Dry calluses on hands

If the usual callus in the form of a blister is formed due to friction, then hard dry calluses on the hands - on the hands and fingers - have a slightly different origin and are treated differently.

Causes of the dry calluses on hands

The main reason for the appearance of dry calluses on the hands is prolonged and / or constant mechanical pressure with localization on a certain area of the skin. Since the function of the skin is protective, the formation of hard callus is considered one of its manifestations.

At the same time, specific zones are noted where the pressure is increased during a number of activities using tools and equipment. So, the rower's callus from the oar is formed on the metacarpophalangeal surfaces of the palms; between the metacarpal bones and the proximal phalanges of the fingers - a common place for dense calluses in weightlifters and kettlebell lifters; jewelers, engravers and people who constantly manipulate small tools suffer from the thumb, index and middle fingers of the working hand. Hairdressers with the handle of scissors, and gardeners with the handle of a pruner press a callus on their index finger. Even someone who writes a lot by hand can "earn" such a callus on one of the phalanges of the middle finger.

Risk factors

In addition to the activities mentioned above, risk factors for the formation of dry calluses on the hands include  vitamin A deficiency , leading to hyperkeratosis, and  dry skin of the hands , including that characteristic of the elderly.

People with systemic and metabolic diseases are more susceptible to keratotic skin lesions: diabetes, rheumatoid arthritis, scleroderma, gout.

The likelihood of the appearance of such calluses with pathological changes in the metacarpal bones increases; interphalangeal joints of the hands; styloid process of the ulna (processus styloideus ulnae); the appearance of a bony protrusion of the pisiform bone of the wrist (os pisiforme) from the side of the palm - due to trauma, salt deposits, polyarthritis, arthrosis or deforming osteoarthritis, when osteophytes are formed.

Pathogenesis

Explaining the pathogenesis of the formation of dry calluses, experts associate it with the response of skin keratinocytes to repeated traumatic effects - in the form of increased keratinization of the epithelium to protect deeper layers of the dermis from damage.

Limited in area, but intense and often repeated pressure on the skin of the hands and fingers leads to the activation of migrating macrophages of the epidermis (Langerhans cells), which regulate the division of keratinocytes of the basal layer and their differentiation up to the final stage - transformation into dead cells (corneocytes), which form the stratum corneum of the skin.

There is also a direct relation to the complex tissue-specific biochemical processes of growth factors - epithelial (EGF) and transforming (TGFα), stimulating the corresponding keratinocyte receptors; adhesion molecules on their membranes; some interstitial enzymes.

As a result, by increasing the proliferation of the main epidermal cells to the level of hyperkeratosis and thickening of corneocytes, there is a local thickening of the stratum corneum, which, in fact, is dry corn.

If a dry callus appears with a rod on the hand, then this means the formation of a hard keratin cone or root in the center of the zone of increased keratinization of the epidermis, which, under the action of mechanical pressure, deepens into the underlying layers of the skin.

Symptoms of the dry calluses on hands

When the first signs of the formation of dry corns appear on the hand, on the area of \u200b\u200bthe palm or fingers, which is subjected to constant pressure, the skin becomes denser and rougher.

Later, symptoms such as hardening and thickening of the skin area appear, which looks like a dry, hyperkeratolytic plaque of a grayish or yellowish color, less sensitive to touch than the surrounding skin. Or there may be a rather soft yellow ring slightly protruding on the surface of the skin (due to an increase in collagen fibers in the stratum corneum) with a hard gray-yellow waxy center consisting of cemented keratin: this is a core dry callus on the hand. It is she who is accompanied by edema and is painful, since the solid rod displaces the skin tissues and begins to put pressure on the nerve endings. And simultaneous squeezing and damage to the capillaries can cause petechial hemorrhage.

Complications and consequences

If you do not take action, the consequences and complications of long-term dry calluses on the hands are almost inevitable:

• constant pain;
• cracking and ulceration of the upper layers of the skin and damage to deeper tissues in the form of fibrosis;
• ingrowth into the body of the callus of nerve endings and blood vessels;
• infection and inflammation (often purulent).

Diagnostics of the dry calluses on hands

Diagnosis of corns is carried out on the basis of anamnesis, examination and clinical picture.

Instrumental diagnostics using  dermatoscopy  can help in clarifying the size of the callus - the area of hyperkeratosis. And if the patient has pathological changes in the bone structures of the hand or fingers, an x-ray is performed.

Differential diagnosis

Differential diagnosis should exclude: focal palmoplantar keratoderma, Buschke-Fischer papular keratoderma, epidermolytic hyperkeratosis of the fingers, verruciform acrokeratosis and other  keratoderma , as well as keratosis of the palms with pityriasis versicolor and hyperkeratotic form of mycosis of the hands.

Treatment of the dry calluses on hands

For people who are faced with this problem, the main question is how to get rid of dry calluses on their hands. Detailed information on calluses with a stem in the material -  Callus: causes, structure, treatment

The main medicines that help remove such calluses are external agents with a keratolytic effect, which is provided by salicylic acid, urea (urea) or ammonium lactate (lactic acid salt) included in their composition:  salicylic ointment , Solkokerasal,  Hemozol , Keratolan, Karboderm, etc., corn fluid Kollomac

Read more:

• Ointments for corns
• Creams for corns

But before applying the ointment or cream to the corn, it must be made softer with a hot bath lasting a quarter of an hour - in a soapy solution with the addition of sodium bicarbonate (baking soda) and ammonia (no more than 10-12 drops per half liter of solution); with salt and baking soda dissolved in water (a teaspoon per 0.5 l) or with the addition of apple cider vinegar (half a glass per 500 ml). The softened corn is rubbed with a pumice stone, then the hand is rinsed, wiped dry and an ointment is used. It is recommended that such procedures be carried out every other day.

This procedure also precedes the use  of plasters from dry corns .

And therapeutic hand creams contribute to moisturizing and softening the skin .

Additionally, dermatologists advise taking vitamins A, C and D.

The alternative treatment differs from the above described method in that after a warm bath, not a pharmaceutical agent is applied to the corn, but, for example, raw onions, aloe leaf pulp, grated garlic, pine resin.

And herbal treatment is carried out with the same hot baths with decoctions of such medicinal plants as licorice (using the root), chamomile (flowers), sage. And on the steamed corn put a compress with the juice of fresh celandine leaves. If there is an emergency, surgical treatment is performed - laser removal or cryodestruction with liquid nitrogen, although the frequency of relapses after such treatment is quite high. In cases of dry corns with a deep core, surgical excision is resorted to.

Prevention

For most people, the prevention of dry calluses on the hands is the use of protective gloves.

It is also necessary to  properly care for the skin of the hands  - with the use of exfoliants to cleanse the skin of dead cells and prevent its thickening and natural vegetable oils (olive, linseed) that nourish the skin.

Forecast

Doctors do not consider dry calluses on the hands to be a serious health problem; in most cases you can get rid of them. Therefore, the prognosis is excellent. But if the cause of their appearance remains, then the problem is chronic.