What is the treatment for xerosis (dry skin) and fissures on the hands of a 71-year-old female?

From the Guidelines

For cracked, dry hands in a 71-year-old female, I recommend starting with a gentle, fragrance-free moisturizer like CeraVe, Eucerin, or Aquaphor applied multiple times daily, especially after handwashing, as suggested by the most recent evidence 1. To manage cracked, dry hands effectively, consider the following key points:

• Apply a thick layer of petroleum jelly (Vaseline) or a healing ointment at bedtime and wear cotton gloves overnight to enhance absorption.
• Avoid hot water when washing hands and use a mild, soap-free cleanser, as hot water and harsh soaps can strip the skin of its natural oils, exacerbating dryness 1.
• For more severe cases, consider using a urea-containing cream (like Eucerin Advanced Repair with 5% urea) which helps exfoliate dead skin while moisturizing, as urea is known for its humectant properties that help retain moisture in the skin.
• If there's inflammation or the skin is very painful, a short course of a low-potency topical steroid like hydrocortisone 1% cream twice daily for 3-7 days may help, but should not be used long-term due to potential side effects such as skin thinning 1.
• Ensure adequate hydration by drinking plenty of water and consider using a humidifier in the home, especially during winter months when indoor heating can further dry the skin, as maintaining a humid environment can help prevent water loss from the skin 1.
• Avoid irritants and allergens, and be cautious with the use of alcohol-based hand sanitizers, opting for those with at least 60% alcohol and added moisturizers to minimize dryness 1. Aging skin naturally produces less oil and has a weaker skin barrier, making older adults more susceptible to dry, cracked hands. Thus, a comprehensive approach that includes gentle skin care, moisturizing, and protection against irritants is crucial for managing and preventing dry, cracked hands in this population.

From the FDA Drug Label

Directions for itching of skin irritation, inflammation, and rashes: adults and children 2 years of age and older: apply to affected area not more than 3 to 4 times daily Purpose Anti-itch

The treatment for cracked dry hands in a 71-year-old female is not directly addressed in the provided drug labels.

• The labels mention itching of skin irritation, inflammation, and rashes but do not specifically mention cracked dry hands.
• The labels provide dosage instructions for itching of skin irritation, inflammation, and rashes but do not provide guidance for cracked dry hands 2, 2. The FDA drug label does not answer the question.

From the Research

Treatment Options for Cracked Dry Hands

• Applying topical products to replenish lipids and reduce water loss, as suggested by 3, can help manage dry skin in older adults.
• Emollient therapy, involving the use of bath emollients, soap substitutes, and leave-on emollient lotions, creams, or ointments, can be beneficial in managing dry skin conditions, as discussed in 4.
• Suitable skin care products should be chosen to improve skin hydration and restore its barrier function, with a focus on rehydrating and lipid-replenishing components, as recommended in 5.
• Ingredients such as urea, dexpanthenol, and licochalcone A can be effective in treating xerosis cutis, depending on the individual symptoms, as noted in 5.
• Restoring physiologic lipids in the epidermis and providing substances that facilitate epidermal differentiation can help treat xerosis, as mentioned in 6.

Considerations for Older Adults

• Dry skin in older adults can be exacerbated by chronic health conditions and physiological changes associated with aging, as highlighted in 3.
• Comprehensive treatment of xerosis and pruritus is essential to prevent stasis dermatitis and ulcer formation, as emphasized in 7.
• Maintaining or increasing fluid intake, limiting sun exposure, and reducing symptoms of chronic illnesses can also help manage dry skin in older adults, as suggested by 3.