Nail Clinic: Peeling Skin In Exfoliative Keratolysis


With winter weather, chapped, dry skin is nothing new. But sometimes more is going on than you think with peeling skin. Aside from regular dryness, dry skin can be caused by fungal infections, psoriasis, eczema, or exfoliative keratolysis.

What is exfoliative keratolysis?
A common problem, exfoliative keratolysis is the peeling of the outer layer of skin (sort of like a sunburn). Unlike a fungal infection, the peeling covers the whole hand (not just a select area), and unlike eczema, it does not itch. Exfoliative keratolysis can begin as small blisters that turn into a peeling that never really seems to go away or heal.

What is the cause?
It is unknown why some people get exfoliative keratolysis, but we do know it has something to do with changes in keratin production. It can also be genetic – something a person just has their whole life. Another cause is extended exposure to moisture – such as having hands continually wet or soapy – which shows up in those who often do dishes, and some people in the medical profession who repeatedly have to wash their hands. In this last case, wearing gloves can make a huge difference in relieving exfoliative keratolysis.

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What can help treat it?
If clients often have wet hands, gloves should be worn to keep them dry instead.

?For chapped hands, moisturizing can make a world of difference. Lotions or creams containing urea or lipids (often ingredients ending in –ate) help protect skin.

For very chronic cases that resist all other remedies, “photo chemotherapy” may be used by a dermatologist. This essentially entails the patient applying ointment sensitive to the UV light, leaving it on for thirty minutes, removing it, and then putting the affected area under a UV light box for another thirty minutes.

What should you do?
As a tech, remember it is not your place to diagnosis or treat any conditions you see in your clients. And if you do see a major issue, you should not attempt to continue servicing your client, as this could make any unknown condition worse. In minor peeling, avoid doing any electric filing on the skin of your client. In fact, dermatologists recommend you stay away from the skin altogether – you can gently clean around the nails – but avoid the skin itself. Acetone especially can further irritate skin, so if using acetone is necessary, apply a layer of white petroleum jelly to skin first. This protects the skin from the acetone, and a gentle over-the-counter cleanser can then remove the petroleum jelly.

[Image: Thinkstock/iStockphoto]

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