Symptoms
Skin tears on the fingers – known as rhagades – are deep, cleft-like, and often keratinized lesions that extend into the dermis of the skin and occur mainly near the fingernails at the tips of the fingers. They may also occur on the back of the hand. Despite their small size, the skin tears sometimes cause severe, throbbing pain and may limit daily activities. Small hemorrhages are also observed. In case of a persistent and multiple occurrence, they can cause relevant suffering. Skin cracks often occur together with dry and horny hands. Infectious diseases may develop as complications, because the cracks represent an entry point for pathogens such as bacteria.
Causes
Skin tears occur when dry, inelastic, or diseased skin is stretched. The cause of the tears is usually overuse of the skin. They also commonly occur with skin conditions such as hand eczema. Possible risk factors include:
- Cold and dry air during the winter months.
- Frequent hand washing, dry hands
- Repeated contact with soaps, disinfectants, care products, cleaning products, chemicals and water.
- Allergies
- Genetic predisposition
- Age
- Profession, e.g. hairdressers, painters, health professionals, cleaners.
- Underlying diseases such as chronic hand eczema or psoriasis.
The dermis of the skin contains nerve endings that are activated by various stimuli and trigger the sensation of pain.
Diagnosis
Simple skin tears can be self-treated. However, as mentioned above, skin diseases such as allergic or irritant contact dermatitis may be present at the same time and should be diagnosed by medical or dermatological treatment.
Treatment
Hand creams should be used several times a day for prevention and treatment. They nourish the skin, make it supple, have a hydrating effect and promote wound healing. Skin protection creams are also used. Wear gloves when cleaning and working with water. Temporarily refrain from activities that put a lot of strain on the hands or, if possible, have someone else do them. Use mild soaps and do not wash or disinfect hands too frequently. Use a humidifier in the winter. Treat and cream hands with a grease pencil before sleeping and wear cotton gloves while sleeping. Grease sticks (e.g. Dermophil India, Peru stick, Tuc) are preparations with a solid consistency consisting of a lipophilic base containing active ingredients such as essential oils, camphor, perubalsam or local anesthetics. Lipsticks look like large lip balms. They have wound-healing, hydrating and analgesic properties. Possible adverse effects include allergic reactions. Protective varnishes (e.g., Urgo skin tears) or liquid patches are applied locally with a brush or other applicator and form an impermeable film on the skin tear. This leads to pain relief because the stimuli no longer reach the nerves. At the same time, wound healing is promoted. Depending on the composition, the agents may sting when applied. An alternative is to glue them together with superglue. However, these products were not developed for dermatological use and can sometimes cause allergies. They are not intended for medical use. Various plasters and bandages are used to protect the skin injury. These include waterproof plasters, hydrocolloids, fingertip plasters, finger cots and self-adhesive gauze bandages. Wound healing ointments with active ingredients such as dexpanthenol, calendula (marigold), hyaluronic acid or vitamin A can help promote wound healing (e.g. Bepanthen, Ialugen, Vita-Hexin, Weleda Calendula). They also lead to hydration and temporary sealing of the skin lesion. Healing ointments may additionally contain disinfectants to prevent infectious diseases. In the simultaneous presence of eczema or allergies, topical glucocorticoids or topical calcineurin inhibitors may be applied on medical recommendation. In phytotherapy, cardiosperm ointments are also used for this purpose. Nutritional supplements such as evening primrose oil (EPO) can be tried. The effectiveness is not undisputed.Caution: some of the products used are allergenic (e.g., Peru balm, chamomile, latex gloves) and should be avoided if you are prone to allergies.
