What causes dry, flaky skin on the palms of your hands?

Is it dry skin, eczema or something else?

Dryness alone does not identify the cause. Dry, thick, scaly hands can be a sign of hand eczema, and finding what is causing the eczema is part of getting relief. Tiny blisters on the hands can point toward dyshidrotic eczema, a type of eczema that also affects the feet.3

Psoriasis can cause painful cracks on the palms and soles. Its scaly patches often have clear edges, and on darker skin they can look violet or dark rather than obviously red. Nail changes, including small pits, yellowing or separation from the nail bed, are worth mentioning during an assessment.5

What helps with dry, flaky skin on hands?

1. 1Remove rings before washing. For hands affected by dyshidrotic eczema, damp skin trapped beneath a ring can trigger a flare.
2. 2Wash with lukewarm water and a mild, fragrance free cleanser. Avoid hot water. For eczema prone hands, a mild liquid cleanser is preferable to a bar cleanser.
3. 3Gently pat your hands dry rather than rubbing them. Leave the skin slightly damp.
4. 4Apply a thick cream or ointment after each wash. Plain petroleum jelly is one option for dry, chapped hands.
5. 5Reapply moisturizer whenever your hands feel dry. A plain emollient without active medicines can usually be used as needed.

Keep necessary handwashing: use soap and water when your hands are visibly dirty, before eating and after using the restroom. Alcohol based sanitizer can further dry cracked or chapped hands, so choose a mild cleanser when you have a choice. If sanitizer repeatedly triggers dyshidrotic eczema, ask a dermatologist about a suitable option; sensitivity to an ingredient can cause a flare.27

Which moisturizer should you choose?

For eczema prone hands, choose a cream or ointment rather than a thin lotion. Lotions contain more water and less oil, so they are less effective at keeping moisture in. Ointments can feel greasy and rub off on clothes, so their commitment to moisturizing is not especially discreet.6

Emollients are ingredients that soften skin and help relieve scaling. Petroleum jelly forms a coating that helps skin hold onto existing moisture; glycerin and urea attract water to the skin. For eczema, a cream containing ceramides can help replace some of the moisturizing substances the skin lacks. A dermatologist can also suggest a dimethicone barrier repair cream for dyshidrotic eczema.126

Choose fragrance free products. Fragrances can trigger allergic reactions and eczema flares, and natural products are not automatically better for eczema. Introduce only one new moisturizer at a time so that a reaction is easier to trace. A product labeled for eczema relief does not replace treatment for an active flare.16

Protect your palms while you work and sleep

For dyshidrotic eczema, put on gloves before wet work or contact with irritants, including washing dishes and handling household cleaners. Wear 100% cotton gloves beneath waterproof gloves for wet tasks to help prevent irritation. Cotton gloves alone suit tasks where your hands stay dry. Remove rings before applying moisturizer and before sleep, too.2

Apply moisturizer before bed, then wear white cotton gloves through the night. Cotton gloves help keep hand moisturizer from rubbing off onto your sheets, which have never requested a skincare routine. They also limit damage from scratching during sleep.6

For severe dryness, a wet glove treatment is another option: apply a thick ointment such as plain Vaseline before bed, add damp white cotton gloves, then cover them with dry white cotton gloves. Remove both layers in the morning and apply fresh moisturizer.7

Avoid known allergens. Latex, nickel and topical antibiotics such as neomycin or polymyxin can cause allergic reactions. Unscented laundry detergent and avoiding scented fabric softener sheets can reduce irritation. With dyshidrotic eczema, avoid scratching and overheating; heat, dryness and sweat can trigger flares. Testing can help identify allergens when the trigger is unclear.27

What should you expect from treatment?

Moisturizers can soften peeling skin and ease discomfort from dryness. Regular use can help prevent cracks, but eczema is a chronic condition: skin care helps manage flares rather than cure it. An eczema rash can require a prescription steroid. If you already use prescription hand creams, follow your clinician's layering instructions; some medicines need to go on before the emollient.167

Diagnosed palm psoriasis can need treatment beyond moisturizer. Options include prescription creams and thick barrier creams, while chronically thickened palms can need products that soften the thick skin. A dermatologist should assess psoriasis that makes working painful. Fungal infection can coexist with psoriasis, so persistent scaling sometimes needs skin scrapings rather than another cream.4

When should you get medical help?

Contact a healthcare professional for wounds that do not heal, persistent itching, irritation, redness or a rash, or a chronic skin problem that is not improving. If a new product causes irritation or a rash, stop using it and seek advice.1

Seek emergency medical care for a rash accompanied by fever, red streaks, yellow or green drainage, warmth, pain or sudden rapid spread. A widespread or blistering rash also needs emergency assessment.1