Article by Dr Manasa S
Pores and skin fissure is the title given to a situation whereby there’s dry and cracked pores and skin. It seems as if there are ‘tiny cuts’ within the pores and skin. The pores and skin across the cracks tends to turn out to be thickened and calloused.
Frequent areas of prevalence of pores and skin fissures are
– in between the toes
The pores and skin fissures happen as a consequence of excessive dryness of the pores and skin. This situation can be known as xerosis. Firstly, these cracks begin out as small cracks. Later, because the illness progresses they’ll get deeper and in addition could also be related to gentle to extreme ache. After a sure time period, these cracks get related to callus formation which appears to be like yellow or darkish brown in color.
Frequent web site of prevalence of pores and skin fissures
Pores and skin fissures happen at locations that are below the strain of bodily stress reminiscent of heels of the foot. Heels assist the load of the physique. On account of fixed strain of physique weight over the pads of the toes would possibly increase the pores and skin and trigger pores and skin cracks / fissures.
Different areas the place fissures happen are – on the fingertips, between toes or fingers, and on different areas of the physique that are vulnerable to dryness.
Causes of pores and skin fissures
Pores and skin dryness – A lot of the pores and skin fissures are brought about as a consequence of excessive dryness of the pores and skin. Later, this progresses with formation of callus and thickening, related to change in color to yellow or brown color. If this situation isn’t handled at this stage, cracks develop on the pores and skin. Additional, fissures develop within the pores and skin at and across the cracks.
Environmental causes – Dry and chilly local weather makes the pores and skin dry. This will increase the probabilities of pores and skin fissures
Improper foot-care – Strolling barefoot and sporting open-backed or unsupportive footwear like excessive heels places a strain on the heel and this will increase the chance of creating pores and skin fissures.
Overuse of detergents – Steady and repeated washing of palms and toes with harsh detergents pose higher danger of creating dry pores and skin which could result in cracks within the overused components of the physique.
Frequent hand washing – Individuals or occupations the place frequent washing of palms are required – like healthcare professionals, home helps and people who find themselves concerned in each day home works of washing and cleansing are inclined to develop dryness over the uncovered pores and skin and finally cracks develop over these areas. A current report exhibits that healthcare professionals have been discovered to expertise 70% of dry pores and skin circumstances and 39% had fissures within the pores and skin as a consequence of frequent washing of palms which is a requirement of the occupation.
COVID-19 pandemic – This modified the best way the individuals checked out hand hygiene. Healthcare employees across the globe have been the larger group who have been a lot affected as a consequence of frequent hand washing throughout this pandemic. This led to the onset of gentle to extreme dryness of palms resulting in onset or exacerbation of pre-existing eczema. Of a complete of 143 medical doctors surveyed throughout 2021, probably the most widespread signs have been dryness – 42%, itching – 17.5%, scaling – 21% and redness – 11.2%. These have been as a consequence of extreme and frequent use of hand sanitizers.
Vitamin deficiencies – can result in dry and itchy pores and skin which if left untreated would possibly find yourself in manifestation of pores and skin fissures. A wholesome pores and skin wants a superb variety of proteins and nutritional vitamins like Vitamin B, C, A, E, D and Ok and minerals like zinc and important fatty acids like omega fatty acids. Deficiency of any of those very important important components or micronutrients talked about above would disturb the conventional development and upkeep of wholesome pores and skin.
Different well being circumstances inflicting cracks and fissures within the pores and skin
Diabetes Mellitus – People who’ve been affected by diabetes for a very long time are inclined to have dry pores and skin and so are they extra vulnerable to develop pores and skin fissures. Diabetes is related to nerve injury within the decrease extremities, which is called autonomic neuropathy. In consequence, a person recognized with diabetes is at the next danger of creating pores and skin cracks with or with out ache and bleeding.
Psoriasis – Psoriasis is an autoimmune dysfunction that’s characterised with thick plaques of lifeless cells over the affected components. These plaques are at a excessive danger of creating cracks.
Eczema – This situation causes dry, itchy patches of pores and skin related to irritation. These dry and infected pores and skin patches have the next likelihood of creating cracks and fissures.
Fungal infections – Fungal infections are additionally one of many causes for pores and skin fissures. Athlete’s foot (Tinea pedis), a standard instance of fungal an infection which begins on the toes, can unfold to your complete foot inflicting cracks and fissures.
Angiopathy – Angiopathy is a situation which is related to injury to blood vessels, together with veins and arteries. On account of some underlying pathology, the pores and skin doesn’t get sufficient blood provide which hinders the wholesome development and upkeep of the pores and skin.
Pathogenesis of pores and skin fissure
Dry pores and skin situation is the precursor for many of the pores and skin fissures. When the pores and skin will get thickened and calloused over a time period, the pores and skin loses its elasticity and small cracks are fashioned. When these pores and skin fissures are left untreated, the cracks deepen, resulting in bleeding and an infection.
Forms of manifestation of pores and skin fissures
Pores and skin fissures might be both superficial or deep seated.
Superficial fissures are minor cracks that don’t penetrate into the deeper pores and skin layers. Then again, deep fissures penetrate into deep layers of pores and skin and are related to extra extreme problems like bleeding with or with out ache.
Signs of pores and skin fissure
Seems as ‘cuts or cracks’ within the pores and skin
Affected pores and skin mostly appears to be like yellow or darkish brown in color
Pores and skin is thickened and calloused
Early indicators of pores and skin fissures embrace dry pores and skin, scaly and redness
Pores and skin fissures on the foot makes it tough to stroll and stand for very long time, it can be painful
Itching, ache and bleeding are the superior indicators of pores and skin fissure
When pores and skin fissures should not handled promptly, they may get contaminated and would possibly flip into wounds after which lastly to ulcers
Care of pores and skin fissures at residence
There are particular measures that may be adopted as each preventive and therapeutic measures.
Basic measures embrace –
Hydration – preserving the hydration correct by consuming sufficient water
Balanced meals – consumption of balanced meals which comprise complete grains, fruits, greens and lean proteins
Clothes – sporting clear clothes, socks and sneakers which permit correct aeration
Sandals – Selecting sandals or flip-flops to put on in public swimming swimming pools or showers in order to forestall getting affected with athlete’s foot
Air humidifier – One ought to use air humidifier, if the dry air is a motive for dryness within the pores and skin
Common use of lotions, moisturizers and emollients –
– Lotions which comprise glycerine and urea assist to shed lifeless cells off the pores and skin and thus get deeper into the pores and skin layers. This helps to heal the cracked pores and skin surfaces.
– Lotions which comprise beeswax and sure mineral oils assist to extend the water content material of the pores and skin by stopping the lack of water by evaporation.
– Lanolin and propylene glycol acts as emollients to fill within the fissures of the pores and skin. These lubricants assist in correct hydration of the pores and skin and thus give the smoothness to the affected half.
Pumice stones – Eradicating or exfoliating lifeless cells on the toes with the assistance of pumice stone retains the pores and skin wholesome. However care must be taken when there’s already a crack or fissures on the pores and skin related to or with out an infection or ache or bleeding.
Use of oils – Sure oils and different substances which can be utilized as therapeutic massage oils to forestall and handle fissures of their early phases embrace:
– Coconut oil – Use of coconut oil has been discovered to be very efficient for dry pores and skin circumstances. It moisturizes the pores and skin together with improvisation of the conventional capabilities of the pores and skin.
– Almond oil – It helps to heal the fissures of the pores and skin by enhancing the capabilities of the pores and skin barrier. It additionally helps in stopping water loss within the pores and skin.
– Avocado oil – Making use of the avocado oil on to the fissured pores and skin will increase collagen manufacturing and aids in dashing up the therapeutic of wounds.
– Oat oil – Utility of the oat oil provides up the moisture content material and reduces irritation, thereby prompts correct wound therapeutic.
Honey – Honey when used acts as a pure moisturizer, helps in therapeutic of the cracked pores and skin. Honey additionally possesses some antibacterial properties, which could assist in prevention of pores and skin infections.
Aloe vera – Aloe vera is a well-liked and efficient herb which finds a superb place due to its antioxidant properties and soothing impact on the pores and skin. When utilized to the fissured pores and skin it helps in enhance of the collagen manufacturing and thus aids in wound therapeutic and when utilized recurrently would possibly stop the formation of fissures by enhancing the elasticity of the pores and skin due to its antioxidant property.
When to seek the advice of a pores and skin specialist?
– One ought to seek the advice of a pores and skin specialist within the beneath talked about circumstances –
– When there is no such thing as a enchancment even after making use of moisturizers or caring for fissures at residence
– If the pores and skin fissure is contaminated and related to or with out bleeding and the fissures are deeply located
– If the fissures are related to irritation and soreness with or with out discharge of foul-smelling liquids
– If the fissures are related to athlete’s foot, a standard fungal an infection of the toes
– When the fissures are deep rooted with problems reminiscent of discharge of pus and bleeding with excessive ache, it would want a pores and skin specialist to take away the broken pores and skin and clear the injuries or to shut the fissures with pores and skin glue or bandages to maintain them closed.
– People who find themselves already affected by persistent diabetes, psoriasis, eczema or every other persistent pores and skin problems or any medical situation want to go to the pores and skin specialist to get a complete method in direction of the pores and skin fissures.
In Ayurveda now we have a situation talked about amongst Vata Nanatmaja Rogas i.e. ‘particular problems brought on by solely aggravation of vata’ named ‘Vipadika’. An analogous situation has been defined within the context of ‘Kshudra Kushta’ – minor pores and skin problems whereby it’s known as ‘Vaipadika’. Vaipadika is outlined as fissuring and cracks in palms and toes with extreme ache.
Pores and skin fissures defined on this article pertaining to ‘palms and toes’ might be in comparison with Vipadika. It may be handled on the traces of ‘Vata Roga Chikitsa’ or ‘Kushta Chikitsa’.
Associated Studying – Vipadika