Diabetes and Cracked Fingertips: Everyone's Hands Need Helpby David Mendosa Patient Advocate
People with diabetes are like everyone else, only more so. This realization has been slowly growing in my mind as I began to appreciate that while we talk all the time about how those of us with diabetes need regular exercise, good nutrition, and weight control, everyone needs that too.
Even the complications of diabetes are more intense manifestations of what anyone may experience. For example, the problems that we often experience with our skin are similar to what just about everyone experiences, although maybe we experience them more often or more severely.
High blood glucose levels can sure make wound control more difficult. But I know from my own experience that even as I have controlled my blood glucose, my hands can get just as dry and cracked as they ever were. Maybe more so.
Maybe it's the typical dryness of winter. Maybe it's the special dryness where I have lived for the past three or four years. Maybe it's because I'm more active outside now. But it's certain that my hands need help.
And everyone's hands need help. My dermatologist, Yan Isabel Zhu, emphasized that to me last month when she checked me for skin cancer, as she does at least once a year. "We all need to apply a thin layer of hand and skin cream every time we wash our hands," she told me during a recent check up. "In all seasons and in every part of the country."
Applying hand and skin cream every time I wash my hands has been a challenge. I've been a good boy. I wash my hands regularly -- including every time I go to the bathroom or come into my place from outside. That avoids a lot of problems.
But it causes problems too. My hands get awfully dry and cracks often develop.
Apparently these "split fingertips" are an awfully common problem among people with and without diabetes alike. A recent column in the "People's Pharmacy with Joe and Terry Graedon" brought out a large number of reader suggestions.
I don't doubt that we have many good ways to prevent or at least minimize these cracks or split fingertips. But we have to remember to follow my dermatologist's advice to apply the cream every time we wash our hands. And even when we don't.
As I write this I have a couple of split fingertips that make typing a bit painful and invite infection and inflammation. I have been applying hand cream every time I washed my hands, but I just came back from a backpacking trip where, although I wasn't washing my hands, I exposed them much more to the elements than usual, and I failed to apply it regularly.
The difficult part of all this for me is which hand and skin cream to use. While we have many to choose from, I'm guessing that it's best to avoid any of them that contain potentially harmful chemicals called phthalates and parabens.
A surprising number of hand and skin creams, including some formulated especially as "diabetic skin" therapy, contain parabens -- under several names, such as methylparaben, propylparaben, ethylparaben, and butylparaben. On the recommendation of my favorite Certified Diabetes Educator, I now avoid all such products.
But we have many alternatives and even vegetable oils, like pure coconut, can help when we have nothing else on hand. Still, skin care products unfortunately are greasy and take too long for inpatient people to work into their skin.
My CDE gave me a free sample of one greasy product that I can tolerate when I need it. After cracks have developed in my fingertips, I can put up with the greasy inconvenience of one such product, Aquaphor Healing Ointment from Eucerin because it works so well for me.
But for everyday use I prefer a different product. Dr. Zhu, my dermatologist, recommends and gave me samples of a skin cream that lacks both the troubling chemicals and the grease. It also mercifully free of any dyes and fragrances.
What she recommends is "Vanicream Moisturizing Skin Cream." While she told me that Costco has it at the best price, I also found it at my neighborhood pharmacy. Now I keep a tube of it on every sink in my place to remind me that cream follows water. It's less confusing that way. It's great -- when I remember that like everyone else that I need to use it.