Hello,

You are still dealing with an eczema condition, despite the different named manifestation. Exfoliative keratolysis would be a subcategory under eczema or dermatitis. The type of eczema that you are experiencing is commonly known as hand eczema, and medically classified as dyshidrotic eczema. The common manifestation of dyshidrotic eczema is an irritation of the skin on the palms of the hands and the soles of the feet. It is characterized by clear, deep blisters that itch and burn. However, dyshidrotic eczema is not limited to the soles of the feet or palms of the hands; it can also manifest along the edges of the fingers and the toes. In addition it is not limited to a manifestation of blisters that burn or itch. Hand eczema can also manifest in non-inflammatory scaling over large surface areas. This type of scaling is called xerosis. Another description of that type of pealing is exfoliative keratolysis. For a grammatical analogy; eczema would be the noun, dyshidrotic eczema desribing the type of eczema could be correlated to the adjective, and exfoliative keratolysis which describes the action taking place could be equated to the verb. Thus, although there are different name classifications, you are still dealing with the same subject: eczema.

Going even further into that eczema description, your hand eczema (or dyshidrotic eczema manifestation) could have been brought about by a contact irritant. This would give it yet another sub-classification of contact eczema or contact dermatitis. The sub-classification diagnosis of eczema simply helps to be more specific on a broad dermatitis or eczema diagnosis. The subclassifications also help in determining the cause by promoting the identification of the allergen/irritant culprit. Nonetheless, you are still dealing with eczema. Just like there are various names used to identify car (ie. vehicle, automobile), there are various names used to identify eczema. As a result, don't let the different names overwhelm you; an eczema manifestation is what you are still dealing with. The exfoliative keratolysis or xerosis describes the flaking of the eczema skin.

What your hand is shouting through this eczema manifestation is the need for nutrient replenishment. It is expressing, through the symptom manifestation, a severe deficiency in the follwing nutrients: beta carotene, zinc, selenium, essential fatty acids, quercetin, and vitamin C, D, & E. With the extreme flaking/dryness (exfoliative keratolysis or xerosis), your skin is shouting a specific deficiency in your essential fatty acids, vitamin C, and vitamin E. The essential fatty acids and vitamin E help the skin cells to maintain hydration, thus relieving it of dryness and promoting healthy cellular regeneration. By providing that needed moisture to the skin cells, those nutrients help to regulate abnormal proliferation of the superficial skin layers. In other words, they help to prevent the hyperkeratosis (excessive or rapid exfoliation) which causes the flaking/peeling. Vitamin C works to strengthen connective tissue in blood vessel walls. This increases the vascular resistance and integrity. It does this by helping in the manufacturing of the important protein, called collagen.

You cannot effectively address eczema without addressing your diet/nutrition. My suggestion is that you become familiar with the deficiencies that your eczema represent so that you can incorporate foods that contain these essential nutrients into your diet. To help you in that regard, I suggest the following website: http://www.wholehealthmd.com Check out the "healing eczema with what you eat section".

I know that you stated you hadn't made any significant changes in creams or products that you use on your skin; however, and because there is a strong connection between a contact dermatitis and hand eczema or dyshidrotic eczema, I believe that something triggered your latest flareup. Contact with nickel, balsam, or cobalt metals are some triggers. Chemical contact with the hands (ex. hair dyes, perms, paints) is an irritant. Gardening with your bare hands in the dirt could produce this type of severely dry and peeling skin. Dishwashing liquid, detergents or chlorine/bleaches would also produce this type of severe drying/irritation. Constant hand submergence in water could promote that type of drying through an over saturation. Hand contact with water containing chlorine or fluoride could produce that type of irritation. Constant use of antibacterial waterless hand wash sanitizers could promote this type of reaction as well. Hopefully this helps to trigger a connection in your mind of what the culprit could have been.

In addition to those contact irritants, stress also plays a major role in hand eczema. Stress becomes a factor due to the release of cortisol which produces an abundance of histamine release causing the eczema flareup.

Steroid creams would simply make a bad problem worse; in that, they further debilitate the immune system (through suppression); thus making you more vulnerable to infection. As a result, the desire when using skin care treatments is to use products that work with the natural chemistry of the skin to promote healing. Vitamin C is a natural antihistamine; thus it serves as a better alternative over steroids because it provides the benefit without detriment to the immune system.

Burt's Bees carrot nutritive lotion or buttermilk lotion are good natural alternatives. Shikai's Borage Skin Therapy lotion and Colloidal Oatmeal Skin Therapy lotion by Nature's Gate are some other natural alternatives.

My bias is with the Burt's Bees product line because that is what has brought about my family's success. Nonetheless, there are a wide variety of natural alternatives from which you can choose. You want to look for products that contain such things as beta carotene, zinc, vitamin C, vitamin E and your essential fatty acid sources. Burt's Bees has a wide variety of product from which you can choose. Although it is not so new to them, one of their newest editions to me is the Burt's Bees Herbal Defense Ointment. It is specifically formulated for the spot treatment of "delicate skin conditions that require extra protection", like minor burns, sun exposure, and scrapes. Since the flaking that you described sounds slightly similar to a chemical burn, this product may be something you would want to consider testing out. You can visit your local Whole Foods Market to test sample the product for yourself if you are a resident of the United States.

What types of product are you currently using on your skin?

aunty