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Painful skin cracks

Q:

Every year when the weather turns cold, I develop painful cracks in my fingers. At times, the pain is so intense that I almost can’t use my hands. What’s the best way to treat these cracks? Can I prevent them in the first place?



Paul Anthony, Washington, PA


A:

Rhonda Karol, a dermatologist in Forest Hills, N.Y., responds: Because cold air does not hold moisture as well as warm air, cold weather can irritate the skin and cause chafing, dryness, and—as you’ve discovered—even cracks.

Year-round, especially in the winter, avoid frequent handwashing, because this can dry the skin further. When you do wash your hands, use mild, unscented, hypoallergenic soaps. Use protective, nonlatex gloves when performing wet work on the job and at home. Several times throughout the day, particularly after washing your hands, apply a moisturizer.

Petrolatum-based products (that is, those that contain petroleum jelly) are often best, but because they can feel greasy, you might choose to use a lighter, less greasy moisturizer during the day and a petrolatum-based moisturizer in the evening. When outdoors, protect your hands with warm gloves. If cracks or fissures develop, continue using these moisturizers to prevent further disruption of the skin barrier and to promote healing.

Topical antibiotic ointments can help by preventing infection or treating infection if the open area has become colonized with bacteria. Unfortunately, there can be allergic reactions to over-the-counter antibiotic ointments. People can develop allergic reactions to a wide variety of ingredients in moisturizers as well, though reactions to petroleum jelly are uncommon.

If the fissures do not respond positively to these measures, consult a dermatologist, because a variety of conditions such as eczema, contact dermatitis, psoriasis, and even fungal infections also can cause fissuring of the skin. A dermatologist can help to determine the cause of the cracking and recommend treatment with appropriate prescription medication.



From Fine Homebuilding 225, pp. 80 January 19, 2012