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Exfoliative keratolysis also known as ‘keratolysis exfoliativa’, and ‘focal palmar peeling’ is a common skin condition that causes the skin of the palms and soles of foot to peel off. Exfoliative keratolysis aggravates during summer, and most often affects teenagers. Sometimes, on the end of a finger, the split on the skin may be deeper, and it can make the skin feel numb and hard, and can take longer time to peel off.

Exfoliative keratolysis may be lead by pompholyx, which is an itchy form of eczema having small fluid-filled blisters.

Exfoliative keratolysis (EK) can be initially identified with air-filled blisters apparent on the palms, fingers or soles of feet. With time, these blisters rips open and leaves small collars of peeled scales of skin. The skin beneath becomes tender, dry and red. EK is usually not itchy.

Condition of EK can be confused with another autoimmune skin disorder, called “psoriasis“, which causes scaly patches of the skin.

The symptoms of EK generally aggravates if exposed to irritants. Such irritants may include detergents, soap, solvents and water. In due course, normal skin forms, but exfoliative keratolysis recurs frequently.

Exfoliative Keratolysis
Exfoliative Keratolysis

Exfoliative Keratolysis Causes
There is no known cause that causes this skin condition, but factors believed to be responsible include genetic factors and allergy. Though stress may not be the leading factor for EK, but it can trigger or aggravate the condition to make it worse.

Exfoliative Keratolysis Treatment

Topical steroids are often given exfoliative keratolysis. Intravenous steroids may be given in severe cases, but steroids usage has its own side effects, when used for a long time. The following may be helpful:

  • Protect the affected area from irritants
  • Use emollient hand creams, which contain silicone, lactic acid or urea
  • Photochemotherapy – a technique used to boost the immune system.


Exfoliative keratolysis is not a disease that aggravates to such a condition that may cause a threat to life. By maintaining proper lifestyle and avoiding the irritants, the pain or tenderness of this skin condition can be reduced.


  1. Ricardo Godina
    May 19, 2012 at 6:36 pm

    Exfoliate Keratolysis does have cure!!!!
    Indian Hemp Grease,glob it on day and night the more the better!
    Also Iv been taking apple cider vinergar pills and olive tree extract to help the body from the inside to kill this curse iv had for 30 years!next grab some syrup and mix it wirh apple cider vinergar evenly and dip ur hands into it for 10 mins at a time daily,also before a shower spray ur self with vinegar all over so the fungus has nowhere to hide,carefull with the fumes,u will feel clean and new down to ur thoughts!lastly use baking soda toothpaste to catch any fungus hiding in the teeth.

  2. Mike Newcombe
    September 29, 2012 at 5:26 pm

    I have had EK for 10yrs now and have tried all the cures listed to no avail, i started trying to work out what is causing it, it appears on hands and feet so logic states what’s on your hands and feet but no where else? Answer nails, when i have EK bad i also notice a change in my nails (they get thicker and harder to cut, samples of skin from effected areas test negative to fungal infection).
    I decided to start trying something new, I cut my finger/toe nails short and have kept them short, then twice a day (morning and evening)i applied antiseptic tea tree nail solution (made by Optima under the name Australian tea tree)on the top of my nails and crucially under the cut short nails where the skin meets the nail.
    I have stopped using Urea cream and steroid cream and my skin has improved to such a point i felt it only fair to share my descovery, i must also point out i am a manual worker and have suffered this condition quite badly until now.
    I hope this works for you as well as it has for me. Tea tree has more antiseptic/anti fungal strength than carbolic acid.

  3. Mia
    October 24, 2012 at 2:46 am

    I am 20 years old and have suffered from this my entire life. Doctors always told me never to use harsh soaps and detergents so I avoided them at all costs, opting for ‘soap free’ products instead. I can safely say now however that I have not had this happen in a year from performing one simple routine. Thourough hand washing.
    I began studying nursing a year ago and obviously a requirement of this is clinical handwashing with hospital grade soaps. I was scared to wash my hands as I thought they would get worse but within a week my skin had cleared up. I now do at least 2 clinical hand washes each day and the skin on my hands has been perfect ever since! I’m not saying that this will work for everyone but for me it has been my cure.
    I notice that if I do not wash my hands as much the skin will begin to peel again, but I will just step up the hand washing and it goes away before it gets bad.
    Always moisturise after washing though!

  4. Valerie
    January 21, 2014 at 6:40 pm

    I, too, suffer from exfoliative keratolysis but have discovered some things that work for me. Quite by accident, I discovered that eating peanut butter daily kept my symptoms mostly at bay but not completely gone. Then I started taking hyaluronic acid for knee pain and my symptoms completely disappeared. If I stop taking the hyaluronic acid, the symptoms reappear. My cholesterol, triglycerides and LDL are very low and my HDL is high. I have wondered if this problem arises from not enough fatty acids in my diet. Does anyone know if any studies have been done looking at this?

  5. kay
    February 11, 2016 at 6:47 am

    I also have Exfolitive keratolysis, which started 5 yrs ago after the removal of a massive ovarian brenners tumor and ovaries were removed. I find that my symptoms disapeer if I stop eating eggs. (from chickens). If I eat one flour tortilla I get a break out. Ive also researched and found that this could be from a mineral and vitamin difficiency. Ive also taken calcarea sulfurica, a homeopathic remedy, which seemed to help a lot!

  6. Cheryl
    May 15, 2016 at 1:06 am

    This all sounds exact,lay like me. I have had these symptoms recurrently for 30 years. The odd thing is that it is only on my left hand, my dominant hand. I have even had my nails have dents as they come away from the cuticle and fall off as the dent grows out.

  7. Tom
    June 20, 2016 at 2:40 am

    Had Ek for a few years now, it’s usually bad in summer and bearable in winter. I’ve realised that during hot season I tend to shower or be involved in water based activities a lot more than in cold seasons. I have started using gloves while showering, cut off some water activities and keeping my skin moisturised all of the time. skin seems to get better.
    Some precaution (works for me)
    – wear Gloves every time you have a shower make sure you seal off on the wrist.
    -keep hands moisturised
    -always use gloves protect your hands from irritants, like soap, or friction from weights at the gym, or tools if you are a handy person.

  8. Julie Tuggle
    July 31, 2016 at 5:23 pm

    I found a product called salted coconut hand scrub that polishes off the little bits of dry skin and moisturizes. It’s by LUSH cosmetics. Some of the lotions leave my hands feeling greasy and this hand scrub washes off.

  9. Alexandra
    September 16, 2016 at 2:16 pm

    I have suffered from EK for 3 years now. Tryed every emollient cream outhere including corticosteroids. ..to no avail.
    Than l started to do some research on skins conditions and what l have founed is that allmost all of them are not caused by external factors but rather internal . Your skin is the biggest organ in the human body and when something is wrong on an internal level it will let you know though external symptoms. All major autoimmune skin conditions are actually caused by a compromised gut flora! YES you are what you eat. So l started taking care of my intestinal flora and after only 2 months my skin improved faster and better than in 3 years after using tens of emollients and corticosteroids. All l did was to take probiotics and Indian herbal antibiotic which is an excellent blood purifier ! My fingers are almost entirely clear and my condition has improved a great deal. I’m not an expert but ut worked for me so l do recommend you try it.

  10. Princess Piselli
    November 25, 2016 at 10:58 am

    Nice content, I will share this

  11. Paula Williams
    February 5, 2018 at 5:30 am

    I have suffered with this condition for 5 years now and am releived to find other people do too. My problem started when I was asked at work to take down and pack away 3 artificial Christmas trees at work. By the time I’d removed all the baubles etc, my hands were filthy. After a few days they were red, itchy and blistering up. Now they just peel all the time, and hurt like hell when I have a bath due to serious and painful pruning. I am going to try some of these remedies and also ‘bag balm’ which is used to treat cows’ udders…wish me luck!

  12. Janiece
    June 23, 2018 at 6:41 pm

    I have suffered severe EK for 31 years. I suspect there are a number of things that cause a person to have this. It may be different causes for different people: foods, lack of vitamins, etc. However, this past year (after much trial and error) I finally found something that treats the symptoms with about 95%. My palms looked horrible, and would cycle in and out of major peeling (1.5 weeks of peeling, 1 week of decent skin.) Among other things, I had tried lactic acid lotions, but I did not like the feel of it and it didn’t seem to do what I needed it to. Finally, I tried using medical grade lactic acid and applying directly to my skin. I started with 40% grade and left it on until it dried, the rubbed my hands together until the exfoliating skin stopped coming off. I have now increased to 90% grade (not recommended until you know you can handle it.) I try to exfoliate with this once a week. The only time I have real problems is if I forget and go for more than a week and a half. For the most part, my skin looks great although I still have redness/pink areas where the skin is new. I only wish I had discovered this when I was a teen. I am no longer embarrassed of my skin.

  13. john hulme
    August 12, 2018 at 12:28 pm

    Had for years
    Gut bacteria should be looked at upper intestinal tract
    look at the color of your faces (secondary bile acids)
    is it lighter than usual. Just had an attack, change in diet reduced its length
    You might more prone during summer, suggesting seasonal disorder (melatonin) tied in with bile acid production, look specifically at tuning your diet those times (eat more green leafs spinach broccoli) to reduce the severity of the attack. Sorry for the robotic response Alexandra is right . You need to figure
    out whether it is a genetic mutation regarding bile acid production, or melatonin dysfunction

  14. jean moltes
    December 17, 2018 at 8:15 pm

    @Mike Newcombe @Mia
    Hi all in this thread,
    I find that using tea tree essential oil (Melaleuca) on my nails and affected areas of my palms, as described a few years ago by @Mike Newcombe, is helping me a lot.

    I have been using this treatment for 2 months, the symptoms have greatly decreased within the very first week :
    My hands look just great now!
    only a couple of 1mm small spots of peeled skin still appears around the side of my index or thumb and the lower palmar region (more visible after long exposition to water), but nothing compared to how bad my hands looked last summer.

    I’m not entirely sure, but skipping applications from time to time seems to have less efficient results.
    I still have concerns if this improvement wouldn’t just be due to the fact that exfoliative keratolysis symptoms tends to periodically appear and disappear depending of the season and that we are almost in winter here, so this could explain the “recession” in my symptoms.

    I already experienced a few times a total disappearance of the symptoms for a short period, only to see them come back worse (once after i did lot of dish washing without gloves)

    I somehow hope that Mike Newcombe could give us an update on his condition and how it worked out for him in the long run, even though his post is from 2012…
    Anyway, thanks to you for posting this, it has been really helpful so far.

    if you ever read this, thanks to you as well, for sharing about the clinical hand washes. I try to add this as well in my healing routine but am not sure :
    Could you give us more specific details about how to perform this properly and what type of soap you use (some brand or composition)?
    Also, it would be great to have an update on your condition as well.

    Regarding diet, I’m trying to increase root vegetables and leafy greens, as they are said to help improve hyaluronic acid levels, which apparently help healing and hydrating your skin.

    Lastly, it would be great to have everyone update on their conditions, as most posts are now several years old, and so we could have a better perspective at what treatment is working or not working for each of us.

    thank you all and I wish you the best recovery guys.

  15. Mark
    July 21, 2019 at 6:05 pm

    Hello everyone,
    Can someone give me suggestions to treat this? It started on my left hand after I started law school. I could literally peel sheets of skin off my palm. I have very thick skin from working my whole life, and no hand creams even touch this EK. It’s only my left hand, palm and fingers.
    The best I now can do is scrub the crap out of my hand in the shower with a stiff brush and then wear a food-handler glove overnight after I slather my hand with Bag Balm. It works, but after a couple days it comes back. I have considered putting my hand into a bucket of vibrating wet sand to abrade the skin down to deeper levels, but I don’t think the back of my hand would be able to take it. Also, I notice that some times my left nails grow funny. Does tea tree oil help any of this?

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