What is the treatment for cracked skin around the fingernails?

Treatment of Cracked Skin Around Fingernails

For cracked periungual skin, apply topical petrolatum daily as the primary treatment, combined with gentle skin care and avoidance of moisture and trauma. 1, 2

Primary Treatment Approach

Daily application of topical emollients to cuticles and periungual tissues is the cornerstone of management. 1 Specifically:

• Apply petrolatum around the nails due to its lubricant and smoothing effects on the skin, which prevents evaporation of moisture by forming a protective film on the surface 1, 2
• Use hypoallergenic moisturizing creams or ointments once daily to smooth the skin and prevent dryness 1, 2
• Begin moisturizer treatment immediately and continue consistently 1

Essential Preventive Measures

Keep hands dry and out of water whenever possible to prevent further maceration and cracking 1, 2:

• Wear gloves while cleaning or doing wet work 1
• Pat skin dry after washing rather than rubbing 1
• Use gentle, pH5 neutral soaps and tepid water for hand washing 1, 2

Avoid all trauma and manipulation of the periungual area 1, 2:

• Do not trim cuticles, as this increases risk of infection and worsens cracking 1
• Avoid biting nails or picking at the skin 1
• Cut nails straight across and not too short 1, 2
• Avoid friction and excessive pressure on the nail folds 1, 2

Treatment for Inflammation or Infection

If there is associated redness, swelling, or pain suggesting inflammation or early paronychia, apply high-potency topical corticosteroids 1, 2:

• Use high-potency topical corticosteroids alone or combined with topical antibiotics for self-limited lesions 1
• Apply to nail folds twice daily 2
• Hydrocortisone 1% cream can be effective for milder cases 1

For suspected secondary infection, consider antimicrobial treatment 1:

• Topical povidone iodine 2% twice daily has shown benefit in controlled studies 1
• Use antimicrobial soaks and washing with cleansers 1
• Oral antibiotics may be needed if infection is established 1, 2

Important Treatments to Avoid

Do not use greasy creams for basic care, as they may facilitate folliculitis development due to occlusive properties 1, 2

Avoid topical acne medications (including retinoids), as they may irritate and worsen the condition through their drying effects 1, 2

Use topical steroids cautiously and only under supervision if prolonged use is needed, as they may cause perioral dermatitis and skin atrophy if used inadequately 1, 2

Additional Supportive Measures

• Wear fine cotton gloves when appropriate instead of synthetic materials 1
• Use only clean, smooth towels 1
• Consider oral biotin supplementation for underlying nail brittleness if present 3

Follow-Up and Monitoring

Reassess after 2 weeks of treatment 2:

• If no improvement or worsening occurs, consider alternative diagnoses such as fungal infection, eczema, or psoriasis 1
• Monitor for signs of infection development (increased pain, purulent discharge, spreading erythema) 1, 2