Persistent Dry Cracked Skin: Seeking Effective Treatments and Solutions - Dermatology

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Why won't the dryness, cracking, pain, and itching in my hands and feet heal?


My mother started experiencing dry and cracked fingers over a year ago.
She has visited dermatology multiple times, and the doctors prescribed topical medications, but her condition has not improved and has actually worsened.
Initially, it was only her hands, but now her toes are also experiencing dry and itchy symptoms.
After a year of ineffective treatment from Western medicine, she began to explore some alternative therapies, but they have also been ineffective.
Now, every finger on both hands looks like it has a hard shell, is very rough, and often cracks.
She frequently complains of pain and itching.
Someone mentioned that it might be due to a change in her constitution.
If the skin symptoms are indeed caused by a change in constitution, which specialty should she consult?

A Qiao, 20~29 year old female. Ask Date: 2002/05/19

Dr. Chen Yiying reply Dermatology


Hello, Ms.
A-Qiao; it would be advisable for your mother to consult a dermatologist.
She may be experiencing contact dermatitis, and if she continues to have prolonged exposure to irritants such as cleaning agents, it may be difficult for her condition to improve.
Of course, there is also the possibility of some rare diseases, so I recommend seeking further evaluation and treatment at a major hospital.

Reply Date: 2002/05/19

More Info


Persistent dry and cracked skin can be a frustrating and painful condition, especially when it affects daily activities and quality of life. Given your mother's situation, it seems that she has been experiencing a worsening of symptoms despite multiple visits to dermatologists and various treatments. This condition could be indicative of several underlying issues, including eczema, psoriasis, or even a form of dermatitis, which can be exacerbated by environmental factors or changes in skin care routines.


Understanding the Condition
1. Possible Causes:
- Eczema: This is a common condition that can cause dry, itchy, and cracked skin. It often flares up due to environmental triggers such as cold weather, low humidity, or irritants like soaps and detergents.

- Psoriasis: This is a chronic autoimmune condition that leads to the rapid growth of skin cells, resulting in scaling and dryness.

- Xerosis: This refers to abnormally dry skin, which can occur due to aging, environmental factors, or underlying health conditions.

- Contact Dermatitis: This can occur when the skin reacts to certain substances, leading to dryness and cracking.

2. Impact of Age: As people age, their skin tends to lose moisture more easily, which can lead to increased dryness and cracking. This is often compounded by factors such as decreased oil production and changes in skin barrier function.


Recommended Treatments
1. Moisturizers: The cornerstone of treatment for dry skin is regular and effective moisturizing. Look for products that contain ingredients like:
- Urea: Helps to hydrate and soften the skin.

- Glycerin: A humectant that draws moisture into the skin.

- Ceramides: Help restore the skin barrier and retain moisture.

- Petrolatum or Mineral Oil: These occlusive agents can lock in moisture and provide a protective barrier.

2. Topical Steroids: If there is significant inflammation or itching, a mild topical steroid may be prescribed to reduce these symptoms. However, these should be used under the guidance of a healthcare provider to avoid potential side effects.

3. Avoid Irritants: It’s essential to identify and avoid any potential irritants that may be exacerbating the condition. This includes harsh soaps, hot water, and certain fabrics.

4. Humidifiers: Using a humidifier in the home, especially during dry winter months, can help maintain moisture in the air and prevent skin from drying out.

5. Diet and Hydration: Encourage your mother to stay hydrated by drinking plenty of water and consuming a balanced diet rich in omega-3 fatty acids, which can help improve skin health.


When to Seek Further Help
If your mother’s condition continues to worsen despite these interventions, it may be beneficial to consult with a specialist. Here are some options:
- Dermatologist: If she hasn’t seen a dermatologist recently, it may be worth seeking a second opinion or a referral to a specialist who focuses on chronic skin conditions.

- Allergist: If there is a suspicion of contact dermatitis, an allergist can perform patch testing to identify specific allergens.

- Rheumatologist: If there are concerns about autoimmune conditions, a rheumatologist may be able to provide insights and treatment options.


Conclusion
Persistent dry and cracked skin can be a complex issue requiring a multifaceted approach. It’s crucial to continue seeking medical advice and exploring different treatment options until a suitable regimen is found. Encourage your mother to maintain a consistent skincare routine, avoid irritants, and stay hydrated. If the condition persists or worsens, further evaluation by a specialist may be necessary to identify any underlying health issues that could be contributing to her symptoms.

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