Rhagade: Causes, Symptoms & Treatment

A rhagade or chapped skin refers to a deep tear in the skin, often caused by very dry skin, but often secondary to other diseases. Deep injuries must be treated properly, as in the worst case blood infections can follow.

What is a rhagade?

Rhagade is a classic symptom of dry skin, but it can equally be a reaction of the skin to injury and infection. When the skin is severely dehydrated, it can become brittle and cracked. Small cracks then widen and become distinct fissures that penetrate into deeper layers of the skin. The onset of rhagades is usually preceded by a chain reaction: dry skin often leads to scaling, these begin to itch and the affected person scratches, which leads to deeper injuries. The causes of rhagades can be manifold. It can be due to diet, dry or cold weather, dermatitis, hormonal fluctuations, allergic reactions or other disorders. Chemicals such as alcohol or many skin diseases also lead to rhagades, e.g. psoriasis, eczema or Sjögren’s syndrome. Deep injuries can lead to dangerous blood infections.

Causes

Rhagades can be triggered by environmental factors. Dry indoor air during the cold winter months is particularly important here. Some diseases also promote rhagades, especially those that have an effect on the nervous system, cause dehydration or reduce sweat production. Anhidrosis is a common side effect of diabetes and reduces perspiration of the skin, which can cause it to become dry and cracked. Dermatitis is an inflammation of the skin with similar consequences that can have many causes. Diabetic neuropathy is often seen with high blood glucose levels and affects the nerves. If the skin is merely exposed to a particular stressful situation and develops lesions as a result, the consequences can be treated with simple therapy. However, if the rhagade is a symptom of another cause, special treatment may be needed.

Symptoms, complaints and signs

A rhagade shows up as a tear in the skin. This skin tear can vary in size and depth. However, it cuts through all skin layers in any case. Thereby, these skin cracks do not necessarily occur due to an injury, but are rather a phenomenon in case of too dry skin and bad weather conditions. In most cases, these cracks can develop over a longer period of time. The affected person first feels a feeling of tension in the corresponding area, but does not yet see a skin crack. In principle, a rhagade can occur on all parts of the body, but it is particularly common in the area of the corners of the mouth. Here, the skin tear can also lead to pain and a feeling of tension. Most rhagades in this area are characterized by the fact that they heal very poorly. The symptoms of a skin tear intensify with the strain and stretching of the corresponding part of the body. The skin ruptures can also occur between the fingers or toes. If rhagades occur on the anus, they are usually referred to as fissures. The fissures can bleed if they reach deep into the tissue. The accompanying symptoms of the fissure are often dry skin in the immediate area and itching. In addition, cracks that are already present are susceptible to secondary infections.

Diagnosis and course

Full treatment of a rhagade depends on the specific cause of the injury. If it is related to another, more serious disease or disorder, that in particular must be treated. To clarify the circumstances of the rhagade, the doctor may ask the following diagnostic questions: How long have you had the rhagade? Do you have these lesions on other parts of your body as well? Have you had redness, itching, and pain? Does the affected area feel warm? Has the affected area already bled? Have you had or do you have a rash? Did you have a herpes or similar on the affected area? Have you had or do you have a fever? Do you suffer from any allergies? Have you been bitten by an insect?

Complications

In most cases, rhagade does not cause any particular complications. However, if it is treated incorrectly and especially if it is unhygienic, it can lead to serious infections or even blood poisoning. In the worst case, this can lead to the death of the patient.In this disease, the affected person suffers from severe cracks in the skin. The cracks can occur on various parts of the body and may also significantly reduce the aesthetics of the affected person. This can lead to inferiority complexes or lowered self-esteem. Furthermore, the skin itself is dry and cracked and often affected by itching. Fever or rashes on the skin may also occur and have a very negative effect on the patient’s quality of life. The treatment of the disease takes place without complications with the help of creams and ointments. In case of inflammation or infection, antibiotics are administered. As a rule, this results in a positive course of the disease. The life expectancy of the patient is also not negatively affected by the disease. However, it is possible that the disease may recur despite treatment.

When should one go to the doctor?

Since rhagade does not usually heal itself, this condition should be treated by a doctor. Only proper treatment can prevent further complications to the skin. Without treatment, the affected person can suffer from blood poisoning in the worst case and die from it. A doctor should be consulted if the patient suffers from severe cracks in the skin. The cracks can appear on different parts of the skin and have a negative impact on the aesthetics of the affected person. If these cracks occur over a long period of time and do not disappear on their own, it is essential to consult a doctor. The cracks can also appear at the corners of the mouth. Since the rhagade indicates another underlying disease, a doctor should always be sought early to determine this underlying disease in order to avoid further complications. Itching of the skin may also indicate rhagade and must be examined by a physician.

Treatment and therapy

For rhagade that does not have more serious causes, certain precautions and skin care tips can be followed to improve the situation. Moisturizing creams and oils, such as olive oil, keep irritated skin elastic and aid the healing process. Wearing rubber gloves when washing dishes or similar activities will keep the skin from drying out further. It is also essential to avoid contact with chemicals or alcohol on the skin. If the injuries to the skin become too deep, the dermatologist should be consulted to get appropriate treatment. Cortisone ointments are a common form of initial treatment. Their use reduces redness and swelling, which allows the injured skin to heal. If there is already evidence of infection, an ointment with antibiotics may be prescribed to fight the bacteria entering the wound. In the case of dyshidrosis, a lotion with lactic acid may also be applied to prevent the skin from scaling and peeling. Applications of these creams are usually one to two times a day and may need to be continued for weeks.

Prevention

If rhagade is related to another disease or skin problems, it cannot really be prevented. In general, dry and chapped skin, especially during the winter months, should be treated in a timely manner with moisturizing creams to prevent possible worse injuries.

Aftercare

Rahgades can often hurt a lot, especially since they usually occur in sensitive areas such as the anus or mouth. Usually, these are caused by a lack of moisture. If this is the cause of the appearance of a rhagade in sufferers, they can treat it with a commercial moisturizer. Simple ointments or oils can also be used to treat rhagade. Likewise, lactic acid and lotions have been found to have a positive effect on rhagades. However, if the rhagade occurs due to another cause, it is recommended to consult a dermatologist. He will then treat the rhagade accordingly. In most cases, cortisone is used for this purpose. In some places where the rhagades may occur, there is a high risk of infection in affected individuals. In the worst case, these can lead to the death of affected individuals. For this reason, rhagades should always be examined and treated by a doctor. In many cases, sufferers are sometimes given a special antibiotic.This should be taken by the affected person strictly according to the instructions of the attending physician. Rhagades must never come into contact with sharp substances. This should be avoided by gloves imperatively.

What you can do yourself

Rhagades, also called fissures, can hurt a lot, as they preferentially occur in sensitive areas such as the mouth or the anus. In addition, although they are usually small, they are always very deep and separate all layers of the skin. Rhagades occur in places where the skin is no longer elastic enough to follow natural movements or they occur due to a skin disease such as eczema. If there is simply a lack of elasticity, the patient can use commercially available moisturizing creams, ointments and oils to make the affected area supple again. Lotions with lactic acid have also proved effective here. If the rhagade is due to a skin disease, it should be examined by a dermatologist and treated with specific agents. Cortisone is often the drug of first choice here. Depending on where the rhagade is located, there is a risk of infection. Such infections can even be fatal, so these rhagades urgently belong in medical treatment. In many cases, the doctor will then prescribe an antibiotic for his patient. It should be taken consistently by the patient according to the doctor’s instructions. Rhagades should not come into contact with chemicals or harsh cleaning agents. Those who have them on their hands, for example, should wear gloves when rinsing or cleaning to prevent further drying of the skin.