From the Guidelines
Severe skin sloughing and cracking of the fingers should be treated with a combination of topical moisturizers, corticosteroids, and protective measures, and if inadequate control is achieved, consider alternative diagnoses and additional treatments such as phototherapy and/or systemic agents. When treating severe skin sloughing and cracking of the fingers, it is essential to identify and remove any potential irritants or allergens causing the condition. Apply a thick, fragrance-free moisturizer like petroleum jelly (Vaseline), CeraVe, or Eucerin several times daily, especially after washing hands. For inflammation and itching, a topical corticosteroid such as triamcinolone 0.1% or fluocinonide 0.05% cream can be applied twice daily for 1-2 weeks. Some key considerations for treatment include:
- Applying topical moisturizers and corticosteroids as needed
- Protecting the affected area with cotton gloves or bandages
- Avoiding harsh soaps, hot water, and frequent hand washing If symptoms persist or worsen, it is crucial to consider alternative diagnoses, such as contact dermatitis or cutaneous lymphoma, and additional treatments, as suggested by the guidelines of care for the management of atopic dermatitis in adults with phototherapy and systemic therapies 1. In cases of infection, topical antibiotics like mupirocin or oral antibiotics such as cephalexin 500mg four times daily for 7-10 days may be necessary. For severe cases, prescription treatments like tacrolimus ointment or oral immunosuppressants might be required, and consultation with a dermatologist is recommended for further evaluation and treatment. These treatments work by restoring the skin barrier, reducing inflammation, preventing infection, and allowing the skin to heal, ultimately improving morbidity, mortality, and quality of life.
From the FDA Drug Label
Directions adults and children 2 years of age and older clean the affected area apply a small amount of this product (an amount equal to the surface area of the tip of a finger) on the area 1 to 3 times daily may be covered with a sterile bandage The treatment for severe skin sloughing and cracking of the fingers is to clean the affected area and apply a small amount of bacitracin (TOP) product, which can be done 1 to 3 times daily. It is also recommended that the area may be covered with a sterile bandage 2.
- Key points:
- Clean the affected area
- Apply a small amount of product
- Apply 1 to 3 times daily
- May be covered with a sterile bandage Note that the provided drug label does not explicitly address severe skin sloughing and cracking, but it does provide general guidance on the use of bacitracin (TOP) for minor cuts and scrapes 2.
From the Research
Treatment for Severe Skin Sloughing and Cracking of the Fingers
- The treatment for severe skin sloughing and cracking of the fingers may involve the use of moisturizers and barrier creams to help repair and protect the skin 3.
- A study found that daily wearing of fabric gloves to prevent loss of moisture and lipids from the surface of the hands has been regarded as good in the management of hand eczema, which can cause skin sloughing and cracking 4.
- Emollient creams, such as those containing urea and glycerol, have been shown to improve the skin's barrier function and reduce dryness and irritation 5.
- Topical corticosteroids may not be suitable for use in cases where infection is the known cause of the disease, as they can increase susceptibility to bacterial and fungal infections 6.
- Antibiotic therapy may be necessary in cases where bacterial infections are present, such as in severe staphylococcal and streptococcal infections 7.
Prevention of Skin Sloughing and Cracking
- Preventive measures such as wearing protective gloves, using barrier creams and moisturizers, and practicing good skin care habits can help prevent skin sloughing and cracking 3.
- Skin protection education may also be beneficial in preventing occupational irritant hand dermatitis, which can cause skin sloughing and cracking 3.
- Regular and liberal use of emollients is recommended for all patients with eczema, even between episodes of itching and redness, to soften and soothe the skin 5.