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Dr. Nair
Dr. Nair, Dermatologist
Category: Dermatology
Satisfied Customers: 9190
Experience:  MBBS, MD (Dermatology, Venereology & Leprology)
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I have dry cracking skin on the palms of my hands. The cracks

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I have dry cracking skin on the palms of my hands. The cracks are quite deep. I tried cortisone cream. It seemed to help a bit but then it would stop responding and flare up again. I work in an electrical workshop and come into regular contact with copper bars & steel cutting fluid. I have been on holiday recently for three weeks and there was no noticeable improvement. It's now creeping up some of my fingers.

Would a photograph of the affected area be possible at your convenience? If not do let me know and I'll work on your question without one.
Customer: replied 4 years ago.

Thank you for the photograph. Your condition looks highly suggestive of Palmar Psoriasis. This is an autoimmune condition of the skin characterized by the skin being made faster than normal in certain areas leading to symptoms (redness, thickening and fissures). An allergic or irritant reaction to the metals and cutting fluid you are exposed to could be worsening matters but I don’t think they are the basic cause of the problem.

The condition responds best to prescription creams/ointments such as Halobetasol + Salicylic acid, Daivobet, Tazarotene. If you cannot see your doctor for these then here is an over the counter regimen that can help:

1. Cortizone cream + Mg 217 sal-acid ointment twice a day (morning & evening) over all affected areas. Mix these two creams in equal proportion before applying. Use them for 5 days consecutively followed by 2 days off and repeat the cycle (e.g use from Mon to Fri each week and take the weekend off). This preserves the cortizone creams effectiveness which can otherwise disappear with continued use due to a phenomenon called ‘tachyphylaxis’.

2. Triton Mg 217 intensive strength medicated tar ointment: apply over skin lesions once at night. Wash off in the morning. Can stain clothing so appropriate precautions should be taken.

3. Balnetar Therapeutic Tar Bath: Add to tub of water as directed on the bottle - soak hands in tub for 15-20 minutes. If this is not possible then use soapworks coal tar soap bar and leave lather on for 5 minutes. Product does not smell very good and will stain clothing but is effective.

4. Olive oil or Neutrogena body oil massage to affected areas once a day. This is optional.

NOTE: All of these are available over the counter & online at Treatment will need to be continued for 2-3 months for maximum benefit. Supplements which are useful in the condition are Vitamin A, Beta Carotene and Omega-3 fatty acid and you can take one capsule of each everyday after breakfast on a prolonged basis to help prevent recurrences.

Hope this information is useful, please feel free to ask if you have any queries.

Please remember to only rate my answer when you are satisfied. If you do have any queries please respond via the REPLY button. I will be happy to continue further and do everything I can to provide you with the service you seek.

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