Supplies to get:
1) wide coarse/medium plastic nail file (drug store, nail sculpting)
2) cotton squares, those that are used for makeup removal
3) a bottle of hydrogen peroxide (27% works fastest)
4) zinc oxide ointment (rash section, no fragrance, fewest additives)
5) 1% hydrocortisone ointment (with least amount of additives)
6) vegetable oil (avocado or borage esp. good)
7) optional: bag balm
About an hour before sleep, soak the cotton square with h2o2, and rub the sick areas for a few seconds. The weaker strengths of h2o2 will require repeated application or soaking -- people tell me that soaking in 3% for 15 min does the job. (If you don't want the fingers applying the strong stuff to get the burn, flush them with water immediately. Saliva works for me too.) Then let air-dry, and let the peroxide get to work burning the sick cells out, and oxygenating the skin so it can repair itself. (The sick skin will turn white and it will itch/tingle, but this will stop after about half hour to an hour depending on the intensity of exposure to peroxide and the extent of the disease. Healthy skin on palms and soles will not be affected.) After the skin is dry, grease up with the hydrocortisone ointment. (Do not use plastic gloves! Cotton gloves or socks may be helpful.) In the morning use the zinc ointment. Repeat the next day. (If you use the 7.5% h2o2, you can repeat the treatment again that day.) I have found that several days of treatment (27%, once a day, at night) will usually bring the itch and other problems quickly under control. Also, if the skin is bad, working on one foot or hand at a time makes the treatment more manageable. Once you get the hang of this, and the disease starts retreating, it is possible to treat with the 27% even three times a day. The results come faster.
The diseased skin will eventually dry out and crackle or crust over, and become resistant to treatment. (The cracking, dry skin is part of the disease cycle, not caused by the peroxide treatment.) At this time, you need to slough off the dead built-up skin so that the disease cannot hide underneath. The simplest way is to use the plastic file. (I no longer recommend urea creams for this since they can bring on a flare.) Putting on the zinc cream and then rubbing the skin with a cloth is another way that has worked for some. Then soften with some oil. You may go through several cycles of dry crackled skin (aka the mosaic stage). Eventually, more and more healthy skin will begin to emerge, and the white areas will grow smaller. Apply oil topically whenever the skin needs some lubrication during the day, throughout this acute care period. Some people like to remoisturize with the bag balm. If you experience any thickened skin (usually around deep cracks, on heels, or next to nail beds), file down this thick skin prior to treatment (first soaking the affected skin in warm water helps). This will allow the treatment to penetrate. The h2o2 treatment will quickly dry out any extant vesicles. Newly-forming vesicles will be prevented from "ripening."
Important: when the treated skin begins to tingle/itch intensely, flush the hand or foot with hot water (as hot as you can stand), briefly (2-3 seconds). This will quickly dissipate the discomfort. Can be repeated. ALSO NOTE: Stopping all other cosmetics on hands or feet, esp. those with water in them (creams and lotions) is crucial for healing. If you must use something, Aquaphor regular ointment is usually ok. (And keep the file clean by splashing with peroxide every so often.)
-- Best of luck!
Written by Vera Bradova © 2003-2007
Updated 12-15-2006
