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Dermadoc
Dermadoc, Board Certified Dermatologist
Category: Dermatology
Satisfied Customers: 2390
Experience:  MBBS, DNB DERMATOLOGY
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Occasionally, my knuckles (both hands) will very suddenly turn

Customer Question

Occasionally, my knuckles (both hands) will very suddenly turn beet red (rash-like), sometimes with what appears to be little blood spots and splits in the skin. When this occurs, it's extremely painful. Applying lotion of any kind will usually make it even more painful, and causes a burning sensation. Most of the time, it disappears within anywhere from 10-15 minutes to an hour (although on occasion, the knuckles remain red or pink for many hours afterwards).

This is a fairly new phenomenon for me. I don't know if there's an actual pattern in terms of what triggers it, although occasionally it happens after I've washed my hands. I don't think it's a reaction to the soap.

I'm reasonably sure this has something to do with dry skin, especially at this time of year when it's already pretty dry. I'm sure washing hands doesn't help dry skin, but since this has only been happening this year, I don't want to assume anything. Can you tell me what's causing this - and what I can do to prevent it from happening? When it does happen, what's the best product to use to relieve the pain/burning?
Submitted: 2 years ago.
Category: Dermatology
Expert:  Dermadoc replied 2 years ago.

Dermadoc :

hello

Dermadoc :

do you have a photo which you can post here?

Dermadoc :

do the knuckles go pale before becoming red?

Dermadoc :

it could be what we call raynaud's phenomenon.

Dermadoc :

you can go through this link.

Dermadoc :

you can tell me if thats matching with your concern.

Customer :

You're back!. I actually posted this question for you yesterday (I'm the one with the cyst - which, by the way, isn't MRSA (I tested negative). No, I don't have a photo, and I don't recall noticing my knuckles looking pale before this occurs. I am noticing lately that my knuckles sometimes feel like sandpaper.

Dermadoc :

i am sorry, i dont think i have answered a question on cyst for you.

Dermadoc :

but its good that you tested negative for mrsa

Dermadoc :

feel like sandpaper is indeed indicative of very rough and dry skin.

Dermadoc :

washing hands frequently can dry out the skin quite a bit.

Dermadoc :

you need to apply aveeno moisturizing cream on the knuckles when they are wet to trap the moisture in.

Customer :

Are you Dr. Oppenheim? If not, my mistake. I will check out the link (I'm somewhat familiar with Raynaud;s). This only happens occasionally, and does seem to be connected to dry skin (but maybe I'm wrong). I don't like the overall picture this is painting. I just (more or less) ruled out having Sjogren's Syndrome, and now I'm having weird cysts, which we know can be connected to autoimmune conditions.

Dermadoc :

i am sorry, i am not dr. oppenheim.

Dermadoc :

please check out the link and let me know.

Customer :

Okay.

Dermadoc :

ok

Customer :

Well - there are some similarities, but from what I'm reading, it sounds like it affects the fingers, not just a few knuckles.

Dermadoc :

yes, you are right.

Dermadoc :

but sometimes the hand can be affected, its just a possibility i wanted to bear in mind according to your symptoms.

Customer :

When the symptoms do affect the hands, does Raynaud's cause the area to feel extremely dry?

Dermadoc :

dryness is usually not a known part of it, but it can happen.

Customer :

When this is happening, I also occasionally see what looks like tiny cuts/slits on my knucles (like you'd see with very dry lips).

Dermadoc :

that can happen, its aggravated due to the dryness you are facing.

Customer :

I looked at some photos of Raynaud's online, and they show extremely pale (almost white) fingers in contrast to the red areas. I don't see anything like that (although my skin is naturally pale to begin with). So are you inclined to think this is more a dry skin issue?

Dermadoc :

yes, i will consider it a dry skin issue. please apply the moisturizing cream on the wet skin, that will help a lot. also you can take evening primrose supplements. that helps in making the skin soft and supple.

Customer :

I also rarely wash my hands in cold water (usually luke warm to very warm). Would running my hands under cold water (in an attempt to produce symptoms) be a good test? Should cold water always trigger this?

Dermadoc :

i dont recommend you do the test on your own. cold water triggers it if you have raynaud's phenomenon. i would recommend that you let yur doctor do the test for you so he can evaluate it well.

Customer :

Well, I may encounter cold water before I manage to be in a doctors office. Is it dangerous to run my hands under cold water if there's a chance this is Raynaud's? It isn't fatal, right? As I mentioned; when this happens and I attempt to apply lotion, it usually causes burning and increased pain. Maybe I need to use an Aveeno-like lotion only.

Dermadoc :

its not fatal.

Dermadoc :

its ok.

Customer :

Given the fact that I generally don't wash in cold water (I think the last time this happened, the water was luke warm), wouldn't this probably rule out Raynaud's?

Dermadoc :

yes, it does rule it out considerably, thats why i am recommending that you try out the moisturizer the way i suggested.

Customer :

In the (hopefully unlikely) event that this IS Raynaud's, how does condition this affect people long-term?

Dermadoc :

these are the complications:-

Dermadoc :

  • Gangrene or skin ulcers may occur if an artery becomes completely blocked (most likely to occur in people who also have arthritis or autoimmune conditions)

  • Permanently decreased blood flow to the area can lead to thin and tapered fingers, with smooth, shiny skin and slow growing nails

Dermadoc :

please let me know if you have any queries.

Are you finding this answer useful?

hope this answer was useful. please click on the green accept button if so. any bonus and positive feedback would be appreciated.

Customer :

Can these symptoms be prevented with proper care/treatment? (BTW, the other doc I refered to on this site uses the name Dermdoc).

Dermadoc :

yes he is dermdoc 19

Dermadoc :

yes, with proper care, these symptoms can be prevented.

Dermadoc :

Avoid exposure to the cold. Dress warmly when you cannot avoid cold. If you smoke, stop smoking, as it further constricts the blood vessels.

Customer :

I don't smoke. Does anything other than exposure to cold trigger Raynaud's symptoms?

Dermadoc :
  • Avoid caffeine

  • Stop and avoid medications that cause tightening or spasms of the blood vessels

  • Keep the body warm. Avoid exposure to cold in any form. Wear mittens or gloves outdoors and when handling ice or frozen food. Avoid getting chilled, which may happen after any active recreational sport.

  • Wear comfortable, roomy shoes and wool socks. When outside, always wear shoes.

Dermadoc :

please let me know if you have any queries.

Are you finding this answer useful?

hope this answer was useful. please click on the green accept button if so. any bonus and positive feedback would be appreciated.

Customer :

Yes - but does anything OTHER THAN COLD STIMULATION cause Raynaud's symptoms?Interesting. As I'm sitting here typing, several knuckles have turned a bit red (two with little 'cuts), and they're moderately painful (I applied lotion several times prior to this happening, obviously to no avail). Does Raynaud's just happen spontaneously?

Dermadoc :

no, it doesnt happen spontaneously.

Dermadoc :

Raynaud's phenomenon can be associated with other conditions. This is called secondary Raynaud's phenomenon.

Common causes are:

Raynaud's phenomenon also occurs without another disease, medication, or cause. This is called primary Raynaud's phenomenon.

Customer :

I see that stress can be a trigger (and I suppose that may cause a spontaneous attack). When I think about it, this started when the weather turned colder and the air dryer. Since this has only happened when I'm at home (which means the outdoor temperture isn't a trigger) - and since I wash my hands all year round, dry skin must be a major factor (if not the sole cause). Don't people with Reynauld's have symptoms year round if they wash their hands in too-cold water, take things out of the fridge/freezer, etc.? Sorry to toss so many questions at you......

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