How can I best care for fissures on my palms and/or soles of my feet?

Fissures can be a difficult problem as they are painful and can make it difficult to use your hands normally or walk without discomfort.

Effective treatment of your CTCL will eventually help the fissures, but it can take months for treatment to work, or if medications or treatments lose efficacy, it can take time to find a new effective treatment.

To care for fissures, we want to protect the skin in these areas from other irritants, and also prevent infections from occurring. Wear gloves when doing any irritating or dirty work like washing dishes or cleaning.

In general, when washing your hands:
1. Hand sanitizers may be too painful to use, washing hands with a mild soap may be better 
2. Use lukewarm water- Avoid HOT water. 
3. Use a fragrance-free mild soap. Most commercial hand soaps are harsh and contain fragrances. Some recommended products include:
• Dove sensitive bar soap
• Cetaphil gentle skin cleanser
• CeraVe Hydrating Cleanser
• Vanicream bar 
4. Moisturize right after handwashing to “lock-in” moisture. You may need to use moisturizers several times a day, especially after hand washing. Some preferred moisturizers include:
• Neutrogena Norwegian Formula hand cream
• Cetaphil cream
• CeraVe cream
• Vanicream Moisturizing Skin Cream
• Aveeno Eczema Therapy Cream
• Petroleum jelly, Vanicream moisturizing ointment (formerly known as Vaniply), or Cerave Healing Ointment (may be too greasy feeling for daytime use)
  
For feet and hands:
1. Always apply your prescription medications (creams and ointments) first! Then apply your moisturizer. If possible, apply at different times of the day. 
2. At bedtime, apply your prescription medication (if directed to do so) and an ointment like petroleum jelly, Vanicream moisturizing ointment, or Cerave Healing Ointment.
Then cover your hands with cotton gloves or feet with cotton socks for the night. 

Some patients find that applying a “liquid bandage” or another form of glue to fissures can help with discomfort. I recommend you discuss this with your dermatologist to get their opinion before you try this.

Also see Keratoderma

Answer provided by:
Keri Chaney, MD
Assistant Professor
Medical College of Wisconsin