Once the weather starts getting colder, the tops of my hands get so dry that they crack and start bleeding. I’ve tried all kinds of hand lotions, and while they help some, they never completely cure the problem. The problem is so bad that when I run water over my hands, they burn badly, and I spend much of the winter time in pain. As soon as the warmer weather approaches, the intense dryness and pain goes away. What does Dr. Herzog recommend?
Dr. Jo Herzog
Dear Laura Gail,
Thanks so much for a wonderful question, as this problem is not at all uncommon. I, too, have this problem in winter. This condition seems to happen most frequently when we have a combination of cold and dry air. Chapped hands and chapped lips often appear around the same time. Both can be very sore and painful, and both can be made worse by exposure to water or moisture.
When our hands get this dry, this calls for serious moisturizing. Water on our hands is fine if we lock it in with a moisturizer; however, it makes things worse when it evaporates on our skin and makes unprotected hands drier. Each time our hands get wet, it is wise to follow with moisturizer immediately to lock in moisture.
Thick creams are much better than thin lotions at protecting and sealing in moisture. Thick creams used to come primarily in a jar, but some now come in tubes as well. Cetaphil, Cerave, Eucerin, and Vanicream are all examples of products that come in thick creams. There are many others out there that are probably equally good. Another product, Aquaphor, is similar to the aforementioned creams and does a wonderful job, although it has a more greasy feel.
You need to apply these creams several times a day, especially after washing. Water on hands is not a problem, but letting them get bone dry without using any moisturizer and then running out into the cold is just looking for trouble.
If liberal use of cream doesn’t help, you can try occlusive therapy. After a bath or shower (warm but not hot water), apply a good, thick moisturizing cream. Put your hands in baggies, cover with socks, and relax for and hour or two. An alternative to plastic bags and socks is using damp white cotton gloves under waterproof gloves. When you remove these, you can apply a little more cream if all has been absorbed.
If this does not do the trick, the next step is using OTC hydrocortisone cream twice daily for a few days (in addition to the moisturizers that you would use in between). This is harmless and will take out some of that inflammation and sting. If after this you still have a problem, see a dermatologist for some more serious treatment.