This blog will explain Exfoliative Keratolysis, its causes, symptoms, risk factors, management & best homeopathic treatment to cure it completely.
It is a simple non-infective skin disease. It is also known as Lamellar dyshidrosis, recurrent focal palmar peeling, and recurrent palmar peeling.
As the name suggests ‘palmar peeling’ means skin pills from the palm region. It is characterized by dryness of skin and small air-filled superficial pustules.
It affects commonly palm and fingers. It affects rarely to soles and feet. It commonly appears in the summer season and among young active people. Cold weather, dry air, and excessive wash of hands are causative factors of skin peeling hands.
It is a harmless condition. It does not have chances of any infection and complications.
This condition has differential diagnoses like contact dermatitis, eczema, and psoriasis. Contact dermatitis is a reddish skin peeling after contact with allergens like color or paint. Eczema is characterized by fluid-filled blisters on the hands and soles. Psoriasis has blackish discoloration of the skin with itching on the hands.
Exfoliative keratosis has dry skin and blisters but no pain. It can be treated with topical agents and homeopathy. Homeopathy treatment is good for a dry skin condition and to avoid any other complications.
Types of Exfoliative Keratolysis:
There is no classification for exfoliative keratolysis available. But depending on the skin peeling and severity of symptoms, we can differentiate it into acute, chronic, and recurrent exfoliative keratolysis.
1. Acute exfoliative keratolysis:
It is a primary stage of skin peeling of hands. A patient complains of dry skin of the palm with initial air-filled blisters on fingers.
A patient does not feel any pain with dry skin. It can be treated with an application of coconut oil and keep your hand moist. It is a harmless condition. It can be misdiagnosed as contact dermatitis and eczema.
2. Chronic Exfoliative Keratolysis:
It is a rarely occurring condition. Some patients complain of cracking and bleeding from the dry skin of the palm region.
A patient who lives in extremely dry weather or cold air is susceptible to chronic exfoliation of palm skin.
3. Recurrent Exfoliative Keratolysis:
A patient complains of recurrent skin dryness every summer or after contact with specific detergent and solvent. Sometimes continues hand and sole perspiration may cause recurrent skin peeling from palm and sole regions respectively.
Specific allergic conditions and hereditary are causative factors for recurrent exfoliative keratolysis.
Exfoliative Keratolysis Causes:
Exfoliative keratolysis is a harmless condition. Weather, activities, allergic conditions, and hereditary conditions are causative factors for it.
Weather:Â Â Â Â Â Â Â Â Â Â Â Â Â
Extreme weather affects the skin. Cold air, dry summer heat, and dry air may cause dryness of palm skin and produce small blisters over the hand region.
Activities:
Active young adults who are sports people and athletes are susceptible to more perspiration of the palm and sole region, which leads to friction of the skin. This is the causative factor for the exfoliation of keratolysis.
Saltwater fishermen have more cases of exfoliation of keratolysis. Some studies show that salt water is the causative factor, but some studies show some bacteria from fish skin may cause the peeling of the skin.
Allergic conditions:
Most of the time, a person who is allergic to detergent, solvent, and water is more prone to exfoliative keratolysis.
People who wash their hands continuously may have dryness and peeling of palm skin.
Family History:
It is a rare causative factor for exfoliative keratolysis. Very rarely some families may have a tendency for peeling of skin from palm and sole regions.
Exfoliative Keratolysis Symptoms:
As discussed, earlier peeling of the skin, dry skin, and superficial air-filled blisters on fingers are key symptoms of exfoliative keratolysis.
It affects the palm, finger, and rarely the sole regions.
It is a harmless condition but sometimes it may cause bleeding and cracks on the skin of the palm and the sole parts of the body.
Microscopic examination reveals cleavage within the outside horny layer of skin (the stratum corneum).
A patient who perspire more and who wash their hands repeatedly are more susceptible to exfoliative keratolysis. A patient complains of dryness of skin without itching, burning, and pain.
In rare cases, a patient complains of redness of the skin with bleeding and pain.
The primary stage of peeling of the skin is the eruption of superficial air-filled blisters in a focal area of the fingers and palm. Slowly it leads to dryness of skin and peeling of the skin.
It may be misdiagnosed with psoriasis, contact dermatitis, and eczema. Because some patients complain of exfoliative keratolysis after the use of solvent, detergent, and salty water.
Risk Factors for Exfoliative Keratolysis:
Exposure to harsh weather, allergens, and family history are risk factors for the peeling of skin from the palm.
Weather:
A patient who exposes to cold air, summer, and dry weather is more susceptible to exfoliative keratolysis.
Allergens:Â
A person who has a tendency for exfoliative keratolysis and handles detergents, solvents, and water, then he is more prone to peeling of the skin of the palm.
Family history:
Person who has a family history of exfoliative keratolysis is at high risk to develop peeling skin of the palm and sole region.
Diagnosis:
Exfoliative keratolysis is a harmless skin condition. Diagnosis is depending on the clinical features, family history, personal history, and lab tests.
Skin appearance is important to diagnose it clinically. Typical skin appearance is dry skin, air-filled superficial blisters on fingers, and peeling of skin present on palm and finger region only. Occasionally exfoliative keratolysis affects the sole part also.
Family history and personal history in detail are important parts to diagnose peeling skin conditions. Some patients may have a family history of exfoliative keratolysis. Some may have an allergy to detergent, solvents, and water which leads to exfoliative keratolysis.
Lab tests are required to confirm the diagnosis of exfoliative keratolysis from other similar conditions like contact dermatitis, fungal infection, or psoriasis.
Skin biopsy confirms the diagnosis if it shows cleavage and a partially degraded edge at the horny outer layer of skin (Corner desmosomes within the stratum corneum).
A skin scraping was sent to a laboratory to diagnose fungal infection. A patch test is for evaluation of any potential contact allergy.
Most of the time diagnosis of exfoliative keratolysis depends on the clinical features of a patient.
Exfoliative Keratolysis Management:
Management of exfoliative keratolysis depends on symptom severity. This is a self-limiting condition. In most cases, it resolves spontaneously without any intervention.
The patient feels discomfort and irritation about peeling skin on the palm, application of emollient hand cream is a good solution. The emollient cream which contains urea, lactic acid, and silicone is best for use.
Patients who are sensitive to detergent, solvent, and harsh hand wash, may use glows during the use of mentioned irritants. Or take proper hand care and protection while handling allergic material.
Patients who are susceptible to exfoliative keratolysis during harsh dry weather, summer, and cold weather; must use protection cover and moisturizers to keep hands moist.
Photochemotherapy may be helpful to patients, who are suffering from recurrent exfoliative keratolysis.
Topical steroids are not useful for peeling skin in this condition. Instead of it, use silicon and lactic acid cream.
If the patient has a family history of exfoliative keratolysis and personal history of allergies, then homeopathy is a good treatment to limit the recurrent episodes of exfoliative keratolysis.
Best Homeopathic Medicines for Exfoliative Keratolysis:
Homeopathy remedies are useful to treat the tendency of exfoliative keratolysis and the acute case also. There are remedies as well as creams and lotions available for exfoliative keratolysis.
To treat a patient with help of homeopathy we need clinical features, personal history, and family history of a patient. There is no generalized remedy for exfoliative keratolysis. Every patient manifests the peeling of skin differently, so each patient requires a specific remedy.
There are two types of remedies available chronic and acute. Chronic remedies are helpful to limit the recurrence of exfoliative keratolysis and lessen the effects of allergens. While acute remedies are helpful to treat primary conditions of exfoliative keratolysis like dryness of skin with blisters.
Homeopathy treatment follows individualization. Therefore, no two patients are similar, and everyone requires a remedy that suits that person only. On the other hand, creams and lotion are helpful for everyone for external applications.
Certain remedies are helpful for exfoliative keratolysis:
1. Alumina: Chapped dry skin of palm aggravated
Alumina is a good remedy for chapped dry tottery skin. Skin symptoms return every winter season. A patient complains of itching when getting warm in bed.
Skin complaints are associated with constipation.
Dose and Potency:
Alumina is useful in 6C, 30C, and 200C potencies. Give 4 globules of Alumina 3 times per day for 6 days. Apply Alumina ointment externally 2 times a day.
2. Anacardium: Exfoliative keratolysis with warts on the palm
It is indicated for dry and thick skin of the palm region associated with a vesicle on the fingers. A patient complains of swelling of fingers.
Exfoliative keratolysis is associated with mental irritability.
Dose and Potency:
Anacardium is useful in 6C, 30C, and 200C potencies. Take 4 globules of Anacardium 2 times a day for 5 days.
3. Bismuth: Exfoliative keratolysis of palm and sole region
This is especially indicated by excessive dryness of the skin of the palm and the sole region. Dry skin is associated with warm perspiration.
A patient has cold limbs, but the palm and sole are warm.
Dose and Potency:
Bismuth is useful in 3X, 12X, and 6C potencies. Give 4 globules of Bismuth 2 times per day for 5-7 days depending on the severity of symptoms.
4. Calcarea Carbonica: For exfoliative keratolysis of palm from hard water
This is a chronic remedy. It can be helpful to reduce the tendency of recurrence of exfoliative keratolysis.
A patient complains of chapped hands after the use of hard water. A patient has dry and raw soles of feet because of cold sweat of feet.
A patient complains of coldness with dry skin of hands and soles.
Dose and Potency:
Calcarea carb is useful in 30C and 200C potency. Take 4 globules of Calcarea carb 30, 2 times a day for 15 days.
5. Castor Equi: For the thickness of skin and epithelium
Castor Equi is useful for the thickness of skin and epithelium of the palm and the sole regions. It is indicated for cracked and chapped skin of the palm region of the hands.
Dose and Potency:
Castor Equi is useful in 6C and 30C potencies. Give four globules of Castor 3 times per day for 15-20 days.
6. Cistus Canadensis: For exfoliative keratolysis of palm after exposure to cold air and water
It is indicated for hard, thick, dry, and cracked skin of the palm regions. A patient is extremely sensitive to cold air and any form of cold.
Working men develop cracked and thick skin on the palm of their hands.
Dose and Potency:
Cistus is useful in 3x, 6X, and mother tincture forms. 5 drops of Cistus mother tincture mixed with water to wash hands. 4 globules of Cistus once a day for 3 days.
7. Graphites: Useful for hard and cracked skin of hands in places
It is useful for children and middle-aged people. It is indicated for hard, dry, and cracked skin without affection of eczema.
Graphites help to reduce the tendency of a person for exfoliative keratolysis. Skin complaints reappear during summer.
Dose and Potency:
Graphites are useful in 30C potencies and cerate form. Take 4 globules of Graphites, once a day for 8 days. Apply Cerate externally on the dry cracked skin of the palm.
8. Lycopodium: Recurrent exfoliative keratolysis of palm and sole during the summer season
This remedy is useful for the dry and shrunken skin of the palm and the sole region in summer. A patient complains of profuse sweat on the feet and the hand.
Skin becomes thick and indurated with brown spots here and there.
Dose and Potency:
Lycopodium is useful in lower potencies and mother tincture form. Give 4 globules of Lycopodium 6C, 2 times a day for 15 days, or use lycopodium mother tincture 5 drops, 2 times a day for 15 days.
9. Natrum Carb: For exfoliative keratolysis of the palm with blisters on tip of fingers
It is useful for the dry, rough, and cracked skin of the palm associated with blisters on tip of fingers. It is useful for chapped hands after exposure to sun heat. A patient complains of profuse sweat.
This is a useful remedy during summer heat and after the suppression of hand sweat.
Dose and Potency:
Natrum carb 6C is useful potency. Take 4 globules of Natrum carb 2 times a day for 10 days.
10. Natrum Sulph: Acute remedy for exfoliative keratolysis of the sole.
It works best for dryness and burning of the sole associated with blisters and vesicles on the toes and feet regions.Â
A patient complains of dryness of skin during damp weather.Â
Dose and Potency:
Natrum sulph is useful in 3X and 6X potencies. Give 4 globules of Natrum sulph, 2 times a day for 10 days depending on the severity of symptoms.
11. Petroleum: For exfoliative keratolysis with bleeding of the skin
Petroleum is indicated for dry, cracked, rough, and lethargy skin of the palm of hands. It is useful for chapped hands and fingers bleeding especially for housemaids.
This is a remedy for a patient who works in water like fisherman and housemaids. A patient complains of thickness, dryness, and rawness of hands. They complain of deep cracks at the tip of the fingers.
Skin symptoms are aggravated every winter and disappear in the summer season.
Dose and Potency:
Petroleum is useful in 3X, 6X, and 6C potencies. Take 4 globules of Petroleum two times a day for 7 days. Apply petroleum ointment externally.
12. Sarsaparilla: For exfoliative keratolysis of sole during summer
Sarsaparilla is indicated for deep cracks on fingers, toes, and sole parts of the feet. A patient complains of dry skin after exposure to cold air and working in water for a long duration.
Dose and Potency:
Sarsaparilla is useful in 3X and 6C potencies. Take 4 globules of Sarsaparilla, 3 times a day for 8-10 days.
13. Selenium: Useful for dry and scaly exfoliative keratolysis of the palm region
Selenium is useful for the dry and scaly eruption of the palm region associated with itching. A patient complains of dry skin and blisters between fingers.
Dose and Potency:
Selenium is useful in 3X and 6C potencies. 4 globules of Selenium 3 times a day for 5-6 days.
14.Silicea: Useful for exfoliative keratolysis of fingertips of hands
Silicea is useful for dry skin and eruption on the fingertips of the hands associated with profuse sweat.
A patient complains of cracks at his fingertips after exposure to damp and cold weather.
Dose and Potency:
Silicea is useful in 6C and 30C potencies. 4 globules of Silicea 2 times a day for 15 days. Apply Silicea cream externally on cracked skin.
15.Sulphur: Useful to reduce the tendency of Exfoliative keratolysis
Sulphur is useful for dry, scaly, and unhealthy skin of the palm and sole regions. A patient complains of exfoliative keratolysis after exposure to cold air, water, and detergent.
A patient complains of burning sole with profuse perspiration.
Dose and Potency:
Sulphur is useful in 6C and 30C potencies. 4 globules of Sulphur once a day for 3-4 days. Â
Remember that homeopathic remedies are prescribed based on individual symptoms and characteristics. It’s crucial to consult with a qualified homeopath for proper evaluation and personalized treatment. Homeopathy focuses on treating the whole person, so a detailed case study is necessary to select the most appropriate remedy.
Homeopathic medicines should be taken only when prescribed by a homeopathic physician. Self-medication may aggravate the original conditions.