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Exfoliative Keratolysis

Exfoliative keratolysis is a condition, in which there is peeling of skin on the hands and feet. This story provides information regarding its causes, symptoms, and treatment.
Dr. Sumaiya Khan
There are many different skin conditions that can affect the body. These can have different effects on the skin, right from peeling to redness. Most of these conditions are caused due to heat or because of an infection in the body. However, sometimes, these conditions may also not have a definitive cause.
One such condition is exfoliative keratolysis. This is a skin disorder, wherein there is focal peeling of the skin of the palmar surface of the hand and in some cases, the soles of the feet. Therefore, it is also known as 'focal palmar peeling'.

Causes

Although the exact cause of this condition is not known, there have been a few triggers and possible conditions in which this skin condition erupts. It is more commonly observed in young adults. Excessive sweating during summer time may lead to the exfoliation of skin.
Also, when the symptoms occur, they often get aggravated by irritants like water, soap, detergents, or by things like chemicals and solvents.

Symptoms

The symptoms of this condition are usually seen on the palmar surface of the hands. It begins with an outbreak of small air-filled blisters on the hand. Then, these blisters eventually burst and lead to the formation of visible skin tags, which make the hands look like they are peeling.
Usually, this condition is seen more often on the fingers and fingertips, which leaves harder skin that takes a long time to heal due to the constant peeling of skin on the fingertips. The skin becomes normal gradually; however, exfoliative keratolysis may recur after a few weeks.
Hands that have the burst blisters leave behind scales of skin which are circular and often tender with peeling skin. This may make the affected skin red and cracked in nature. These burst blisters are usually not very itchy.
If these symptoms are seen at the base of the fingers, then the skin that is split in this region may be deeper and subsequently, it may become harder, numb, and more difficult to heal.

Treatment

Unfortunately, there is no known or fixed treatment for exfoliative keratolysis. Feet and hands that are affected by this condition need to be taken extra care of. Unlike some other skin conditions, this does not get any better with topical use of steroids. Thus, the best way to deal with this condition is the by mode of prevention.
You will need to take extra care of your hands and feet, especially during summer time. Try not to handle irritants like detergents and soap. Also, you can try using some hand creams that contain lactic acid, urea, or silicone, which help soothe and soften the skin.
The prognosis of this condition is good, and only very rarely are the symptoms so severe that there is need for active medical treatment. If the condition becomes unbearable, then you may undergo photochemotherapy.
This condition is usually mild. Although the peeling can be embarrassing and slightly unnerving, it does not always need medical treatment. This is because, despite repeated attacks of this condition, no long-lasting damage to the skin is seen.
However, if the condition does become so severe that it hampers your day-to-day activities, then it is best to consult a dermatologist.
Disclaimer: This story is for informative purposes only, and should not be used as a replacement for expert medical advice.