Dry calluses on the hands

If a regular blister-like callus is formed due to friction, then hard dry calluses on the hands – on the wrists and fingers – have a slightly different origin and are treated differently.

Causes dry calluses on the hands

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

In this case, specific zones are noted where the pressure is increased during a number of activities using tools and equipment. Thus, a rower's callus from an oar forms on the metacarpophalangeal surfaces of the palms; between the metacarpal bones and the proximal phalanges of the fingers is a common place for dense calluses in weightlifters and kettlebell lifters; in jewelers, engravers and people who constantly manipulate small tools, the thumb, index and middle fingers of the working hand suffer. Hairdressers with the handle of scissors, and gardeners with the handle of pruning shears press on their callus on the 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 above activities, 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 common in the elderly.

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

The likelihood of such calluses appearing increases with pathological changes in the metacarpal bones; 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) on the palm side - as a result of injury, salt deposits, polyarthritis, arthrosis or deforming osteoarthrosis, 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 against damage to the deeper layers of the dermis.

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

Also noted is a direct relationship to complex tissue-specific biochemical processes of growth factors - epithelial (EGF) and transforming (TGFα), stimulating the corresponding receptors of keratinocytes; adhesion molecules on their membranes; some intra-tissue enzymes.

As a result, due to the increased proliferation of the main epidermal cells to the level of hyperkeratosis and compaction of corneocytes, a local thickening of the stratum corneum occurs, which, in essence, is a dry callus.

If a dry callus with a core appears on the hand, 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 influence of mechanical pressure, deepens into the underlying layers of the skin.

Symptoms dry calluses on the hands

When the first signs of a dry callus appear on the hand, on the area of the palm or fingers that is subject 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 slightly protruding on the surface of the skin, a fairly soft yellow ring (due to an increase in collagen fibers in the stratum corneum) with a hard waxy center of a gray-yellow color, consisting of cemented keratin: this is a dry rod callus on the hand. It is this that is accompanied by swelling and can be painful, since the hard rod displaces skin tissue and begins to press on the nerve endings. And the simultaneous compression and damage to the capillaries can cause pinpoint hemorrhage.

Complications and consequences

If no measures are taken, 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 of nerve endings and blood vessels into the body of the callus;
• infection and inflammation (often purulent).

Diagnostics dry calluses on the hands

Diagnosis of calluses is made on the basis of anamnesis, examination and clinical picture.

Instrumental diagnostics using dermatoscopy can help to clarify 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, X-ray is performed.

Differential diagnosis

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

Treatment dry calluses on the hands

For people who have encountered this problem, the main question is: how to get rid of dry calluses on the hands. Detailed information regarding calluses with a core in the material - Core callus: causes of appearance, structure, treatment

The main medications that help remove such calluses are external agents with a keratolytic effect, which is provided by the salicylic acid, urea (carbamide) or ammonium lactate (lactic acid salt) included in their composition: salicylic ointment, Solcokerasal, Hemosol, Keratolan, Carboderm, etc., callus liquid Collomak

Read more:

• Ointments for corns
• Creams for corns

But before applying ointment or cream to the callus, it should be softened with a hot bath for a quarter of an hour - in a soap solution with the addition of sodium bicarbonate (baking soda) and ammonia (no more than 10-12 drops per half a liter of solution); with table 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 callus is rubbed with pumice, then the hand is rinsed, wiped dry and the ointment is used. It is recommended to carry out such procedures every other day.

This procedure also precedes the use of plasters for dry calluses.

And medicated hand creams help moisturize and soften the skin.

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

The folk treatment differs from the method described above in that after a warm bath, instead of a pharmaceutical product, you apply, for example, raw onions, aloe leaf pulp, grated garlic, or pine resin to the callus.

And herbal treatment is carried out with the same hot baths with decoctions of medicinal plants such as licorice (they use the root), chamomile (flowers), sage. And a compress with the juice of fresh celandine leaves is placed on the steamed callus. If there is an extreme need, surgical treatment is carried out - laser removal or cryodestruction with liquid nitrogen, although the frequency of relapses after such treatment is quite high. In cases of dry calluses with a deep core, they resort to surgical excision.

Prevention

For most people, preventing calluses on their hands involves wearing protective gloves.

Proper care of the skin of the hands is also necessary - using exfoliants to cleanse the skin of dead cells and prevent its thickening, and natural vegetable oils (olive, linseed) to nourish the skin.

Forecast

Doctors do not consider dry calluses on the hands a serious health problem; in most cases, they can be eliminated. Therefore, the prognosis is excellent. But if the reason for their appearance remains, then the problem is chronic.