Fingertips. Fingertips. Fingertips. (I hear the wind blow...)

September 25, 2008 5:15 PM

What is wrong with the skin on my hand?

I have had a history of dry skin on my hands, and of course it gets worse in the winter. There's something new this year, though. I've had these patches of itchy dry skin on my fingers for years now, but this is the first time it's had an effect on the growth of a nail. Here is a not very gross, but kinda big picture with notes as to what's going on. The right hand has several patches, the left only has a little patch on the ring finger. I've been moisturizing the hell out of it, especially every time I wash my hands.

Does anyone else have something like this? Is it something beyond just plain dry skin? What should I do to treat it?

posted by buriednexttoyou to health & fitness (16 comments total)

Go see a doctor, and get a referral to a dermatologist.
posted by flabdablet at 5:26 PM on September 25, 2008

Psoriasis can affect the nails, in a similar fashion. From my experience, it's more of a pitting, though.

Hie thee to a dermatologist and DO NOT GOOGLE psoriasis nails because it'll only show you horrifying and extreme cases (also from my [brand new two minutes ago] experience).
posted by mimi at 5:37 PM on September 25, 2008

Your pictures are very insightful :) However... you really need to see a doctor about this. Your nails can tell you about your overall health, not just your skin/nail health. Problems like thyroid issues and chronic lung disease can present in nails. Here is an interesting slideshow from the reputable Mayo Clinic about nail problems:

http://www.mayoclinic.com/health/nails/WO00055
posted by FergieBelle at 5:39 PM on September 25, 2008

That is not ordinary dry skin. That is something you need to see a doctor about. Good luck!
posted by Sidhedevil at 6:09 PM on September 25, 2008

It's eczema. If it has to do with eczema and hands, I've dealt with it. The skin shedding in spotty patches? Had it, it was eczema. The puffy cuticle and resultant deformed fingernail? Had it twice (eczema) and it takes for ever to grow out.

You do need to go the doctor, because you're going to beat it much easier with topical steroids that are stronger than you can get OTC. But don't let the alarmist answers here scare you. It's clearly eczema, and you'll feel 95% better within 48 hours of seeing a doctor.

If you don't have health insurance or something awful like that, get 1% hydrocortisone ointment from the drugstore along with a moisturizing cream that has urea in it (like Eucerin in the plastic tub, but get the generic equivalent if possible because that stuff's expensive.) Apply the ointment twice a day and the Eucerin whenever you think about it.

You're not terribly sick, you don't have a tropical fungus, you have a form of hypoaquatic eczema. You will probably not even need a referral to a dermatologist unless your GP is really overcautious.

You can mark this response as "best answer" when you get back from the doctor.
posted by Mayor Curley at 6:44 PM on September 25, 2008 [4 favorites has favorites]

i also believe it is probably eczema. you could try the OTC stuff, but you're really going to do better going to a doc and getting a script. it will take a while for the nail stuff to work itself out, but if you keep on top of it, it will get better.

and i have to say those are some of the best "diagnose this" pics i've ever seen on metafilter!
posted by misanthropicsarah at 6:50 PM on September 25, 2008

Looks like either psoriasis or eczema. The former is characterized by pitting (little holes) in the finger nails. But you should have a dermatologist diagnosis it.
posted by mikeand1 at 7:44 PM on September 25, 2008

What do you do for a living? I am a bartender, and your condition looks a lot like "bar rot," a condition many bartenders get from cutting and handling citrus (limes, lemons, etc.). Strangely enough, the best cure for this seems to be creams and gels intended for athlete's foot. It works a charm.

Though, it's probably eczema.
posted by AlliKat75 at 7:47 PM on September 25, 2008

What do you do for a living?

I'm a hand model.

No, I'm an illustrator who's working on sloughing the skin of a bank teller. So, no citrus-centric occupations here.

Thanks to those who recommended a visit to the dermatologist's, but I've been to plenty of them over the years, and they just don't stack up against you MeFites. They don't care as much, and they cost a lot more. I'd much rather get advice from people who have had this than from people who have seen this.

And thanks for the compliments on the photos, misanthropicsarah. Flickr's in the profile. ;)
posted by buriednexttoyou at 8:44 PM on September 25, 2008

along with a moisturizing cream that has urea in it

Well, somebody has to say it: try peeing on your hands in the shower.
posted by bink at 10:52 PM on September 25, 2008

I would agree that it looks almost certainly like exzema. After highschool I worked in a restaurant for about 5 years and all of the fluids (citrus, animal blood(s), detergents, hot/cold water,etc) damaged the skin on my hands to the point where it now doesnt grow/heal as fast as it should (basically I have permanent exzema., doesnt help that I live in a very dry climate) I have a prescription for a topical steroid cream/lotion that I use daily and totally kicks ass. (except for the part about having to use it for the rest of my life)
posted by jmnugent at 2:21 AM on September 26, 2008

You know it already of course, but it's eczema. My hands look exactly like yours, including the uneven ridging in the nails.

A few tips from someone who's had this since early childhood (about 35 years):

1. Topical steroids (if you're prescribed them): wash your hands first (no soap), pat them dry, and apply your steroid cream/ointment thinly. Never use the cream/ointment over the top of a moisturiser, cream or any other potion - it'll be much less effective. Don't be tempted to overuse the cream - that does more harm than good.

2. Avoid using soaps if you can. I use this stuff instead of soap, shampoo or shower gel and I find it much less hostile to my skin than conventional products.

3. Apply the cream/ointment for at least a couple of days after all signs of the eczema have gone; otherwise it will reappear in the same area (it tends to lie 'dormant' below the surface).

4. You may find that an ointment (paraffin-based) works better than a cream - it tends to stay on the skin better, and may cause less irritation. In my case, all creams seem to cause irritation, but that's not the norm.

5. Be careful with moisturising - your skin may be dry, but many moisturisers will aggrave the eczema. Sometimes it's better to apply a barrier such as petroleum jelly to prevent moisture loss and let the skin rehydrate itself on its own.

6. Watch out for dietary triggers - for me it's peanuts and beer (damn you, vindictive gods!) - they make my eczema itch like crazy.

7. Urea - definitely something to try, as urea deficiency is part of eczema. Try a proper cream rather than peeing on your hands; it really needs to be in an oil/water emulsion to penetrate the skin properly. But, as with any moisturiser, stop using it and switch to something else if it causes any further irritation.

8. Eczema may recur in cycles over several years, or it may clear up and disappear altogether. But with the right regimen of steroids and moisturisers will manage it effectively.
posted by le morte de bea arthur at 3:43 AM on September 26, 2008

FTW; some of the best medical pics we've had to work with.

If the doctor gives you cortisone, it's helpful to baste it at bedtime and wear cotton gloves. Nothing occlusive, cotton. That's 8 hours during which you are less likely to wash your hands all the time, and possibly forget the goop or blow it off this time. Occlusive is bad, because those drugs are designed to be used where they are exposed to air. The gloves just keep it from rubbing off on the sheets so it stays in contact with the skin.
posted by unrepentanthippie at 10:06 AM on September 26, 2008

There are different ointments prescibed for eczema. If the first one doesn't work well, ask for another; don't give up. The right cream will make a huge difference.
posted by wryly at 10:38 AM on September 26, 2008

I really like Neutrogena's Norwegian hand cream for my eczema -- kind of like petroleum jelly, but slightly less greasy and slightly more moisturizing. I use it 1-2x a day or so, and it really helps prevent flare ups. (It doesn't work very well to treat flare ups once they've appeared though. I need prescription steroids for that.) As others have noted, finding the right moisturizer is key. The lighter creams, including over-the-counter hydrocortisone creams, mostly irritate my skin and make me more prone to eczema patches. So, if you go the OTC hydrocortisone route, definitely get the ointment (petroleum jelly based) instead of the cream.

(BTW, here's what I'm talking about: http://www.drugstore.com/qxp17010_333181_sespider/neutrogena_norwegian_formula/hand_cream_fragrance_free.htm)
posted by pitseleh at 10:26 PM on September 26, 2008

I'm a bit late to this question, but I just wanted to add that I have had problems with eczema for years and have recently discovered the miraculous cure that is tea tree oil (melaleuca). I keep a bottle of full strength essential oil in the medicine cabinet and rub it directly on the affected area when I have an outbreak. If I apply twice a day, it usually clears up in a few days with the tea tree oil. It's fantastic. I used to use prescription cortisone applications (and also urea), but found that while it helped with the itchiness, it never really got rid of things altogether, so I'd be treating the same patches on and off all winter. With the tea tree oil, the stuff just seems to vanish.
posted by amusebuche at 8:19 PM on September 27, 2008