Peeling skin on the hands: pathology or temporary discomfort

Dry hand skin is a problem that affects many people. In medicine, dehydration of the skin is called “xerosis.”

Peeling, wrinkles and cracks on the skin of the hands cause cosmetic and physical discomfort and are a signal of the necessary care for your health. If your brushes feel rough to the touch, lose elasticity on both sides and feel tight, then your skin urgently needs special care.

To get rid of the discomfort and unaesthetic appearance of dry skin, you need to find the cause that caused dry hands.

Since there are no sebaceous glands on the palms, sebum is not produced in them. In the absence of natural lubrication, sebum, sweat performs its function of moisturizing the skin on the hands. Sweat protects against drying out and cracking. However, dehydrated skin is very common. There are many factors that lead to dry hand skin, tightness and roughness, and each of them requires intervention. Proper hygiene and care will keep your hands beautiful and healthy.

Causes

The cause of eczema is the body’s reaction to a variety of factors: chemical, infectious, medicinal, physical.
This reaction can be genetically determined (up to 60% if both parents have eczema) and consists of a complex of inadequate reactions of the body’s immune, nervous and endocrine systems to antigens. Why hands? Our hands come into contact with a huge number of different substances and environments: microbes and fungi, various detergents and cleaners, antiseptics (even in soap), temperature effects, prolonged exposure to water, professional contact with various aggressive chemicals. It is not surprising that at some point the body can malfunction and react violently to a seemingly ordinary stimulus.

What causes dry hand skin

The reasons why hands become rough and dry can be divided into two groups: external and internal.

Internal factors include:

• disruption of the functionality of internal organs and systems;
• weakened immune system;
• hereditary predisposition to dry skin of the hands;
• hypovitaminosis or vitamin deficiency (insufficient amount of vitamins);
• changes in hormonal balance;
• an allergic reaction to something;
• stress reactions.

External factors that lead to dry skin:

• negative effects of detergents;
• low-quality or unsuitable cosmetics;
• improper hygiene;
• adverse weather conditions;
• deficiency of moisture and fats;
• frequent contact with hot water;
• harmful effects of ultraviolet rays.

If a moisture deficiency occurs, which is accompanied by roughness, cracking, tightness and wrinkling, it is recommended to thoroughly reconsider your lifestyle and find out what led to dehydrated hand skin.

Forecast

The prognosis for eczema is most often favorable.
If you start proper treatment in time, you can curb the disease and get rid of its consequences. With adequate therapy, itching and elements of the old rash disappear, a new rash does not appear. Eczema is a chronic disease, so it is worth adhering to preventive measures and maintaining a state of remission. However, the timing of relapse is still unpredictable. Doctors give the most favorable prognosis for acute eczema. Recovery may be worse if eczema develops in young children, the elderly, or people whose bodies are weakened by infection. To enhance drug treatment, a hypoallergenic diet, physical activity, walking and hardening will help.

Diseases that are accompanied by dry skin

If dry skin is caused by pathologies inside the body, you should consult a doctor.
Creams, ointments and baths will only provide a temporary effect. While the skin will only be helped by eliminating the pathology that caused moisture deficiency. The following can lead to dehydration of the hands: allergies, fungus, iron deficiency anemia, gastrointestinal pathologies, skin diseases, weakened immunity, diabetes mellitus and other reasons. Allergies
An allergic reaction can be caused by wearing inappropriate jewelry on your hands or eating foods. Only a dermatologist can help determine the type of allergen. You can get rid of dry skin caused by allergens by completely eliminating contact with them.

Fungal infection
Dry hand skin can be a consequence of the pathological effects of fungi.
Often the feet and nail plates are simultaneously affected. If you suspect a fungus of any nature, it is recommended to consult a dermatologist or mycologist. The doctor will help determine the type of disease and tell you how to get rid of it. Iron deficiency anemia
Dry hand skin is just one of the manifestations of this disease, however, it is not the most pleasant one.
Timely consultation with a doctor (hematologist or therapist) and a balanced diet can completely get rid of anemia and its manifestations. Pathologies of the gastrointestinal tract
If the functions of any of the gastrointestinal organs are disrupted, the process of food absorption is disrupted.
Lack of vitamins and microelements adversely affects the skin. This becomes the main cause of dry epidermis. Skin diseases of various types
Psoriasis, dermatitis, keratosis, and eczema can lead to disruption of the hydrolipid balance. They not only cause dry hands, but also manifest as cracks, itching and redness in many areas of the skin. In this case, careful medical monitoring of the skin of the hands and other affected areas is required. Proper use of medications will help get rid of pathologies and their unpleasant manifestations.

Diabetes mellitus
With the development of diabetic neuropathy, sweating is impaired, which provokes the appearance of small cracks in the skin, dryness and a feeling of tightness.
Medicines prescribed by a doctor will help reduce the unpleasant manifestations of the pathology. Weakened immunity
Immune system dysfunction is not uncommon these days. Poor environmental conditions, overwork, poor nutrition and ignoring diseases - all this leads to weak immunity. In turn, manifestations on the skin in the form of dryness, cracks and redness serve as a signal about the need to monitor your own health. The skin on the hands and face suffers first, because they come into most contact with the environment.

Treatment of severe peeling hands

Common skin pathologies on the hands are treated with hormonal creams and ointments. The treatment regimen may include vitamins and antibiotics.

During the examination, the dermatologist will assess the condition of the skin, determine the cause and recommend additional measures that will alleviate the condition:

• take long, hot baths less often;
• moisturize the skin of your hands with oils;
• avoid soaps with an aggressive pH;
• use towels made of natural fabric.

General strengthening procedures promote rapid recovery.
It is important to normalize the diet and the diet itself, increase the body’s protective functions and improve metabolism. This is facilitated by physical exercise, acupuncture, massages, hirudotherapy, the effectiveness of which has been proven for skin diseases. August 16, 2021
Author of the article: dermatologist Mak Vladimir Fedorovich

Cracks in the arms or legs due to various diseases

If the symptom is caused by the reasons described above, it should go away fairly quickly after they are eliminated. In other cases, you need to sound the alarm - this means there is a disease that requires urgent treatment. Wounds that do not heal for more than 2 weeks or appear too often cannot be eliminated using home remedies - a comprehensive approach to treatment under the guidance of a doctor is required.

Here is a list of diseases that can cause cracks.

1. Hormonal disorders. Dryness of the epidermis accompanies any pathology of the thyroid gland, as well as diabetes. If the underlying disease is not treated, there is a high probability of complications in the form of damage to internal organs and the nervous system.
2. Malfunctions of the gastrointestinal tract. The connection between the digestive process and the external state of the body is ensured through metabolism. With ulcers, gastritis and dysbiosis, the blood does not receive enough nutrients, which negatively affects the elasticity of the epidermis. As a result, it becomes dry and dehydrated.
3. Eczema. The disease is dangerous because it quickly becomes chronic and cannot always be corrected. Painful wounds are one of the first signs of illness. Symptoms also manifest themselves in the form of peeling, severe itching, and sometimes hyperemia.
4. Fungus on fingers. In most cases, it affects the lower extremities, which is associated with insufficient hygiene or visiting public places without shoes (for example, public showers or baths). Less commonly, fungus develops on the hands, but it is no less dangerous in this case. Once pathogenic microorganisms have settled in a certain place, it is extremely difficult to expel them from there. The infection also often spreads to the nails, contributing to their destruction.
5. Psoriasis. Contrary to popular belief, this autoimmune disease is not infectious in nature, so you cannot become infected with it. The development of the disease is caused by a complex internal imbalance, due to which it is impossible to completely cure psoriasis - it can only be corrected, and in some cases it is possible to completely eliminate its manifestations.

Causes and symptoms of muscle atrophy in the arm, shoulder and hand

The article was prepared by a specialist for informational purposes only. We urge you not to self-medicate. When the first symptoms appear, consult a doctor.

Atrophy of the muscles of the arm, hand, and forearm develops mainly as a secondary disease against the background of impaired innervation (nutrition, blood circulation) in a certain area of ​​muscle tissue and less often as a primary disease (usually with myopathy), when motor function is not impaired.

Causes of muscle atrophy in the arm, shoulder and hand

For the development of muscle atrophy, the predisposing reasons are: occupational factor (constant overexertion during heavy physical work), arthrosis of the wrist joint, endocrine pathology - obesity, diabetes mellitus and thyroid diseases, acromegaly; cicatricial processes after injuries, metabolic and systemic diseases (lupus erythematosus), tumors of various origins, congenital pathologies of the lower limb.

Symptoms of muscle atrophy in the arm, shoulder and hand

Muscle atrophy is a serious disease that primarily affects muscle fibers. The main typical symptom is the symmetry of the lesion (except for myasthenia gravis) and the slow development of the disease (except for myositis), atrophy of the affected muscles and weakening of tendon reflexes with preserved sensitivity.

Most peripheral nerves have a mixed structure, and when damaged, the work of sensory, motor and autonomic fibers is disrupted. It happens that one of the fibers is most affected.

If motor fibers are involved in the process, then paresis of the muscles innervated by this nerve occurs. The patient complains of muscle weakness, low muscle tone. Atrophy does not develop immediately, but 2-3 months after the lesion. In the absence of proper treatment, after a year and a half, the muscle will completely atrophy.

If sensory fibers are involved in the process, the clinic manifests itself as parasthesia - patients feel a tingling sensation, goosebumps. Neurological symptoms are expressed in the form of hyperesthesia (increased sensitivity) or hypoesthesia (decreased sensitivity). A feeling of numbness in the affected limb appears with extensive damage to the nerve fibers.

In most cases, there is a decrease in pain sensitivity while maintaining tactile sensitivity. In the later stages of the disease, deep hypoesthesia occurs, up to a complete lack of sensitivity. Redness or paleness of the skin, the appearance of a marble pattern indicates vascular disorders that occur when the vegetative fibers are directly damaged.

As a rule, increased or decreased sweating of the affected limb is associated. The concern is a burning pain of a hyperplastic nature, radiating to the entire limb involved in the process. The trophism (cellular nutrition) of tissues is disrupted due to deep vegetative disorders.

Atrophy of the arm muscles begins, as a rule, from the most remote or distal parts of the upper limbs. The hand takes on the appearance of a “monkey hand” due to damage to the interosseous muscles and fingers. There is a complete loss of tendon reflexes, but sensitivity is retained in the affected limb. As the disease progresses, the muscles of the neck and torso become involved in the process.

Diagnosis of atrophy of the muscles of the arm, shoulder and hand

Making a diagnosis does not currently cause any particular difficulties due to the introduction of electromyography and biopsy of the affected muscles into the clinical examination. The patient is required to undergo biochemical and general blood tests, and a urine test; The activity of muscle enzymes is determined in blood serum (mainly by the CPK method). Creatine and creatinine levels are calculated in urine. According to indications, the patient is sent for a CT or MRI of the cervicothoracic spine and brain, and examination for endocrinological pathology.

Treatment of muscle atrophy in the arm, shoulder and hand

When choosing a treatment method, the following factors are taken into account: the form of the disease, the severity and extent of the process, the age of the patient. Along with drug treatment, great importance is attached to proper nutrition, physiotherapeutic procedures, courses of therapeutic massage and gymnastics, and electrotherapy. In some cases, it is appropriate to prescribe psychotherapy sessions for the patient.

Currently, there is no drug that can completely cure muscle atrophy, but the correct choice of treatment method and timely diagnosis can slow down the pathological process, restore muscle regeneration and return lost abilities to the patient. The main thing is to strictly adhere to the doctor’s recommendations.

Author of the article:

Mochalov Pavel Alexandrovich |
Doctor of Medical Sciences therapist Education: Moscow Medical Institute named after. I. M. Sechenov, specialty - “General Medicine” in 1991, in 1993 “Occupational diseases”, in 1996 “Therapy”. Our authors

Skin xerosis. Part 2: treatment

Dry skin is a constant symptom of various skin diseases, such as atopic dermatitis, psoriasis, eczema, etc. It has now been proven that the constant use of combined moisturizing and lipid-restoring skin products is an essential component in the treatment of many dermatoses [1]. Restoring the damaged epidermal barrier becomes a priority for dry skin. The higher the skin's permeability to water, the deeper the surfactants (surfactants) of detergents, microbes and toxins penetrate into it, causing an inflammatory reaction and the formation of free radicals in the skin. Dry skin is cyclical in nature with an age-related tendency to worsen the condition, so rational cosmetic care adapted to the physiology and structure of the skin is very important. Moisturizers reduce the subjective feeling of tightness, dryness, discomfort, increase the elasticity and tolerance of the skin, even out the microrelief and color of the skin, and strengthen the water-lipid mantle.

The increase in the number of moisturizers with different mechanisms of action occurs in parallel with increasing knowledge about the physiology of the stratum corneum. The study of the epidermal barrier (primarily the lipid matrix) led to the creation of a new therapeutic direction in dermatology - “corneotherapy”. “Corneotherapy” - “treatment of the stratum corneum” (from Latin corneum - horny and English therapy - treatment). It was proposed by the famous American dermatologist Albert Kligman, who has the honor of discovering the role of retinoids in the treatment of acne. A. Kligman became a pioneer in research into the physiology of the outer skin, which led to the development of the concept of the “living stratum corneum”.

You can eliminate dryness of the stratum corneum in various ways:

1) creation of an occlusion on the skin surface that prevents transepidermal water loss (TEWL); 2) use of replacement therapy; 3) use of emollients; 4) creation of osmotic humidification; 5) restoration of the epidermal barrier; 6) use of hygroscopic agents; 7) activation of aquaporin synthesis.

Creation of an occlusion on the skin surface that prevents transepidermal moisture loss. Probably the oldest method of moisturizing is the use of substances that create a waterproof film on the surface of the skin that prevents evaporation. In this way, a compress effect (occlusive dressing) is achieved, which restores and improves the diffusion of fluid from the capillaries of the dermis into the epidermis. Moisturizers with an occlusive effect are used mainly in dermatology, in the treatment of diseases accompanied by increased skin dryness and inflammatory processes, in cosmetology after plastic surgery, such as skin resurfacing, and also to protect the skin during frequent contact with detergents. It is important to remember that this method can be used when the properties of intercellular lipids are undisturbed. This method allows you to capture and redistribute moisture throughout the entire thickness of the epithelium. Although, according to Koshevenko Yu. N. (2008), such occlusion leads not only to a slowdown in the restoration of the barrier function of the epidermis, but also to a disruption in the secretion of lamellar bodies [2].

Occlusive type humidifiers include:

1) fatty acids (lanolin, stearic, etc.); 2) fatty alcohols (lanolin, palmitic, caprylic, etc.); 3) hydrocarbon oils and waxes (vaseline, paraffin, mineral oils, squalene); 4) phospholipids; 5) waxes of plant and animal origin (carnauba wax, lanolin); 6) solid vegetable oils (cocoa, shea, coconut, macadamia, etc.).

Traditionally, in dermatology, for dry, non-oily skin, lipophilic creams of the “water in oil” type are used; such creams are difficult to wash off and, due to the occlusive effect, do not allow the skin to lose moisture and protect against overdrying [3].

Vaseline is the most reliable and proven occlusive coating in dermatology. It is used in products intended to moisturize the skin for psoriasis, atopic dermatitis, etc., as it retains moisture in the skin very well. On the one hand, Vaseline creates a physical barrier to evaporating moisture, on the other hand, it “glues” the horny scales together, resulting in a decrease in the area of ​​contact between the intercellular spaces and the air, which inhibits the process of transepidermal water evaporation. A gel containing 5% petroleum jelly reduces TEWL by 98%. However, moisturizing the skin with Vaseline can be regarded as passive, since it only helps to retain the moisture that is already in the stratum corneum. Another option for hydration - active - is that hygroscopic substances that are capable of binding and retaining water through ionic interactions are introduced into the stratum corneum [4].

Vaseline is currently practically not used in cosmetology, since it is subjectively uncomfortable to use: it is poorly absorbed, shiny, and leaves a feeling of a sticky film. Some cosmetologists recommend Vaseline-based creams to protect the skin during the winter. However, studies have shown that petroleum jelly creates a deceptive sensation of warmth and thereby increases the likelihood of frostbite [5, 6].

Moisturizers intended for the winter period often include saturated fats (goose, badger, bear). Cosmetics containing saturated fats soften the skin well, protect it from frostbite and drying out, but it is not recommended to use it constantly [5].

It should be added that at low temperatures, moisture evaporates from the surface of the skin very quickly, so the prevailing opinion that there is no need to use moisturizers in winter is nothing more than a misconception. It is important to choose them correctly. Winter products should not form too dense an occlusive film and disrupt tissue respiration processes. Such preparations usually include shea butter, jojoba, and macadamia oil, which are quickly absorbed by the skin and create a thin, mobile film without disturbing natural processes. In the winter season, you should be wary of products containing hyaluronic acid and urea, which excellently retain moisture, but in the cold they turn into a crust, resulting in damage to skin vessels.

Recently, silicone occlusive coatings (for example, dimethicone) have become popular, which are widely used in plastic surgery after laser resurfacing, dermabrasion, and other operations. Silicone film, like Vaseline, retains moisture in the skin, preventing stress caused by disruption of the epidermal barrier [5, 7–9].

Occlusive moisturizing creams quickly eliminate dry skin, reduce inflammation and itching in skin diseases, however, they do not eliminate the causes of skin dehydration and can cause local tissue swelling, so they are not suitable for everyone. Thus, if the process of normal restoration of the barrier structures of the stratum corneum is disrupted, for example, in certain skin diseases, occlusive creams are necessary. If there is a chance of restoring the stratum corneum barrier, they should be used only in emergency cases. They are contraindicated for people with healthy skin, as they can disrupt the barrier properties of the epidermis [2].

Replacement therapy. In order to increase the moisture content of the stratum corneum, the same substances that are part of the natural moisturizing factor are added to cosmetics. These are urea, amino acids (serine, glycine, alanine, proline), minerals (magnesium, potassium, sodium, calcium), sodium pyrroglutamate (Na-PCA), lactic acid. Penetrating into the thickness of the stratum corneum, they are localized around corneocytes and create a kind of aqueous membrane [10]. Such humidification has a delayed but prolonged effect and is least dependent on air humidity. The result lasts until the moisturizing components are removed along with the horny scales [5, 8, 10].

Urea is introduced into cosmetic formulations in a concentration of about 5%. Not recommended for use in cosmetics for sensitive skin and children's cosmetics. Has moisturizing, exfoliating and antimicrobial effects. When a person sweats, part of the sweat evaporates, and urea remains on the surface of the skin, adsorbs moisture from the air and retains it in the stratum corneum. It is capable of destroying hydrogen bonds of protein chains, changing the configuration and state of aggregation, promoting the binding of water to the surface of the protein. The small urea molecule penetrates well into the skin, so it can simultaneously serve as a conductor for other active ingredients included in the cosmetic product [5, 6, 9].

Lactic acid. According to research, lactic acid and its salts (lactates) act not only as a hygroscopic agent, but also enhance the synthesis of ceramides by keratinocytes. The L-isomer of lactic acid exhibits the greatest activity and significantly (up to 48%) increases the content of ceramides in the stratum corneum. The introduction of lactic acid into the stratum corneum significantly increases its elasticity, eliminates the symptoms of xerosis and reduces the degree of TEWL. Thus, lactic acid has a moisturizing, exfoliating, and antimicrobial effect [5, 6, 8, 10].

Sodium pyrroglutamate (Na-PCA) is formed in cells during the process of keratinization from the filaggrin protein, and is used in cosmetics as a moisturizing ingredient. The best results are obtained by introducing Na-PCA into liposomes [6, 10].

Amino acids . Of the amino acids that make up NMF, serine, lysine, valine, and citrulline are used in cosmetology. As a rule, not pure amino acids are added to cosmetic preparations, but protein hydrolysates (for example, soy, silk, milk proteins). When sericin (silk protein) is applied in the form of a hydrogel on the skin surface, deep and prolonged hydration of the skin, restoration of the amino acid component NMF, and smoothing of the skin microrelief are observed [5, 8].

Procedures using silk protein involve the application and dissolution of silkworm cocoon fibers directly onto the skin and the absorption of this hydrolyzate by the skin. The chemical name for these fibers is fibroin, a fibrillar protein with a molecular weight of 55,000–100,000 daltons. In their natural state, fibroin fibers are interconnected by the so-called “silk rubber” (sericin protein). In order to keep the fibroin fibers in a dry state, scientists were able to separate the protein bodies from each other and then reunite them during the procedure. Some of the peptides and amino acids gradually penetrate into the stratum corneum, retaining moisture in it for a long time [6].

Emollients . To give the finished product optimal sensory characteristics and regulate occlusive properties, ester emollients are added to moisturizers. Based on polyunsaturated fatty acids (vegetable oils), emollient moisturizers are created that fill the space between exfoliating stratum corneum, replace defects in the stratum corneum formed as a result of excessive desquamation of corneocytes, and replenish the lack of surface lipids. Emollients allow you to adjust the degree of occlusion and provide a quick and prolonged softening effect. Animal studies indicate that this type of moisturizer can cause comedones. Thus, the use of occlusive-type moisturizers is justified in cases where it is necessary to urgently block the transepidermal loss of moisture from the skin and maintain the level of hydration necessary for the normal functioning of cells. Such properties are possessed by a series of post-peeling skin care products and hand products that experience daily attacks from surfactants in detergents and destroy the lipid barrier [8, 10, 11].

Osmotic hydration is achieved by increasing the concentration of osmotically active ingredients. As is known, the hydrobalance of the skin is normalized by the mineral substances that make up the thermal waters. Currently, they are used mainly in the form of aerosols. Vaporized onto the stratum corneum, they increase its osmotic pressure. At the same time, water from the underlying layers enters the stratum corneum and is retained in it, normalizing the concentration of salts and restoring the natural water balance. As a result, the water content increases [10].

Restoration of the epidermal barrier . To restore the epidermal barrier, lipids are used both in the form of pure oils and in combination with other ingredients. It has been proven that local application of lipids (ceramides, phospholipids, triglycerides) accelerates the restoration of the lipid barrier of the skin, with the optimal ratio of ceramides, fatty acids and cholesterol being 1:1:1–3:1:1. The process of restoring the epidermal barrier is a long process and occurs only after the epidermal cells receive the necessary building material and produce a sufficient amount of ceramides and other epidermal lipids from which the epidermal layers will be built [6].

In the 90s, the sympathies of cosmetics manufacturers turned away from the use of natural oils, since silicones came into cosmetic production (in the list of ingredients they can be distinguished by the ending “con”, for example, simethicone, cyclodimethicone, etc.), synthetic derivatives of fatty acids ( they usually have complex names, such as isopropyl myristate, etc.) and other achievements of cosmetic chemistry. With these substances, it became possible to create cosmetics with precisely specified characteristics, which is very difficult with natural oils. However, it was later found that the skin can extract the fatty acids it needs from fats and oils and use them to synthesize its own epidermal lipids, prostaglandins and other regulators of local immunity. Fatty acids enter the skin, as a rule, with natural oils containing essential fatty acids (linoleic, linolenic, arachidonic, as well as their derivatives - gamma-linolenic, arachidonic and some others). More often in cosmetics, olive, soybean, corn oils or oils of black currant, borage, borage, and evening primrose are used [6].

Since these oils are easily oxidized, antioxidants are added to them - vitamin E, carotenoids. It is useful to use oils that themselves have an antioxidant effect - avocado oil, shea butter, grape seed oil, wheat germ oil, rice bran oil. Oils with a high content of unsaponifiable fraction (linseed, soybean, shea, wheat germ) additionally have a phytoestrogenic effect and high anti-inflammatory properties.

But you should always remember the downside of cosmeceuticals based on oils and fats. For example, triglycerides create occlusion and disrupt regeneration processes, preventing the natural moisturizing factor from working, i.e., receiving moisture from the air. Mineral oils also cause occlusion; among other things, they increase the skin’s sensitivity to ultraviolet radiation, which can lead to photosensitivity and hyperpigmentation, so in the summer you should not be overzealous with preparations with a high content of triglycerides and mineral oils.

Ceramides have recently become very popular ingredients in cosmetics. The popularity of ceramides is due to the role they play in maintaining the integrity of the epidermal barrier. Due to the presence of a multilayer lipid layer between the horny scales, the stratum corneum is able to effectively protect the skin not only from the penetration of foreign substances from the outside, but also from dehydration.

To transport hydrophilic active substances into the epidermis, transdermal carriers are often used - complexes of hydrophobic molecules surrounding the active components. The most popular transdermal carriers are liposomes—capsules built from ceramides or phospholipids. The liposome wall consists of a lipid bilayer, and the internal hydrophobic space contains biologically active substances.

Liposomal preparations based on ceramides have a good cosmetic effect, but they are quite expensive and difficult to produce due to the low solubility of ceramides in water. Recently, emulsions based on saturated phospholipids (they are similar to ceramides, but have two hydrophobic tails) have become increasingly popular. These can be liposomes or flat membrane-like structures (lamellae). Such phospholipids form crystal structures similar to the structure of the lipid layers of the stratum corneum. When exposed to a damaged stratum corneum, liposomes or lipid lamellae are embedded in areas deprived of lipids, thereby temporarily restoring the epidermal barrier [2, 6, 10].

Fundamental research in the field of cytology, biochemistry and biophysics of the skin has led to the emergence of a new drug that maintains water balance in the skin - the dermal membrane structure (DMS®) of the cream imitates the natural structure of the arrangement of epidermal lipids. DMS has a lamellar structure and undetectable particle sizes, in contrast to the drop-shaped structures of traditional creams. It is this technology that is used to create Physiogel cream, which has a full set of lipids identical to the lipids of the epidermis. A feature of this cream that distinguishes it from other creams is a special substance - hydrogenated phosphatidylcholine (HPC). As is known, natural phosphatidylcholine is a key component of keratinocyte cell membranes. In the stratum corneum it serves as a source for sphingomyelin and ceramides. Hydrogenated phosphatidylcholine, which is part of Physiogel, is essentially a skeleton on which the lipids of the cream are fixed, creating a natural self-emulsifying system. This system provides the cream with a number of properties:

• there is no ability to form emulsions in the form of “water in fat” or “fat in water”;
• forms the lamellar structure of DMS (lamellar structures consisting of bilipid layers that retain physiological lipids);
• able to penetrate deep into the stratum corneum of the epidermis;
• enhances skin barrier properties and photoprotection.

The use of “self-emulsifying” systems based on phosphatidylcholine minimizes the risk of irritation and justifies its use for the treatment of chronic dermatoses. DMS ensures the “correct” penetration of lipids - it is embedded in the stratum corneum, but does not penetrate deeper.

Scientific studies conducted using instrumental research methods (electron micrographs and determination of corneometry) have established that by the 14th day of comparative testing of various creams, Physiogel has indicators that are not inferior to other creams in terms of the degree of skin hydration. But by the 28th day, the moisture content increases 4 times and is far ahead of other creams. These studies prove that Physiogel cream does not provide passive hydration, but active one, restoring the natural water-saving structure of the epidermis.

It should be remembered that the process of skin restoration occurs slowly. Therefore, the effect of using Vaseline, emollients and moisturizers will be more noticeable than the effect of using creams containing essential fatty acids. Since polyunsaturated fatty acids cannot be an emergency treatment for barrier breakdown, they must be taken regularly to prevent the occurrence of deficiency conditions.

Moisturizing the skin with hygroscopic agents. For normal skin without gross pathologies, non-occlusive moisturizers are used. Usually these are gels containing hygroscopic substances (proteins, polysaccharides, glycosaminoglycans).

Glycerin is an effective humectant under normal atmospheric humidity conditions. Glycerin is hygroscopic, but has high volatility, which negatively affects the duration of the moisturizing effect. Glycerin does not have the ability to penetrate deep into the stratum corneum, so its effect is superficial. But it softens the skin, lowers the freezing point of liquid (prevents the cream from freezing on the face on a frosty day), and in humid air it works as a skin moisturizer, attracting moisture from the atmosphere. However, in dry air it has the opposite effect - it draws water from the stratum corneum, so upon short-term contact with the skin it has a moisturizing effect, but then, on the contrary, it aggravates the dryness of the skin, drawing moisture from it. For example, sorbitol is less hygroscopic than glycerin, so there is less risk of skin drying [4].

Propylene glycol is used as a solvent in cosmetic formulations (replaces water). Non-toxic, softens the skin, reduces the freezing point of liquids, and has an antimicrobial effect. It is highly hygroscopic, however, like glycerin, in a dry atmosphere it can draw water from the stratum corneum [4].

Hyaluronic acid (HA) is a glycosaminoglycan, which is the main component of the intercellular matrix of living tissues. Until recently, HA was spoken of as the main substance of the intercellular substance of the dermis. However, recent studies indicate that HA performs essential functions in the epithelial layer of the skin and enters the epidermis not from the dermis, but is synthesized by the corneocytes themselves [12, 13]. In this case, the synthesis of molecules with a very large molecular weight occurs - about 2 million kDa, and the catabolism of HA also occurs in the lysosomes of keratinocytes. This natural polysaccharide takes an active part in the proliferation, differentiation and migration of keratinocytes, therefore its amount is under the control of various regulatory molecules and is maintained at a level of 0.1 mg/kg.

HA is a very popular ingredient in skin care products. Cosmetic preparations with HA have a pronounced moisturizing effect due to the formation of a thin film on the surface of the skin, which helps reduce TEWL, which actively absorbs moisture from the air. This helps to increase the free water content in the stratum corneum, and also creates an “additional moisture” effect, which helps reduce the evaporation of water from the surface of the skin. As is known, HA is able to penetrate into the deep layers of the skin and transport substances associated with it or enclosed in its mesh structure.

Soluble collagen, due to its hygroscopic properties, forms a moisturizing film on the skin, thus reducing water loss through the stratum corneum.

Chitosan is a polysaccharide obtained from the shells of marine crustaceans. Forms a moisturizing film on the skin, softens the skin and protects it from damage.

Beta-glucan is a polysaccharide obtained from the cell wall of baker's yeast. Forms a moisturizing film on the skin, protects the skin from UV radiation, and has an immunostimulating effect.

Activation of aquaporin synthesis. As stated in the first part of the article, transmembrane proteins aquaporins play an important role in maintaining normal levels of skin hydration. The human epidermis contains the main skin aquaporin, aquaporin-3 (AQP-3), located on the keratinocyte membrane.

In skin pathologies characterized by impaired barrier function and dry skin, changes in the expression of aquaporins are observed. An interesting fact is that the expression of AQP-3 decreases in direct proportion to the degree of exudation in eczema, while at the same time its increased expression is noted in atopic dermatitis [14–16].

When the AQP-3 content decreases, the hydration of the epidermis and the barrier function of the skin are disrupted, and its elasticity decreases. In addition, it has been proven that with age, the amount of AQP-3 in the epidermis decreases, which is the main reason for the decrease in hydration levels of aging skin. Currently, an active search is underway for compounds that stimulate the synthesis of aquaporins. Modulation of their expression is one of the promising ways to moisturize the skin [14–16].

In conclusion, it must be emphasized that we are talking not only about auxiliary therapy of cosmeceuticals during an exacerbation, but also about a very important issue - securing remission by actively restoring the integrity of the skin and its normal function with the help of therapeutic and cosmetic products. Today, a doctor’s arsenal includes a sufficient number of moisturizing and softening therapeutic and cosmetic products specially created for caring for the skin of patients, and the ability to navigate them is the key to the success of therapy.

Literature

1. Lomakina E. A. The role of the barrier function of the skin in the pathogenesis of some dermatoses // Modern problems of dermatovenereology, immunology and medical cosmetology. 2009, no. 2. pp. 87–90.
2. Koshevenko Yu. N. Human skin. T. 2. M.: Medicine, 2008. 754 p.
3. Lulman H. Visual pharmacology. M.: Mir, 2008. 383 p.
4. Hernandez E. Polyhydroxy acids against ichthyosis // Peelings. 2010, no. 1. pp. 18–22.
5. Timofeev G. A. Methods of hardware research of human skin // Cosmetics and medicine. 2005; 4:30–36.
6. Margolina A. A., Hernandez E. I., Zaikina O. E. New cosmetology. M., 2002. 208 p.
7. Modern external therapy of dermatoses (with elements of physiotherapy) / Under. edited by N. G. Korotky. Tver: “Provincial Medicine”, 2001. 528 p.
8. Puchkova T.V. Explanatory dictionary of cosmetics and perfumery. M.: School of cosmetic chemists, 2005. 192 p.
9. Ivanova L., Podolyak S. Active moisturizing components in cosmetics // Journal of applied aesthetics Les Nouvelles Esthetique. 2008, no. 3. pp. 125–132.
10. Hernandez E.I. Skin hydration. M.: LLC "Firm Clavel", LLC "School of Cosmetic Chemists", 2007. 32 p.
11. Timofeev G. A. Dry skin. Functional diagnostics. Tactics // Cosmetics and medicine. 2007, no. 2. pp. 58–62.
12. Koshevenko Yu. N. Human skin. T. 1. M.: Medicine, 2006, 360 p.
13. Myadlets O. D., Adaskevich V. P. Morphofunctional dermatology. M.: Medlit, 2006. 752 p.
14. Tkachenko S., Hernandez E. Aquaporins in the regulation of skin water balance // Cosmetics and medicine. 2011, no. 2. pp. 26–33.
15. Cork MJ, Robinson DA, Vasilopoulos Y. et al. New perspectives on epidermal barrier dysfunction in atopic dermatitis: gene-environment interactions // J Allergy Clin Immunol. 2006; 118(1):3–21.
16. Wilkinson JD The skin as a chemical barrier. In: The Physical Nature of the Skin. Marks RM, Barton SP, Edwards C. eds. MPT Press, 1988: 73–78.

Yu. A. Gallyamova, Doctor of Medical Sciences, Professor O. A. Barinova

GOU DPO RMAPO, Moscow

Contact information for authors for correspondence

Treatment of the pathological condition

The first and surest step to getting rid of an uncomfortable condition is to see a doctor. It is optimal to visit a therapist who, if necessary, will refer you to a dermatologist, endocrinologist or gastroenterologist. The exact cause of the cracks will become known after a series of tests (blood tests, scraping of epidermal cells from the affected area, etc.). Based on the diagnostic results, the doctor decides on a plan on how to treat the cracks. As a rule, local drugs with restorative properties, vitamin and immunostimulating complexes are prescribed. For fungal infections, antifungal ointments and creams, as well as antibiotics, are used. Endocrine disorders are eliminated through hormonal therapy.

Soda and salt baths and compresses based on pharmaceutical herbs (chamomile, calendula) are indicated as additional therapeutic measures. Such procedures can be carried out at home. In addition, it is recommended to regularly lubricate the skin with emollient creams and Vaseline.

What to do with dry hand skin?

If the skin on your hands has become dry, your palms are flaky, or your hands feel unpleasantly dry, the skin is most likely having difficulty retaining moisture. This can happen if the natural protective barrier of the skin, its hydrolipid mantle, is disrupted.

Repairing cream for very dry hands CeraVe

CeraVe restoring cream for very dry hand skin contains components aimed at strengthening the hydrolipid barrier and intensively moisturizing the skin. Let's look at them in more detail:

Ceramides: these are lipids that help maintain the protective functions of the skin and help restore and strengthen its hydrolipidic barrier.

Hyaluronic Acid: Draws moisture into the upper layers of the skin, helping to maintain hydration for a long time.

Phytosphingosine: is a phospholipid that helps strengthen the skin's own protective functions. It helps reduce moisture loss from the upper layers of the skin and protect it from dehydration.

CeraVe Revitalizing Cream is formulated with MVE technology, a gradual release of active ingredients that helps provide long-lasting hydration to the skin. It is fragrance-free, paraben-free, hypoallergenic and suitable for very dry hands.

Revitalizing hand cream

For very dry skin

Moisturizes dry, chapped hands, helping to restore and strengthen the protective skin barrier.

More details

What to do if you have dry hands

If the problem is caused by internal causes, you need to focus on treating the underlying disease. However, there are general recommendations that help normalize metabolic processes in the dermis and help eliminate dry skin on the hands:

• keeping hydrated (drinking enough fluids);
• healthy, balanced diet, rich in unsaturated fatty acids (avocado, vegetable oils, fatty fish, nuts, etc.);
• smoking cessation and moderate alcohol consumption;
• adequate physical activity;
• reducing time spent in the sun;
• use of mild cleansers and care products for dry skin.

Center for Aesthetic Cosmetology "SM-Cosmetology" - a place where they will help you

Our Center employs experienced specialists of various profiles - cosmetologists, nutritionists, dermatologists, gastroenterologists, endocrinologists, etc. They will not only help soften the skin of your hands, but will also identify the causative factor of this condition.

The examination at the clinic is carried out comprehensively and individually, taking into account all possible characteristics of the body and past diseases. This approach allows you to choose the optimal treatment and procedures.

Among the methods that guarantee softening and rejuvenation of the skin of the hands in SM-Cosmetology:

• endermolift LPG;
• ultrasonic cleaning;
• microcurrent therapy;
• Starvac massage;
• spa treatments;
• RF lifting;
• ZEIN OBAGI (therapeutic cosmetics);
• various hand skin care products.

Call us and we will answer all your questions in detail!

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Associated symptoms

Often, xerosis is a temporary phenomenon that is disturbing during the cold season. The intensity of the manifestation depends on the general condition of the body, age, and the presence of pathological causes. Additional symptoms may indicate that the condition is caused by a disease:

• redness that spreads to adjacent areas of the skin;
• feeling of tightness, discomfort;
• microcracks;
• wrinkled, dehydrated skin;
• increasing itching;
• the appearance of wounds and ulcers that are difficult to heal;
• roughening of the skin, thickening of the top layer.

Depending on the pathogenesis of the disease, the dermatologist will prescribe a comprehensive treatment regimen with procedures and medications.

Features of seasonal care for dry skin

What to do and how to deal with very dry skin in winter and summer? Will basic care methods vary depending on the season? Yes - and now we will tell you how.

Care in autumn and winter

Dry hands in the autumn-winter period is one of the common problems in both women and men. The skin of your hands may peel, suffer from dryness and a feeling of tightness... The following measures will help combat the fact that your palms or fingers are peeling:

1. Use special hand products designed for use before going outside, and moisturizing and restorative products after returning home.
2. Try not to appear outside without gloves, protect your hands from temperature changes and sharp winds.
3. Do not forget to regularly moisturize your hands when in a room where heating devices are operating.

Care in spring and summer

If your hands peel in the warm season, it may also be a matter of incorrectly chosen care, or a possible lack of vitamins and minerals in the diet. Here's how you can try to fix this situation:

1. Try not only to moisturize the skin of your hands, but also to protect it from aggressive sun rays using cosmetics with SPF protection.
2. Remember to drink enough clean water to prevent general dehydration.
3. Watch your diet: eat more vegetables, fruits, fatty fish and other sources of skin-healthy nutrients.

TOP 4 rules for caring for dry and very dry hand skin

Here are some general tips and tricks that may help if the skin on your palms and hands is flaking:

1. Choose your hand cleanser for daily use carefully. If the skin on your palms and arms is dry, you can pay attention to creamy cleansers labeled “soap-free.”
2. If there are no wounds or cracks on the skin of your hands, then 1-2 times a week you can gently scrub the skin of your hands as an option for intensive cleansing. Gentle exfoliation will not only help stimulate the renewal of the upper layers of the skin, but can also make it more receptive to the use of moisturizing and restorative care products.
3. If your hands are very dry, try to use specialized care every day - for example, CeraVe restoring cream for very dry skin of hands, which contains components that help restore the skin's own protective functions, moisturize it and strengthen the lipid barrier.
4. Don't forget to protect your hands (household gloves) when working with cleaning products and other household chemicals. They often contain alkaline and other aggressive components that can negatively affect the condition of the skin of the hands, causing irritation and dryness.

We hope that this article helped you understand the reasons why your hands may peel, answered questions about what to do with dry fingers, hands and palms, and suggested how you can deal with the problem of dry hands depending on the season!