If the skin on your palms becomes hard and peeling, or blisters appear between your fingers, it may be tinea manuum!

Author: Yao Zhiyuan, Chief Physician of Dermatology Department, China-Japan Friendship Hospital

Member of the Mycology Group of the Dermatology and Venereology Branch of the Chinese Medical Association

Reviewer: Chen Yong, Chief Physician, Beijing Chaoyang Hospital, Capital Medical University

The skin on part or all of the palm becomes hard and peels, and even cracks when the weather is dry in winter. What is going on?

It could be ringworm.

Tinea manuum is a common skin disease in clinical practice, which is caused by fungal infection. When the hands come into contact with fungi, the fungi enter the skin and cause a series of inflammatory reactions in the skin.

Tinea manuum has different clinical manifestations. The first is the blister type, which is a more acute type. Blisters may appear on the fingers, between the fingers, on the sides of the hands, and possibly on the palms. The second is the keratotic scaly type, in which the skin of the palm or the entire palm becomes very thick and hard, and may even peel. In winter, when the climate is dry, some skin may even crack.

Figure 1 Original copyright image, no permission to reprint

So, how does ringworm get contracted?

1. How do you get tinea manuum?

Tinea manuum is often caused by fungal infection in other parts of the body, such as tinea pedis (athlete's foot), tinea cruris, onychomycosis, etc. If it is not treated well and in time, the skin in this area will be scratched with the hands, which increases the possibility of fungal infection on the hands. This is a major way of getting tinea manuum.

Of course, there are other ways of contact infection, such as contact with animals with fungal infections.

2. Is ringworm of the hand highly contagious?

Tinea manuum is somewhat contagious, but compared to tinea pedis, it is not as contagious.

Tinea manuum is contagious in several ways. First, it is self-transmitted. Tinea manuum often only appears on one hand at the beginning, but over time, it may spread to the other hand or to the nails, causing onychomycosis. Tinea manuum can also be transmitted to others through close contact, such as sharing gloves.

Someone asked, can ringworm of the hand be transmitted by holding hands?

It depends on the specific analysis. For example, if tinea manuum is in the active stage, with blisters and even ulcers, it is relatively contagious at this time. If you shake hands or hold hands for a long time, there is still a chance of infection. If the other person has dermatitis on his hands or the skin barrier is not particularly good, it is easier to be infected.

3. How to treat ringworm of the hand?

The first thing is to kill the pathogens, eliminate the fungi, and treat the cause.

The second is symptomatic treatment to alleviate symptoms and relieve itching.

The third is to prevent recurrence.

Antifungal drugs are used to kill fungi. For blister-type tinea manuum, milder, less irritating antifungal drugs are used. For keratotic and scaly tinea manuum, strong antifungal drugs can be used together with drugs that can exfoliate and soften the keratin, such as salicylic acid drugs and urea drugs. Oral and topical combined treatment is also possible.

The course of treatment is also very important. It should be used for two to four weeks. You cannot stop taking it lightly or stop taking the medicine as soon as the symptoms are relieved. With a full course of treatment, tinea manuum can be cured.

Figure 2 Original copyright image, no permission to reprint

What are the antifungal drugs for treating ringworm of the hand?

There are two major categories: one is topical medication, and the other is oral medication.

Topical medications are the main medications. There are several major categories of commonly used topical medications. The first is imidazoles, such as miconazole ointment, econazole ointment, and ketoconazole ointment; the second is acrylamides, such as terbinafine ointment; and there are also some traditional Chinese medicines, such as radix scutellariae tincture.

The most commonly used oral medications are azoles, such as itraconazole and fluconazole; and allylamines, such as terbinafine tablets.

Of course, there are some other dosage forms, such as solutions, powders, and granules, which are sprayed on the skin. Different dosage forms are selected according to different clinical manifestations.

Many patients apply some medicines on their own without being diagnosed by a doctor. In fact, many of these medicines contain hormones, which can cause the condition to worsen.

4. Can tinea manuum be treated with hormonal ointments?

Hormones are a double-edged sword. If used correctly, they are very good drugs, but if used incorrectly, they may backfire and worsen the condition.

Tinea manuum cannot be treated with hormone ointments. Because hormone ointments can provide nutrition to fungi, fungi "eat" hormones and grow more vigorously, and the hyphae become larger. The more you use it, the heavier it gets, and the larger the range. However, hormones have a certain anti-inflammatory effect. After using it, some patients with tinea manuum felt that the itching was slightly relieved in the first two days, but it only has such a small effect.

Therefore, do not abuse drugs, especially hormone drugs. If you have any problems, it is recommended that you go to a regular hospital for a clear diagnosis and use the drugs under the guidance of a doctor.

Tinea manuum is a disease that often recurs. The main reason is that the treatment is not thorough, the course of treatment is not enough, the medication is used for a short time, the fungus is not completely eliminated, and the symptoms are only temporarily relieved. After a period of time, it will recur. Tinea in other parts of the body, if not cured, scratching with hands will also lead to recurrence.