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Dark Knuckles: Causes and Fixes!

Dark knuckles can are an unpleasant issue that can be caused by a variety of conditions. If you have dark knuckles, it's important to know the facts about what might be causing them and the ways that you can treat them.

Causes of Dark Knuckles

  1. 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, 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)
  2. 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)
  3. Some skin diseases will lead to dark knuckles, such as eczema, psoriasis.
  4. Obesity: among its many problems, being over-weight is harsh on the skin.(2)

Treatment for Dark Knuckles

  1. It is always a good idea to check with your dermatologist about treatments. As mentioned earlier, dark knuckles may be the symptom of another health issue.
  2. The biggest piece of 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.
  3. Treat your hands delicately and never let them go dry. That means no washing with very hot water, no excessive rubbing with a towel, and always, always moisturizing them.
  4. Be careful when handling rough objects, such as sandpaper or the back of carpeting when you're removing or installing it! (Yes, I'm speaking as the voice of experience here!).
  5. If you are a boxer, don’t come to me complaining of dark knuckles and expect a simple solution! Stop punching people!
  6. Use a daily exfoliating cream: there are many creams out there containing alpha hydroxy acids (AHAs) 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).
  7. Use whitening agents. In another article, Nicki has mentioned the effectiveness of Ambi Fade Cream ($13.36, amazon.com) with 2% hydroquinone. Add that or another product with whitening agents to your daily regimen. Combined with the exfoliating cream, this will speed things along.
  8. Your dermatologist might decide that your situation warrants a chemical peel in his or her office.
  9. 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)
  10. Weight loss always helps.

Caution: Application of undiluted lemon juice directly on the skin is inadvisable, as it can be drying, which is the opposite of what you need in this situation. It can also 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.

Bottom Line

Dark knuckles are not caused by dirt, so don't do scrubbing away, because that will make the problem worse. Dark knuckles could be caused by skin dryness, trauma to the skin, obesity, and some underlying issues. Treatment should be comprehensive and will take time. You should talk to your dermatologist to figure out the best treatment plan for you.

Sources

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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Date: April 17 2012 at 8:20 PM
Skin Care, dark knuckles, what causes dark knuckles, how to treat dark knuckles, treating dark knuckles

Comments (18)

  1. M7mmed
    July 15 2012 at 6:38 AM

    Insulin resistance.

  2. Yetty
    November 21 2012 at 10:00 AM

    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

  3. Dr. Hanan Taha, M.D.
    December 12 2012 at 12:36 AM

    @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

  4. Dr. Hanan Taha, M.D.
    December 12 2012 at 12:40 AM

    @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.

  5. saadia
    January 31 2013 at 10:03 PM

    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

  6. Dr. Hanan Taha, M.D.
    February 5 2013 at 10:23 PM

    @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.

  7. Kyndra
    March 13 2013 at 4:57 PM

    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.

  8. Dr. Hanan Taha, M.D.
    April 13 2013 at 12:57 AM

    @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.

  9. Afsha
    April 21 2013 at 11:06 AM

    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

  10. Dr. Hanan Taha, M.D.
    April 21 2013 at 7:33 PM

    @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.

  11. Riss
    May 29 2013 at 9:59 AM

    I have extremely dry hands that are dry cracky and dark I have tried Vaseline to creams and it seems as though at night is when it's the worse and itches the most. I'm looking for a home remedie and I heard that olive oil or lime juice are good options is this true? It's very embarrassing to hand extremely dry hands that are dark and cracky

  12. Dr. Hanan Taha, M.D.
    May 30 2013 at 8:49 PM

    @Riss I am concerned. You're describing such distressing symptoms that I wonder if there is an underlying cause more than just skin dryness. It could be eczema or exposure to irritants (like concentrated cleaning detergents or occupational exposure to chemicals). There are also other possible causes. I do advise seeing a dermatologist in person to decide what the real reason is and to address it properly. Good luck.

  13. Chris D.
    May 31 2013 at 12:04 PM

    Dr. Taha, I need some help. I don't have insurance or a lot of money to pay for a dermatologist but my skin condition is getting worse each year. For the past five years i've been dealing with skin darkening on my hands and it's recently started to turn my skin to a rough sandpaper like texture on the affected areas. I first thought it was just hyper pigmentation and decided to just live with it but now I'm getting comments from family and it really bothers me. It looks like i've been working on cars my entire life and have motor oil staining my hands. I have a nervous tic that makes me bite those areas, that's probably the only thing I can think of that may be the cause. A picture can be found here [IMG]http://i40.tinypic.com/f0xkx3.jpg[/IMG] it also appears that i've lost some feeling in those areas. I can still register pressure but not pain. Any advice you can give me would be a great help.

  14. Dr. Hanan Taha, M.D.
    June 3 2013 at 3:57 PM

    @Chris D I am sorry to hear you are experiencing such distress. Five years is a long time! As I have not seen you in person, I cannot make an official diagnosis. However I think it is best to start with the most likely scenario and work our way from there. Biting can indeed lead to a lot of damage, and might very well be the cause if the problem is limited only to the area being bitten. In such a situation, no matter how much you try treating it, as long as you are biting that area it will never improve. So I will advice you to use moisturizers often during the day, and to use an exfoliating cream at night (mild at first then stronger, work your way up from 5 or 8% to 15 slowly). However if there are areas that appear inflamed or infected (red and painful) then you will need to treat them before starting this skin care regimen (with an OTC antibacterial cream). But what will help the situation is trying to control the biting habit. Even if it is not the actual cause, it is definitely not improving your skin condition. Now I say this knowing fully well how difficult it is to break a bad habit. It is part well-power and part distraction. By distraction I mean finding an activity that engages you mentally and physically; so TV and reading are not great options. Rather a hobby like drawing, writing, or sewing; or walking or any form of exercise you like. Good luck. And let me know how things work out.

  15. lindsay
    August 30 2013 at 2:09 AM

    Hi there! I love your articles and advice.. thank you for it :) Well, I am a musician, I play guitar so obviously my hands are one of the first things people notice and it bothers me so much; although my hands are soft my knuckles are so dark, I've tried several dermatologists and non of them seem to help me, I also checked myself for insulin resistance and thyrode and I'm great in my levels... Not sure what to do.. I recently started using "Burt's Bees" I got at a whole foods market, it's organic smells delicious and it specifies to help repair... hopefully it works.. Any suggestions? how effective are the chemical peels? are those the only dermatologist surgeries or treatments for this situation? Thank you!

  16. Priyanka
    September 15 2013 at 8:23 AM

    I m getting brown spots on hands palms feet.....my all vitamin levels are in normal range...these tiny spots are increasing day by day...pls help

  17. Sharmain
    October 18 2013 at 5:15 PM

    I started treatment for bipolar in March 2013. I am taking Epilem 600g; Lamictan 75g and dopaquel-75g p/day.I've developed horrible facial acne which I never had and dark knuckkes; cuticles and toes. How can I help myself as I am livid over all of the above

  18. Damilola
    October 19 2013 at 5:57 PM

    I have a very black knuckle,its very ugly and embarrassing,av been living with it for a very long time now.pls I need your help to remove the black areas of my knuckle

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