Painful cracks in the skin

Cracks or fissures in the skin can be particularly painful. These changes are referred to as secondary changes and result from over drying of the skin, often in individuals with actual underlying dermatitis or psoriasis. The underlying skin in those with fissures is often red, thinned, sensitive and flaky. These gaps in the skin are especially common on the hands but may occur anywhere on the skin surface. Hand fissures are more likely to appear when the hands are mistreated with frequent washing and excessive lathering of soaps that remove the skin’s natural oils or the repeated application of alcohol based antiseptic gels.

If someone wants to remove unwanted bacteria the former is probably better but the later may be less irritating. The hands are more susceptible to drying as we age though cracking occurs at all ages, especially during colder weather. Friction and handling paper and cardboard exacerbate the problem. One solution to this is using a cold air humidifier in the house which may counteract the decreased humidity from forced air and low humidity heat, another contributing factor.

If someone has a tendency to get dry or xerotic skin, then steps should be taken to prevent their development. Prudently minimize washing the hands, perhaps only when they are soiled or exposed to another person who may be carrying a viral or bacterial pathogen. Bar soaps such as Dove Sensitive Skin Beauty bar or Vanicream Cleansing Bar are far less irritating then liquid soaps that contain irritating surfactants, chemicals that reduce the surface tension thus increase lathering. Both of these options contain propylene glycol which is derived from natural gas; in its industrial form is used as anti-freeze! It is a strong skin irritant and is implicated in allergic contact dermatitis. Those allergic to propylene glycol might consider Basis Sensitive Skin Soap though this contains lanolin alcohol, another allergen/chemical that potentially causes allergies. 

Allergic contact dermatitis is diagnosed by a dermatologist or allergist who are experts in patch testing. We recommend you search for a doctor who is a member of the American Contact Dermatitis Society. You can find one by clicking here. Incidentally, if one is allergic to a particular chemical on their skin and that chemical is consumed in foods such as propylene glycol in certain brands of lite beers or various baked snacks, it may exacerbate skin dermatitis even if it does not touch the skin.Systemic contact dermatitis is something to be aware of as there are many culprits. Those allergic to nickel earrings may experience a break out on the skin when they eat nickel containing foods such as chocolate, beans, soy, or oatmeal. If allergic to formaldehyde, a preservative in many skin care products, then systemic contact dermatitis may come from aspartame, the artificial sweetener. The subject of systemic contact dermatitis is very complicated, so make sure to consult an expert.

Regarding hand dermatitis, once cracks and fissures develop it is time for lubricating the hands. Creams are more moisturizing than lotions. Ointment containing petrolatum, bees wax and shea butter are best, but many people do not like the feel of ointments on their hands. Excipial Rapid Repair hand cream is great to apply overnight and there is an Excipial daily protection hand cream to moisturize during the day and protect the hands from irritants. There is also an Excipial 20% or 10% Urea Intensive Healing Cream that is especially useful for rough cracked skin on the knees, elbows and feet. The non-greasy formulation is preferred over Vaseline for the hands and feet. On the other hand, you can always make your own natural hand moisturizer. You can learn to do so by clicking here.