epiceram so you can really goop it on over night and during the day. Other than that, there is a good general cream called "Glaxal Base" and another with high urea percentage called "Dermal Therapy" both available at Costco. I am trying the sand paper method now in the hopes that it speeds the cycle and gets me back to healthy skin faster. One thing for sure is the need to keep away from water, specially hot soapy water, or soaking. I wear gloves for everything including showers. It's so devastating and depressing when those little white blisters appear, here comes 3 weeks of hell again. I wish us all best of luck and thank everyone for their input here.
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Update.

I had a moderate outbreak of EK on my right index finger since I started the "Joplex Protocol".  For whatever reason, my left index finger was not involved this time.  The protocol, however seems to bring the outbreak under control faster than letting it run its course untreated.  Perhaps it seems to be "healing" faster because I use the sandpaper to file away dead skin instead of picking.  Picking always resulted in exposing healthy skin, which caused cracking and bleeding, which slowed the healing process.

An interesting note.  I had run out of Gold Bond Ultimate Healing Skin Therapy Lotion with Aloe, which also contains urea.  I had not had an outbreak of EK since I started using it regularly.  My wife bought me Gold Bond Ultimate Healing Concentrated Therapy as a replacement.  I noticed that the Concentrated Therapy lotion does not contain urea.  It seems like this latest outbreak started after I ran out of Ultimate Healing with Aloe (and urea) and started using Concentrated Therapy (without urea).  

Anyway, it seems like I am on the tail-end of this latest outbreak.  I have my yearly physical exam today.  Even though it goes against my better instincts (since doctors seem clueless when it comes to treating EK), I will probably get him to send me back to the dermatologist.  From the posts I've read on this site, I have come to the following conclusion.  Doctors hate when their patients suggest a diagnosis.  If you go into a doctor's office and say "I think I have EK", the doctors seem to get bent out of shape about it.  It's almost as if they say to themselves, "I'm the doctor here, I will make the diagnosis".  Even if they think you're right, they won't tell you out of pride, and then they'll proceed to "diagnose" you with something else.  Usually "dermatitis" is a good generic diagnosis.  Usually us poor EK sufferers end up walking out of the doctor's office with a useless steroid cream, or some crap like that.

Anyway, that's all for now.

-Aaron    
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I have a quick question regarding the "Joeplex Protocol"
No one has mentioned what grade of sand paper they are using? Like 100 grit, 150 grit, 200? I have been trying the protocol with 150 grit, but one of the issues is that when the white blisters are on thicker skin, I sand the edges as well as possible, but am still left with a thick edge of peeled skin that has to be trimmed with cuticle scissors. Anyone have some input regarding sanding thicker ares of blistered skin? Also just curious if Joe is using a small orbital sander, or some other sander.
One other thing I wanted to mention is when the skin is really raw and sensitive I use a hypo allergenic cream that contains tea tree oil which seems to help speed the healing overnight.
Thanks everyone  
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It has been several years since I last contributed to this EK post (Feb and Oct 2008). I have been suffering with EK for nearly 40 years now – but I may have got the better of it now (touch wood).
I have had some success lately and I remembered this post, so I thought I should pass this on to everyone. I have read through most of the posts since 2008 and it is still clear that the medical profession has still not identified the cause of EK, and that cures are still a matter of trial and error. I have another ‘cure’ that people may want to try and see if it works for them (I hope so).
First - to ensure we are on the same page, EK is very different from some of the other skin problems that many on this post seem to actually have. This is the best site I have found with pictures of EK. http://dermnetnz.org/dermatitis/exfoliative-keratolysis.html
In 2010 I had the misfortune of putting a knife through one of my hands.  After surgery I had my left hand in a hand/wrist cast for 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 going through the usual summer trials and tribulations with EK, my left hand was completely EK free for quite a while after it had all peeled off. Slowly over the next month or so, it caught up and then both hands were again ‘EK Zones’.
I had the usual EK issues for a while and then I remembered that many years ago one of the attempted ‘cures’ that a Dermatologist had me do for a while, had resulted in all the skin on the palms of my hand peeling off.  This involved soaking my hands in a Pinetarsol solution 4-5 times a day.  At the time I thought this was a disaster – but now I started thinking again.  I decided to undertake the same process, and this time committed to keep going with it no matter what.
For the next few weeks I undertook the process and much of the skin on my palms peeled off.  I kept going and slowly over several more weeks I realised that the skin was getting better, and that there was no more EK developing. I kept this up for the rest of that summer and by and large it worked. There were issues though – not all peaches and cream – see later on.
This summer I decided to try it again, so several months before summer, I started soaking my hands in Pinetarsol about 6 times a day. It is now the end of summer and my hands have been great – just the one bad EK outbreak, and a few small ones here and there.  The bad outbreak happened when I went to India for 2 weeks (didn’t take Pinetarsol with me), but after a few weeks back home and treatment the hands were OK again. The little outbreaks happened when I was slack and the weather particularly hot.
During this last summer I have also rationalised down all the additional things that I do that are now my basic EK Management Regime.  These are what I now do :
Pinetarsol – about 30ml per 2 litres of water – soak hands at least 6 times a day (often more) for at least 2 minutes, and occasionally for 5-10 minutes (in front of TV) – always after a shower/bath and after washing hands (no soap). Because it is not cheap I use a water container (2 litre) and keep the same solution for about 4-5 days – remember to wash/rinse hands first. Unfortunately this stuff smells and it will turn any damaged skin yellow – but that skin ‘drops off’ and the new skin that grows is somehow ‘healed’ and made strong by being often soaked in the solution.  Made in Australia by Ego Pharmaceuticals Pty Ltd - http://egopharm.com/category/our-products/pinetarsol
Du’it Foot and Heel Balm Plus – it has 25% Urea Cream. I apply a little each night before going to sleep. Seems to help any overnight ‘repair’ that is going on. Every now and then I get a little EK on my heels or toes – put this stuff on in morning and evening and it clears up in about a week. Du’It is made by Orbis Australasia Pty Ltd. http://www.duit.com.au/c-49-Foot-Care.aspx?reloaded=true
Vaseline Dry Skin Conditioning Lotion.  I apply this as/when need - which is not so much these days.  This keeps the palms from drying out and offers a bit of protection when going outside in hot weather. It is the best I have found and it is absorbed quickly and is not greasy on the hands.  http://www.unilever.com/brands/personalcarebrands/vaseline/index.aspx?WT.LHNAV=Vaseline
Dove Exfoliating Soap (non-soap).  I only use Dove soap and it is by far the best I have used over the years -  http://www.unilever.com/brands/personalcarebrands/dove/index.aspx
Shampoo – I never use ‘normal’ shampoos – if that stuff can soak into hair follicles then it sure can get into the skin. I use Dove shampoo and I do not use a conditioner without gloves (see below re gloves).
Surgical Gloves – Pharmatex Nitrile and Powder Free Examination Gloves. Whilst I was in hospital I noticed all the Doctors and Nurses wearing blue ‘plastic’ gloves and I asked about them. These type of gloves are now used everywhere in Hospitals because they are ‘inert’ – they have no volatile ‘rubber’ compounds nor any ‘powders’ – both of which can cause skin issues. I use these every time I am putting anything on my hands – hair gel, aftershave, sunscreen, absolutely anything.  http://www.pharmatex.com.au/nitrile.html
There it is – I hope that my current regime keeps working for me and that it helps someone else too.
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Hi FlayFingers, sorry for the late response.  Yes, I use an small orbital sander.  As for grit count, I prefer coarse over fine.
--Joseph (joeplex)
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Hi scala500, thanks for taking the time to share your story.  I think for some folks, deliberately removing the skin (as your method seems to do) can really help.
--Joseph (joeplex)
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The joeplex protocol puts new meaning to the term "palm-sander".
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I have just encountered the same condition. I am a nurse and have worked in dermatology for awhile. None of the doctors I was working with could even diagnose or treat what was happening to my hands. I have at my disposal more topical creams that you could imagine. Steroids, antifungals, moisturizers alike were unsuccessful. I have seen a great improvement by using Cutemol. It is not an overnight cure. But I have used it for a week and found significant improvement in being able to touch things (without feeling uncomfortable). I would recommend this product to anyone dealing with EK.
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I have just encountered the same condition. I am a nurse and have worked in dermatology for awhile. None of the doctors I was working with could even diagnose or treat what was happening to my hands. I have at my disposal more topical creams that you could imagine. Steroids, antifungals, moisturizers alike were unsuccessful. I have seen a great improvement by using Cutemol. It is not an overnight cure. But I have used it for a week and found significant improvement in being able to touch things (without feeling uncomfortable). I would recommend this product to anyone dealing with EK.
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I have this condition as well. I have tried every topical and and oral remedy I could find over the counter and homeopathic. The one thing that seems to help is tanning. Sounds a little crazy but I was going to the stand up tanner twice a week for 8 - 10 minute sessions because my doctor thought it might help as a good mood therapy. After each session I would feel great and after two weeks (4 sessions) the 'rash' had completely cleared up.
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That therapy is referred to as PUVA therapy. I tried that for 8 weeks. They put my hands in a small tanning bed and steadily increased the exposure time. It was ineffective for me, and cost a lot of money. Proceed with caution if you are considering this method.
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I've had this for about a year and a half. Not as long as some, but continuously. I've had multiple splits on my hands for the entire time. It starteed with my right thumb and that'a still the worst. Lately, my fingertips split open. Like all of you, I've tried everything.
I've played a musical instrument my entire life. I haven't been able to touch it for months. I'm a pen and ink artist and it's getting to where I have trouble holding my pen.
I think we've all discovered that the medical proffesion is useless to us. They really don't understand it, the information is contradictory, and there doesn't seem to be a cure. It either goes away, or it doesn't.
Steriods proved useless to me. I've read that steroids have no affect on EK in general. Then, in other articles, they reccomend steroid cream as a treatment option. It certainly had no affect on me.
I think it's cotton glove time for me.
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Go to an Afro American Beuty supply and ask for Indian Hemp Grease and glob it rubbing into ur skin,also get syrup and apple vinger and mix it together and dip ur hand in for 10 mins at atime.Iv been taking apple vinegar pills and olive tree extract pills to help the body fom the inside.Finally before a shower spray on vinegar all over ur body so the fungus has nowhere to hide.also u will feel as clean as uv never ever felt before but careful with the vingar fumes,theyre strong.
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Very interesting, I also suffer same condition (left hand only for 5 months) & also note lack of saliva & very dry eyes especially during the night, cold pillow & cold ice on hand offers only relief- so far!, Sue Lowe
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I want to give my own experience, and I hope it may help other people, I had also a similar skin problem, my skin in one finger did peel off and it was worsening day by day, searching in the internet with a similar condition I found: Exfoliative Keratolysis. I think all health problems are linked with our lifestyle and changing our diet and our lifestyle can help our body cure by itself. I changed to eating more healty and now my finger has imporved a lot and is curing itself.
I heard that liver problems are reflected in skin problems, specially  finger and palms. Problems in your liver can be a probable cause, so I tried to take care of my liver, too. I started drinking a lot of water, as much as I could, and eating healthy, a lot of vegetables and fruits, chicken, turkey and fish are very good, avoid anything artificially flowered, sugars, sodas, flour, meat, sausages and fried food, french fries and donuts are all very bad for your organism. For example eating salad is very good, but try to dress it with olive oil or lemons instead of artificially flowered dressings you buy in the market, try to buy as much natural food as possible for cooking, anything artificially flowered or with artificial food preservatives are not good for you and your health.
Vitamins are an essential part of any cellular process including healing. Some vitamins are more important for healing. Vitamins A, C and E are a part of the healing process for the skin. Vitamin A is a fat soluble nutrient. It's most commonly found in carrots, but it's also found in dark green leafy vegetables like romaine and broccoli. Vitamin C is found mostly in citrus fruits like oranges. Vitamin C is also found in orange juice. Vitamin E is found in nut products. Vitamin E is in peanuts, hazelnut, sunflower seeds and almonds. Vitamin E is also found in broccoli and corn oil.
Do not buy vitamin supplements since those are chemicaly made, it´s better to eat the food which give you the desired vitamin.
Good Sleep is important, too, sleeping early and waking up early is good, for example from 11:00pm – 1:00am is the de-toxification of the liver, ideally must be done in a deep state sleep.
I hope this helps, try avoiding medication specially corticoid, this damages your liver and health. Try living more healthy and with time your body will cure by itself, but give him the proper vitamins a nutrients it needs for curing. Give it a try, it won´t happen overnight but try it for a couple of months it´s worth the try. Also you can find advise in an homeopath since he will prescribe you all natural medicine. Here are some links of interest, with information:
http://www.disabled-world.com/artman/publish/liver-foods.shtml    
http://padmasrecipes.blogspot.com/2010/01/some-facts-about-our-liver.html    
http://www.livestrong.com/article/31759-foods-heal-skin/    
Good Luck and God Bless.

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Joeplex and everyone, thanks for responding.

Joeplex, I read all your post but am still confused on one point. Do you sand even good, non-exfoliating skin when you see the start of an outbreak, or do you only sand the area that is peeling (to get the white dead skin off?).

Background on me: I am a RN in the ICU. I have had EK since I started wearing blue nitrile gloves for work about 2 years ago. Water makes it worse, and I wash my hands frequently for work. Changing soaps did not help. I got an allergy test done (Patch skin testing) and it showed I was allergic to blue dye. So, thus, the start of my exfoliative keratolysis may have been caused by blue nitrile gloves that I was allergic to. I have since changed to non-blue nitrile gloves, but still have not seen improvements.

Also to note, my skin seems to improve when I am not at work and not wearing gloves. So for me, EK may NOT be a Type IV allergic reaction, but maybe a contact dermatitis type of EK. In any case, I will try your sand paper method after getting your response and seeing if it helps me out.

Oh, regarding creams - I haven't found anything that helps. Almost feels like putting cream on is a waste because it will just Exfoliate away! haha
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As for me, at the first sign of a breakout, I generally sand the pads of all the fingers, regardless of whether the skin has bubbled up yet.  I might place a bit more emphasis on the areas that have already bubbled up; but my EK generally envelops all fingers if left untreated, so generally I sand the areas that I know from experience tend to be affected.  For me this generally includes the finger tips, pads of the fingers, and to a lesser extent the proximal palmar surfaces of the fingers, and the palm itself.

-- Joseph (joeplex)
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I've been watching this forum for 2 years now. I've read EVERY post and I believe that I've narrowed it down to several facts:

1. Not everyone suffers EK the same way. Some itch; some do not. Personally, right before a foot outbreak, the soles of my feet feel like they are ON FIRE. Otherwise, I do not itch.

2. Over-exposure to water and chemicals absolutely, positively makes it worse. (Also working hard with the hands makes it worse, like when I've been outside pulling weeds or painting the house.)

3. Conversely, very dry air makes it worse. Humidity seems to help. Crazy, eh?

4. EK is cyclic; it gets real bad, then it seems to improve, then it comes back with a vengeance.

5. Forget MDs and PAs. They look at you strange if you mention EK. You are on your own here, and are responsible for finding WHAT WORKS FOR YOU. Perhaps you've noticed that not everyTHING works for everyONE.

6. Steroids help temporarily. Plus they make you cranky and you swell up. Face it. This is for life, so you need to find what keeps it under control, as best case scenario.

7. I find the Joeplex Protocol interesting. I perform a variation of this so I was not surprised to read it. As you've read above, some have success with saltwater. I actually soak my feet in 1 cup Epsom salt and HOT water for 1/2 hour every week, until my skin bubbles up. Then I use a pumice stone to scrape off everything that will come off. Once a week works great. My feet are generally very pretty after a treatment. (Hint: soak during a 30 min TV program... you'll forget all about your treatment.) Plus it feels wonderful.

8. After reading all of the creams that people use, I noticed that UREA based products seem to always work to keep things under control. So far, Gold Bond Ultimate (there are two varieties) work best. Second ingredient is urea. Always check the label before buying. It's quite inexpensive at Walmart-if you have one local. It's not greasy and smells pleasant. I have one in my bag, one my desk, and one next to my bed.

9. Cream up your hands and feet each and EVERY night. Socks are a must. Cream up after washing your hands.

Remember, this is for life. You just have to do these things or just live with the peeling.

Best regards and good luck!
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My EK started about a month ago and now IT'S ALMOST GONE!

First of all, I'm a 21 year old female that goes rock climbing indoor every other day.

My EK started with white bubbles at the tip of my fingers, but because I rock climb I thought it was simply the calluses on my fingers peeling a little bit, so I didn't make a big deal of it until the next time I climbed and 3 layers of my skin peeled off. I recognized it was EK since I had suffered from it for  2 years around 6 years ago, and at that time it just went away by itself.

From doing research I realized I was intoxicated with vitamin A from drinking too much carrot juice, since a cup has 750% of vitamin A and I was drinking more than 1 a day (I found this out because somebody on this forum post about suspecting their carrot intake). I also noticed that my hair was falling in crazy amounts and that last month my period had been late by many days which are all symptoms of hypervitaminosis a.

This is what I did:

- I stopped the consumption of vitamin A and started taking vitamin D (in moderation) so that my body could wash away a little faster the excess of vitamin A.

- Since it was the only cream with urea I found I bought Gold Bond Ultimate RESTORING WITH CoQ10, totally recommend it!

- I also tried Joseph (joeplex) method. I sanded my fingers for a few minutes during the night, put the cream and then went to sleep. I noticed how it would make the break out less dramatic since it would take off all the dead skin accelerating the peeling process and taking away discomfort. I didn't do it every night because I was afraid of not having enough skin left to rock climb, and the rock climbing activity itself was kind of sanding my fingers too.


I know everybody's case is different so I just wanted to share with all of you what helped me and would definitely recommend in case it could help you in anyway.


Thank you and good luck!

Auroravk


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My EK started about 20 years ago and I have just put up with it till now.  I am in the process of a patch test (as we speak), but it doesnt sound like it is going to find out anything.  My EK starts in the spring and actually stops in the winter.  I have only found (1) item or lotion that seems to help me and it is called CeraVe moisturizin lotion.  This lotion has not cured my EK but it does seem to repair my skin faster than any other cream or lotion that I have tried.  Thanks for all the information that I have read on each of your posts.  If I find out anything at the Dr. tomorrow I will certainly make an immediate post to all.  
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This is my treatment regimen:

1) Avoid water as much as possible - I wear waterproof gloves for showering http://www.rei.com/product/828666/sealskinz-waterproof-gloves  (they get less and less waterproof as time goes on). I wear hair ties near the cuff of the glove to prevent water from creeping in. I also wash hands with Cetaphil without water most of the time. Don't know how effective of a wash it is.

2) Try to lotion up after washing hands as much as possible. Not always possible.

3) Use Vaseline or other type of greasy lotion at night. This has really helped. I also use greasy lotion under waterproof gloves before showering.

4) I use the Joeplex method. Bought an orbital sander -  http://www.homedepot.com/h_d1/N-5yc1v/R-100671644/h_d2/ProductDisplay?catalogId=10053&langId=-1&keyword=dewalt+orbital+sander&storeId=10051&relatedSearch=dewalt%20orbital%20sander

I sand off the peeling areas. AVOID over-sanding. You can really cause lesions on your skin which may bleed and get infected, which doesn't help your cause. I would say sand a maximum of 30 seconds in any area. The point isn't to sand off all of the white dead skin. It should be as effective to just sand the general peeling area, and then use a nail clipper to trim the edges.

As of now, no matter if I am in the peeling stage or the healing stage, I am sanding all the areas of my hand where I know I have EK. I am working on a "Progress Note" with pictures of my hands and annotations of what I am doing at the time. I will upload when completed
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Have this for almost 20 years but I may have stumbled onto something.

Thses pics are 40 hours apart. I have been using one capsule of fish oil per application. A needle to pierce the cap, apply to hands a few times per day. Also overnight with vinyl golves. Yes it's stinky but it is helping.

http://community.webshots.com/album/583437202bbGghI?vhost=community

PealyDon
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Thanks, pealydon!
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I added another pic from today at 630pm MST. I did not apply fish oil last night before bed and only once today. I got some 40 percent urea cream today and will use that as needed. I'll post the good or bad as time goes on. The next 2-4 weeks will be the test if this method controls or at least minimizes this condition.
My pattern is every 2-3 weeks begins an eruption and it lasts 2-3 weeks. I have had a break in the pattern going back a few months, very slight peeling and easy to control. I had been using UdderlySmooth and some times O'Keeffes with good results until this outbreak which began Tu, 9/11/12 and this one was a bad one.

I've been in the hot tub twice and did immerse my hands w/o ill effects. My hands are slightly tender but otherwise feel marvelous!

Common fish oil capsules applied topically and lots of faith. :-)

Best to all in this fight,

Don
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I also have an EK, i've search treatment for this, and i found Avon Care Silicone Glove Protective Hand Cream, i look at the reviews of this product and all are positive comments, as i read some of the reviews the condition they are treating is EK. Unfortunately Avon Care Silicone is not available here in the Philippines, its only in the U.S., if you want to see this product just go to reviews.avon.com or type in google avon care silicone glove protective hand cream.
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Hi
I have had EK for 10yrs now and have tried all the cures listed to no avail, i started trying to work out what is causing it, it appears on hands and feet so logic states what’s on your hands and feet but no where else? Answer nails, when i have EK bad i also notice a change in my nails (they get thicker and harder to cut, samples of skin from effected areas test negative to fungal infection).
I decided to start trying something new, I cut my finger/toe nails short and have kept them short, then twice a day (morning and evening)i applied antiseptic tea tree nail solution (made by Optima under the name Australian tea tree)on the top of my nails and crucially under the cut short nails where the skin meets the nail.
I have stopped using Urea cream and steroid cream and my skin has improved to such a point i felt it only fair to share my discovery, i must also point out i am a manual worker and have suffered this condition quite badly until now.
I hope this works for you as well as it has for me. Tea tree has more antiseptic/anti fungal strength than carbolic acid. Mike
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Hey repairman, I think your idea of considering the nails is a smart one.  I am going to try what you said if I ever have another outbreak (thankfully I've been free of the condition for a few years now).  Thanks for sharing.
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Don't even know if you will get this its been so many years since you posted..I also suffer from EK and for me its simply brought on by water...my hands aren't sensitine to soaps or cleaners just showering too long...doiing dishes too long or swimming brings it on for me frequently occuring mostly in the warmer months...my neice and mother have it as well...gotta love genetics!
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I had undergone several stressful life-altering events in 2012, about the same time my first peeling finger was noticed in March. Topical steroid ointments did not help.  Skin patch testing did not reveal anything that could explain this. I am currently on Imuran now for a month.  My doctor will have me on this for a year. This treatment was due to my strong positive response to Prednisone.  Unfortunately this drug may take 2-3 months to work. So far, I have not noticed much difference or relief. I am a Nurse who had to go on disability since 100% of my fingers are either cracked, swollen or often bleeding.  My hands are constantly gloved which bathes my hand in moisture for 12 hours! Having the cuts as mode of entry for infectious agents, it is not recommended to continue working in direct patient care. I will keep this site updated.
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I noticed that when my fingers started to peel off, it was a problem with the liver. I changed my diet. When I eat lot of meet, ice-cream, milk, butter, beacon, jam (animal fat), the condition in my fingers worsens. Drinking a lot of water helps the liver to clean by itself, eating fresh fruit and vegetables, garlic, apples, helps too, it´s incredible but when I change my way of eating my peeling of the fingers cures itself. Eat as healthy as possible (avoid processed food it makes the liver work hard) it´s worth the try it might help you as I did for me.
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No breakouts since Sept! Regular applications of a urea containing moisturizer after the fish oil regimine has kept this under control. Warm weather coming so that will be the test. ;-)
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Avatar_m_tn
Hi,
   I'm Weiren from Hong Kong. Recently I dated this girl who had a case of EK and after some research I found this website. The Joe Protocol caught my attention and I mentioned this to her and now she is trying this. In addition to this, I have access to Intense Pulse Light and a Q-switch laser (used for facial and skin care treatments) and decided to add to the procedure to see if it helps. I used the 2 procedures in an attempt to 'kill' off any bacteria or bugs that may linger in the 'good' skin. It has been only a day and I will keep track of her progress and report back here of our little 'experiment'. Rest assured that I am familiar with using these 2 instruments and no unnecessary risks were taken.
Greetings to all. Thanks for sharing your experiences
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Avatar_m_tn
Hi Weiren,
I live in Ohio (US) and just had a huge palmar break out. For me, it subsides in the winter completely unless I am doing manual labor with metal (nails, hammers, etc). I also do not have any allergies - at least the typical items they test for in a standard allergy test. That being said, as soon as spring hits and everything starts to blossom I  suddenly go from no issues to peeling all over my palms. That leads me to believe it's either an allergy or a reaction similar to seasonal allergies. Nothing but cold weather helps me. I've tried the suggestions in this blog and none have helped. Each year seems to get worse- I'm sure you're pretty miserable after 27 years!
I wish you luck!
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Avatar_f_tn
Hi,

I have had peeling hands since childhood and I'm now 58years old. An eminent dermatologist diagnosed EK in my early 20's but had little to offer and although I've tried numerous creams most made the condition worse. However I have found that our water softener has really improved my skin and generally brought the condition under control. We installed it 15yrs ago. My skin still breaks down and it takes a couple of weeks to recover when I spend too long away from home (unless I go to somewhere with soft water).  I never wash-up, clean or garden without gloves and I try to avoid putting my hands in water as much as possible although limited swimming in the sea is ok.

Has anyone else found soften water helpful?
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Avatar_n_tn
Reading about the soft water alleviating EK makes me think. My hands suffer most when handling lines on boats and it is significantly worse in salt water compared to fresh water. Perhaps there is something in salt water and also in hard water that makes the EK worse?
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5681913_tn?1372280437
hi I am 22 female a few weeks ago I noticed that the last few weeks i had air filled bubbles on my hands and fingers and didnt know what it was. at first i thought it was poison ivy cause my palms were very itchy and cause of the bubbles on my hands and fingers cause poison ivy does that too but now the bubbles r gone and my hands r peeling like crazy so i looked on a website and found this condition that it brought up so this must be what is wrong with me cause it tells me all the same symptoms that I have had since I have had it. this condition is called Exfoliative Keratolysis. and I am not sure what to do about it. I have no medical card or anything so maybe a few of u can tell me more about this condition. to give me more information about it.

Thanks so much!
Meg
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Avatar_m_tn
My son has this severely when he sails.  Unfortunately he is a sailing instructor and it lasts all summer.  Apparently fishermen also get it.  
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Avatar_f_tn
Which life-altering event would help explain KE?  Take your pick of death in the family, job change,moving, getting married/divorced, menopause, becoming the victim of a crime or any sort of victim for that matter, etc. I'll choose menopause.  It just seems to me that it changed my physiology in ways I never dreamt.  I was expecting hot flashes, changes in my figure, but not this.  My palms are ravaged and the dry, peeling areas only seem to spread.  I've tried steroids, Vit A, UV treatments and nothing but nothing is working.  I'm just glad to think it's not psoriasis (yet) and I won't be a candidate for psoriatic arthritis hopefully.
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Avatar_f_tn
I thought of sanding my palms but they seem to always be in the sore, peeling stage.  I don't know which is worse: the hard skin where you can't even stretch your hand out or the peeling.  Both are horrible.  And perhaps if a person didn't have to pee every hour or more often, you wouldn't have to wash your hands that much more.  No-win situation.  I think for me it's old age starting to happen when your body basically turns against itself.
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Avatar_m_tn
Thanks for the advice. I have the exact same situation as you described.  I did do the photo therapy and it did not help one bit. It was a huge waste of time and a lot of money.
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Avatar_m_tn
hey joe

can you please tell me what kind of sandpaper you use?

can you link me a picture of it?

i cant seem to find it anywhere online.

thank you
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Avatar_f_tn
My 9 year old has EK we think.  He is allergic to many things.  As a 9 year old boy he will play and play as a kid does not caring much for the skin on his hands.  As a parent I have had to try and find a solution that does not put him in a bubble.  I am currently using lanolin on him at night -the kind used by breastfeeding mothers- which is so refined as to not trigger his sheep allergy, and then in the morning I spray his hands with liquid bandage spray (isooctane, methyl trimethicone, acrylates/dimethicone copolymer).  I am currently looking for the liquid bandage spray in bulk as the 1 oz bottles get expensive quick.  I double spray his hands before swimming and diving lessons/play.  This works, it does not fix the problem, but it helps.  Spraying before swimming or other water activity or other hard play lets him live a life more like other little boys.  Mostly.  Maybe this will help some of you all too.
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Avatar_m_tn
The steroids do clear it up. My boyfiriend has been diagnosed with EK since 1982. Went through several tests in Indianapolis and nothing was found. No allergies to anything. His also goes away in October and ususally comes back around early March. We both at first thought that maybe grass pollen was causing it but after reading all these blogs and not having an allergen to grass, I know that it is probably not due to the grass. He gets aggrevated every year but he deals with it. This year doesn't seem to be as intensified. I'm wondering if some of you are correct about the stess making it worse. When I met him, he was going through a divorce and it was really bad. I do know that strees makes psoriasis worsen. Since he has been divorced for four years, I notice it being a little better. If anyone finds a cure, be sure to blog it to all the other suffers. Thanks.
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5793907_tn?1374395602
Two days ago, it was an important day in my life. For the first time in about 25 years, and thanks to this forum, I found out the name of the problem that is affecting my hands and feet for this long: exfoliative keratolysis. None of the 4 or 5 dermatologists I'd seen could even name it.

It's been a long reading, but I've read through all your comments. Many of them, very interesting.

I'll probably post many things, but there is a first question that hits my curiosity. I'm not sure, but this may be one of the most active forums about EK in the world. If you do a web search, you find it. Whoever wants to find it, will find it. So, if there was someone in the world doing serious research on this specific topic (EK), I mean in a good lab, being paid with public or private money, trying to go to the ROOT of this problem, along a biochemical/genetic line of study, don't you guys think that he/she would have already searched for that topic, and would have found this forum? If so, why hasn't he/she said anything? Something like "I work in a team that is assessing possible genetic correlation between individuals who suffer this condition", or "we are studying lack of enzyme XXXX, which might be responsible for the dehydration". Anything that could give us some hope, or at least that could make us think that someone in this planet, with the appropriate background and material resources, is devoting time to our specific problem, is trying to find its root cause, and has an enthusiasm to find a cure. Because it is good that we don't give up, and try things by ourselves, like the ceramides creams, the gloves, or the sandpaper, but this is sad. I can't believe that there are zero resources in the world being (seriously) devoted to this, but I don't see any comment on that line in this forum. Is it confidentiality? They don't have to reveal any detail. A few words could mean a lot, to us. And I don't know about the dermatologists you've met, but the ones I've met will never find a cure. You can't finish a journey for which you don't make the first step.

So, if there is a person doing serious lab research about exfoliative keratolysis who is reading this forum, please give us a sign. We don't need much details. Just a sign, up to where you are allowed to. Thank you.

César
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5793907_tn?1374395602
I meant "much detail".
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Avatar_m_tn
I Suffer from EK for 10 years.
Does anyone tried magnesium intake?
Some nails and the skin under it is also abnormal.
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Avatar_f_tn
My 11 year old son has E K and had allergy tests done. He's allergic to Mercaptobenzothiazole, bronopol (preservative), mercapto mix and balsam of peru. His dermatologist told him to avoid these things (which is nion impossible) but they are the cause of his E K.

His hospital also make him a special cream which really does help.

So for everyone who suffers demand Allergy tests and ask your dermatologist to contact Gloucester Royal Hospital UK for the ingredients of Chelsea Night Mix.
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Avatar_f_tn
Like the majority of people here I finally diagnosed myself: exfoliative keratolysis thanks to Dr Google. I did see a doctor months ago but all she said was 'it's eczema, wear rubber gloves when washing up'. Umm I do. That was as far as we got.

I tried Urea cream but all that did was make the peeling less obvious. Mine doesn't get better or worse seasonally. It's a continuous cycle of little red dots that turn into little white blisters that then 'burst' into little circles of peeling that spread out then before the peeling heals I get little red dots then little white blisters then peeling .... and on it goes. It's not itchy or painful but I do seem to have a kind of numbness in the area.

I've tried aloe vera, over the counter Urea cream, lavender oil and papaw ointment. I haven't avoided water, my will for cleanliness is too strong! Then I read Joe's treatment of exfoliating. It's worked better than anything else I've tried in conjunction with using papaw ointment and pure coconut oil with white cotton gloves. It hasn't 'cured' the EK but has made it so much better.

Every day I use a pumice stone and rub the red dots/blisters off. Then I mix Lucas's Papaw (available in Australia) and Pure Coconut Oil on the area then wear a cotton glove 24/7 at home. I re-apply the papaw and oil every few hours. When I first started this treatment, 3 weeks ago, I wore the glove at work too. I don't wear the glove at work now but I still need to slather on the papaw ointment every couple of hours or it starts looking poxy again.

It's reached the stage now that I can go out in public and not scare people. You'd have to look closely to see the slight peeling I have now.

I believe it's an auto-immune disease. They say if you have one auto-immune disease others will follow. I've had about 5 of them i.e fibromyalgia, polymyalgia, controlled Type 2 Diabetes, Rheumatoid Arthritis, chronic urticaria and angioedema. Funnily when the EK appeared my chronic urticaria and angioedema went into remission. I'm happy about that! I'd rather deal with EK than throat and tongue swelling and landing in ER. (4 times in 4 years). Yay!
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Avatar_f_tn
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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Avatar_m_tn
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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Avatar_m_tn
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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