Dark Knuckles: Causes and Fixes!
About the author: FutureDerm.com is proud to introduce Dr. Hanan Taha, M.D., on our staff as a Contributing Writer. Dr. Taha received her MD from Kuwait University in 2002, and a master’s degree in Dermatology from the University of Alexandria in 2010. She also runs a blog in Arabic dedicated to spreading the knowledge about dermatology and cosmetic dermatology in a simple, concise manner (elbashra.com). For her full bio, please visit our About page.
Causes
- First and foremost, dark knuckles are NOT caused by dirt accumulation. Scrubbing them vigorously will not solve the problem and in fact, will definitely make it worse. This can be categorized under “mechanical trauma” or “friction”: skin handles any trauma by one of three responses: it either gets thicker, or it gets darker, or it does both. Unfortunately, knuckles are in the third group, and if you have to use your hands in handling rough material, you can be sure your knuckles won’t thank you! (1)
- Dry skin: excessive washing, exposure to hot water, harsh chemicals (example: household cleaners), and exposure to sunlight without protection all lead to skin dryness. (1)
- Some skin diseases will lead to dark knuckles: such as eczema, psoriasis.
- Obesity: among its many problems, being over-weight is harsh on the skin.(2)
Despite what you may initially think, dark knuckles are not usually caused by dirt, so excessive hand washing will not help and may actually exacerbate the condition.
Treatment
- It is always a good idea to check with your dermatologist. As mentioned earlier, dark knuckles may have an ailment behind them.
- The number one advice I always give my patients is: patience! Almost any skin problem will require some time and patience to see results. Just make sure to follow your daily skin care regimen unfailingly.
- Treat your hands delicately: never let them go dry. That means no washing with very hot water, no excessive rubbing in the towel, and always, always moisturizing them.
- Be careful when handling rough objects. Like sandpaper. Or the back of the carpet when it is time to install it! (yes, voice of experience here!).
- If you are a boxer, don’t come to me complaining of dark knuckles and expect a simple solution! Stop punching people!
Use a daily exfoliating cream: there are many creams out there containing alpha hydroxy acids in a low enough concentration for daily use. Applied nightly on the knuckles, these will moisturize and exfoliate thus will eventually reduce the darkness. (Editor’s note: We love Glytone Retexturize Body Lotion SPF 15, $37.99, Amazon.com, which contains unbuffered glycolic acid and a protective sunscreen).
- Whitening agents: in an earlier article, Nicki had talked about Ambi (2% hydroquinone). Add that to your daily regimen or any other whitening agent you prefer. Combined with the exfoliating cream, this will speed things along.
- A following step, done at a dermatologist’s clinic and after his or her analysis of the situation, would be chemical peels.
- Sun block is a must. Remember, even after treating the darkness, your skin will always need protection if you want to keep the dark spots from returning.(3)
- Weight loss always helps.
Caution: application of undiluted lemon juice directly on the skin is not advisable, as it can be drying, which is the opposite of what we need in this situation, plus it can cause irritation and photosensitivity (sensitivity to light or sun) that would lead to even darker skin.
As always, these tips are only intended to steer you in the right direction. For the best results, see your dermatologist.
Source
1- A. Sood, JS. Taylor. Mechanical Trauma Induced Skin Disorders. In: Fitzpatrick’s Dermatology in General Medicine 2008; Chapter 212.
2- N Puri. A Study of Pathogenesis of Acanthosis Nigricans and its Clinical Implications. Indian Journal of Dermatology 2011; 56(6):678-83.
3- A. Tedeschi, D. Massimino, LE West, G Micali. Management of the Patient. In: Color Atlas of Chemical Peels 2012; Part 5: 201-3.
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About Author
Dr. Hanan Taha, M.D. got her MD from Kuwait University in 2002, and obtained a masters degree in Dermatology in 2010 from the University of Alexandria. She has experience in various cosmetic procedures, such as hair removal, facial rejuvenation, skin tightening, cellulite treatment, and management of stretch marks. Hanan’s passion for dermatology started on her very first day of rounds, and after being undecided for years on which direction to go, she decided to become a dermatologist. A strong believer in patient education as grounds for a healthy living, she strives to thoroughly explain her patients their skin problems or concerns and the proposed treatment plan. She also runs a blog in Arabic dedicated to spreading the knowledge about dermatology and cosmetic dermatology in a simple, concise manner (elbashra.com). Elbashra (البشرة) is the Arabic word for “the skin.”
View all Dr. Hanan Taha, M.D. posts.(10) Readers Comments
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M7mmed
Insulin resistance.
Yetty
I dont know any dermetologist but my knukkles are very ugly and dark my problem is am a hairdresser and i deep my hands in water alot
Dr. Hanan Taha, M.D.
@M7mmed
Hello
I actually talked about this in an article very recently, please visit here http://www.futurederm.com/2012/10/30/obesity-related-acanthosis-nigricans/
Thank you for stopping by
Dr. Hanan Taha, M.D.
@Yetty
Dryness and exposure to various chemicals, as would be the situation for your as a hairdresser, would cause any darkness to be worse. Always remember to use a lot of moisturizer all the time. To avoid skin irritation and hyperpigmentation, try to wear protective rubber gloves as much as possible when handling chemicals. And always wear sunscreen.
Thank you for your comment.
saadia
hi i am saadia an art teacher since 15 years, most of the time i work with card papers cutting with scissors and cutter paint spray and lots of other art stuff. now i have seen from the last month my knuckles are becoming so black, and no beauty in my hands. i used lots of best hand lotions and homemade recipes but no effective. sometimes i really cried a lot, please do help me. tell me the reason first why it happens and also tell me what i have to do with my hands. thanks
Dr. Hanan Taha, M.D.
@saadia
First, I apologize for taking some time to respond as I was away on vacation. Second, I am sorry for your distress. I can imagine this being a difficult problem. Your work will indeed affect the skin of your hands a lot; it will make it quite dry and yes will cause dark knuckles. I don’t usually recommend home remedies. But use a good moisturizer you trust on a regular basis, such as one by Vaseline, Aveeno, Olay, there are many good ones out there. If you can get your hands on Cetaphil Restoraderm that is also a good option. You need to moisturize all the time, that means every time you wash your hands or simply feel your hands are a bit dry. Also use a gentle hand soap or cleanser, like Dove’s hand wash. For dark knuckles, I do highly recommend Ambi’s cream, or you can visit your doctor to prescribe something stronger for your.
Just keep in mind that you will need to make this a regular routine in order to get rid of the dryness and darkness and to keep them at bay.
I wish you the best of luck and let me know how things work out.
Kyndra
Hello. My question Dr. Taha is that I am a letter carrier and over the past 7 years that I have been in this position my hands, mostly my knuckles have darkened tremendously. I find this article very helpfulhowever what can I do to protect/cover my hands as I work? What could you recommend as the coverings would need to be worn for several hours a day and not be too bulky. Thank you.
Dr. Hanan Taha, M.D.
@Kyndra
Hello! I would mainly recommend you carry around one of those small travel size moisturizers, and reapply every so often, really concentrating on the knuckles. Also, if you have to be in the sun a lot, please remember sunscreen for your hands. At night, if you feel you can tolerate it, apply a heavier moisturizer (or something like kukui oil) and wear cotton gloves to bed. Good luck and thank you for your question.
Afsha
Hi Dr.Taha…even i hav dark knuckles n dark toes problem..since two months i noticed that even my leg fingers are alao going black ….im worried alot..im not going out of my home due to dis problem..im so so embarassed…could you please help me i stay in india so please tell me a cream which is easily available here…plz plz plz help me…eben im suffering from psoriasis but its the starting stage plz help me i dnt use harsh chemicals but also mu knuckles are black…will b eagerly waitin for ur reply…bye
Dr. Hanan Taha, M.D.
@Afsha
I am so sorry to hear of your severe distress. I completely understand your feelings of panic and embarrassment. From what I understand, the skin darkness is rather new, and you also have psoriasis. Are you taking treatment for it? The skin darkness could be separate from the psoriasis, or it could be related to it or its treatment. For me it would not be possible to know the cause without knowing your medical background and seeing the problem with my own eyes, and I am also not familiar with medicines in India. I strongly urge you to visit your dermatologist and discuss this with him/her, as they would be in a better position to help you, especially if this is such a new onset symptom.
I hope this helped, and please let us know how things work out.