Chapped Hands

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Chapped Hands

24 Soothing Tips

Where'd those scrub brushes come from? Not the ones in your hands—the ones that are your hands. The ones that are so red, dry, cracked, and painful you wouldn't wish them on your worst enemy. The ones that show up in time for Halloween and don't leave till after Easter. Face it, the Creature from the Black Lagoon had more attractive paws.

How did you get into this mess? Sorry to say, you probably brought it on yourself. First, the low humidity of fall and winter dries and irritates skin. (No, that's not your fault.) Second, as you age, your body just naturally produces less of the oil that keeps skin smooth and supple. (That's not your fault, either.) But bad habits, simple neglect, and lack of good skin sense conspire to make your hands rough and ready to drive you crazy. (And that is your fault!)

So what can you do to soothe those hurting hands? Here's what the experts recommend.

Don't go near the water. "The basic plan for dealing with chapped hands is to avoid water at all costs," says dermatologist Joseph Bark, M.D., of Lexington, Kentucky. "Consider water to be just like acid on your hands, because it is the worst influence for chapped hands that we know of. Repeated washing removes the skin's natural oil layer, which allows moisture within the skin to evaporate. And that's extremely drying.

"You could do what the French do to keep from getting dry skin," laughs Dr. Bark. "They don't wash their hands very often; they just hang them out the window and shake the dirt off! But seriously, always think twice about washing your hands."

Go palm up. "When you must wash your hands often, try to do just the palms," recommends dermatologist Diana Bihova, M.D., a clinical instructor at New York University School of Medicine. "You can wash the palms much more often than the backs of the hands, which have thinner skin and dry out easily."

Use the lotion potion. "Instead of using soap, clean your hands with an oil-free skin cleanser such as Cetaphil or SFC Lotion," says Dr. Bark. "Rub it on the skin, work it into a lather, then wipe it off with a tissue. It's a wonderful way to wash skin without any irritation whatsoever."

Try the bath oil treatment. Taking the no-soap concept one step further, Rodney Basler, M.D., assistant professor at the University of Nebraska College of Medicine, recommends washing your hands with bath oil. "They may not feel really clean like they might with soap, but they won't get dried out, either."

Prevention Is Your Best Solution Chapped hands are always easier to prevent than to treat, says Diana Bihova, M.D. Here are some ways to do that: Stay out of hot water. "A good rule of thumb is to avoid hot water, detergents, and strong household solvents," says Dr. Bihova. Avoid soaping. "Because chapped hands occur when oil is taken from the skin, you should not use a terribly harsh or alkaline soap. You're better off with a mild soap, preferably with a little cold cream in it. I often recommend Dove because it's virtually the mildest soap there is," says Joseph Bark, M.D. Put moisture in the air. "Skin moisturizes itself from the inside out," notes Rodney Basler, M.D. "If there's moisture in the air, not as much would be drawn out through the skin. Therefore, it's a good idea to use a home humidifier." Pamper your hands. "When you apply moisturizer to your face in the morning, immediately apply some to the hands. At night do the same," advises Dr. Bihova. "That keeps them supple and helps resist chapping. I'd say twice a day is a must. In addition, do it after each washing."

Get topical. Use some type of topical emollient every time you wash your hands and at bedtime. "Its strength would depend on the severity of your chapping," says Dr. Basler. "Lotions are the least moisturizing, followed by creams and then ointments. Try a lotion first. If that's not enough to carry you through the winter, step up to a cream, then an ointment."

Don't throw in the towel. "If your workplace bathroom has a hot-air blower instead of hand towels, bring in a towel from home," advises Dr. Bihova. "Hot-air blowers have been associated with chapped hands. If you must use one, keep your hands at least 6 inches from the nozzle and dry them thoroughly."

Go soak your hand. Although in general you should keep your hands out of water, sometimes a therapeutic soak is in order. "For an inexpensive way to achieve the same moisturizing effects produced by skin creams, simply soak your hands in warm water for a few minutes. Then pat off excess water and apply vegetable or mineral oil to the damp surface to seal in moisture," says Howard Donsky, M.D., associate professor of medicine at the University of Toronto.

In the same vein, Dr. Basler recommends soaking in a water and oil solution. "Use 4 capfuls of a bath oil that has a good dispersant (Alpha-Keri is the best) in 1 pint of water. At the end of the day, soak for 20 minutes to get oil back into the skin. That alone will help chapped hands."

Try "Cream C." "If you want the cheapest home remedy going, use Crisco," says Dr. Bark. "It's a wonderful moisturizer that covers the skin and keeps water locked in. The key is to use very little and rub it in well so your hands don't feel greasy. Your skin needs only two molecules' worth of barrier thickness to protect it from water loss. They used to call Crisco Cream C at Duke University, where doctors dispensed it freely. It really works."

"You don't have to purchase expensive creams to get good results," agrees Dr. Donsky. "Inexpensive substitutes for people with dry and normal skin include cocoa butter, lanolin, petroleum jelly, and light mineral oil."

Double up. "When applying any type of lotion or cream, use what I call Bark's double-layer application technique," continues Dr. Bark. "Put on a very thin layer and let it soak in for a few minutes. Then apply another thin layer. Two thin ones work much better than one heavy one."

Try lemon oil. "To smooth and soothe irritated hands, mix a few drops of glycerin with a few drops of lemon oil [both are available at pharmacies]. Massage this into your hands at bedtime," says New York City skin care specialist Lia Schorr.

Dress to kill. A lot of unsuspected things around the home can act as irritants for chapped hands. "I recommend wearing plain white cotton gloves for doing any kind of dry work," says Dr. Bihova. "That includes reading the newspaper and even unloading groceries. Any time you have friction against skin that's already dry, cracked, or red, you aggravate it. The advantage of cotton gloves is that they allow the skin to breathe and at the same time absorb any moisture that accumulates so it won't irritate your skin."

"In addition," according to Nelson Lee Novick, M.D., clinical associate professor of dermatology at Mount Sinai School of Medicine of the City University of New York, "cotton gloves keep the skin clean so you don't have to wash your hands so often and risk perpetuating the problem."

"If you need to get an extra-good grip on something, use leather gloves," says New York hand model Trisha Webster.

Model Your Hands after Hers When your fingers are your fortune, you take darned good care of them. Ask Trisha Webster. She's a top hand model with the Wilhelmina agency in New York City. Those are her hands you see in many high-fashion jewelry and cosmetic ads. If they're not picture perfect, Webster is out of a job. So how does she keep her hands looking young? The same way you can. Stop problems before they start. "I try to keep my hands out of water at all costs," says Webster, "which is why I always let someone else do the dishes (well, it's one of the reasons!). When I can't avoid getting my hands wet, such as during bathing, I always moisturize them immediately afterward. It takes just a few minutes for the moisture that's accumulated in the skin to evaporate. When that happens, your hands are drier than they were before." Get protection. "I never go outdoors in the winter without protecting my hands. That means putting on a good layer of moisturizer and then gloves." Use sun sense. "A long time ago I stopped going out in the sun because it dries and ages hands just as surely as it does your face." If you're not ready to give up the sun, Diana Bihova, M.D., suggests using a moisturizing sunscreen on your hands. "Sunscreens moisturize hands and keep them looking younger, so make their use an everyday habit," she says. "Just stay away from gels and alcohol-based sunscreens, because alcohol is drying. Also, products containing the active ingredient PABA can be irritating if you have sensitive skin."

Mix rubber and cotton. "For wet work, it's extremely important to use cotton gloves under vinyl ones," says Dr. Novick. "If the cotton gloves get wet, change them immediately. Otherwise replace them with a fresh pair every 20 minutes. Perspiration, lotions, and medications on your hands accumulate inside the gloves and may become irritating rather quickly. I don't recommend rubber gloves with built-in cotton linings because it's very difficult to launder them. But you can launder separate cotton gloves in a mild detergent like Ivory Snow or Ivory Flakes."

Dr. Bihova agrees. "The biggest mistake women make when they have hand problems is wearing just rubber gloves. That only makes the hands worse. The rubber traps moisture, keeps the skin from breathing, and creates too much friction."

"Sometimes you can avoid gloves altogether," says dermatologist Thomas Goodman, Jr., M.D., assistant professor at the University of Tennessee Center for Health Sciences. "When you're doing dishes, for instance, a long-handled dish brush keeps your hands entirely out of water."

Go elegantly into the night. Dr. Goodman recommends occasionally wearing cotton gloves to bed for an extra-soothing treatment. "Moisten the fabric with about a teaspoon of petroleum jelly so the gloves won't absorb the cream from your hands. Then apply hand cream at bedtime and slip on the gloves. Leave them on overnight. Your hands remain bandaged, in a sense, and can heal."

"The important thing," adds Dr. Bark, "is not to automatically run to the skin in the morning and wash off the cream. Also I don't recommend sleeping in plastic gloves. They make your hands sweat too much overnight, so that by morning you have the most incredible case of dishpan hands you've ever seen."

Call on hydrocortisone. Over-the-counter hydrocortisone creams and ointments are of value in treating chapped hands. Use Cortaid or any other 0.5 percent cream several times a day, says Dr. Goodman. Then put a heavier, greasier product on top of that. These hydrocortisone creams don't substitute for good hand care, but they are a boost. Every time you wash your hands, reapply them.

Get a salon treatment. "Believe it or not, even shampoo can make your tender hands feel worse," says Stephen Schleicher, M.D., co-director of The Dermatology Center in eastern Pennsylvania and clinical instructor at the Philadelphia College of Osteopathic Medicine. "Either let someone else shampoo your hair or wear plastic gloves."

MEDICAL ALERT Hands That Need a Doctor's Touch "If you have splits and cracks on your hands, you've got hand eczema, and it's a sign you should see a dermatologist," advises Joseph Bark, M.D. "Also, if what you consider to be chapped hands starts as little blisters along the sides of the fingers, it's probably hand eczema and needs potent medication." There are other signs that may indicate that what you have is more than a case of chapped hands. If, after two weeks of self-treatment, your hands don't clear up, you should see a dermatologist, says Dr. Bark. You may have a fungal infection or even psoriasis of the hands. Diana Bihova, M.D., cautions that people (such as doctors, nurses, chefs, and housewives) whose occupations require them to immerse their hands for prolonged periods of time can easily contract monilial paronychia, an annoying fungal infection involving the skin around the cuticle. "Bartenders and waitresses who handle beer, which is yeasty, are particularly susceptible. When the infection strikes the finger's protective nail fold, it becomes red, swollen, and painful."

Put your hands in oatmeal. To remove the top layer of dead skin cells from chapped hands, Schorr recommends a weekly sloughing treatment. "Process 1 cup of uncooked, old-fashioned (not instant) rolled oats in a blender until you have a very find powder. Place it in a large bowl, then rub your hands in the powder, gently removing dry skin. Rinse with cool water, pat dry, and lavish on hand cream. Wait 2 minutes and apply more cream."

Hire a cook. "The juices of raw meat and vegetables—like potatoes, onions, tomatoes, even carrots—are sometimes very toxic to skin, especially if it's already irritated. So you can either hire a cook to do all your kitchen work," quips Dr. Goodman, "or wear tissue-thin plastic gloves when handling food."

"You particularly don't want to squeeze acidic fruits like oranges, lemons, or grapefruit with your bare hands," adds Dr. Schleicher. "They're terribly irritating and will dry your hands further."

PANEL OF ADVISERS

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Joseph Bark, M.D., is a dermatologist in private practice in Lexington, Kentucky, and author of Retin-A and Other Youth Miracles and Skin Secrets: A Complete Guide to Skin Care for the Entire Family.

Rodney Basler, M.D., is a dermatologist and assistant professor of internal medicine at the University of Nebraska College of Medicine in Lincoln.

Diana Bihova, M.D., is a dermatologist in private practice and clinical instructor of dermatology at New York University Medical Center in New York City. She is coauthor of Beauty from the Inside Out.

Howard Donsky, M.D., is an associate professor of medicine at the University of Toronto and staff dermatologist at Toronto General Hospital. He is author of Beauty Is Skin Deep.

Thomas Goodman, Jr., M.D., is a dermatologist in private practice and assistant professor of dermatology at the University of Tennessee Center for Health Sciences in Memphis. He's author of Smart Face and The Skin Doctor's Skin Doctoring Book.

Nelson Lee Novick, M.D., is clinical associate professor of dermatology at Mount Sinai School of Medicine of the City University of New York in New York City and author of Super Skin and Saving Face.

Stephen Schleicher, M.D., is co-director of The Dermatology Center, with offices throughout eastern Pennsylvania. He is also clinical instructor of dermatology at Philadelphia College of Osteopathic Medicine and author of Skin Sense.

Lia Schorr is a skin care specialist in New York City and author of Lia Schorr's Seasonal Skin Care.

Trisha Webster is a top New York City hand model with the Wilhelmina, Inc. modeling agency. She has almost 20 years' experience in the business.