Topical treatments

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Although there is no cure-all treatment for PC, patients who deal with PC symptoms on a daily basis have tried a wide variety of products to treat their PC, especially their plantar keratoderma. These products may be over the counter (non-prescription) treatments, prescription treatments, or homeopathic, herbal, or "natural" treatments.


OTC (Over the Counter) Treatments

These are products that are available without a prescription.


Americaine is a family of benzocaine based topical pain relievers. It is a "hospital strength" pain reliever. There are two varieties of Americaine—Americaine First Aid Spray, and Americaine Hemorrhoidal Ointment. They contain the highest level of benzocaine pain relief allowable without a prescription.

K6a patient "During pregnancy, my sores actually changed texture and seemed to have more exposed nerve endings and blood vessels. The pain was constant and agonizing and to even touch a sore would put me through the roof. Because I had so many holes, or open parts in my sores, the things I used helped a lot. So, the best thing I used was Americaine. It's an over the counter hemorrhoidal ointment. I know that sounds funny since I didn't have hemorrhoids, but it has benzocaine in it - a numbing ingredient. So I put this stuff in my open sores and basically it numbed them so I could handle the pain. I went through tubes of the stuff during my last months of pregnancy."

Americaine is available on [].



[Aquaphor Healing Ointment] protects dry, cracked or irritated skin to help enhance the natural healing process and restore smooth, healthy skin.

1. Clinically proven to reduce healing time of minor wounds
2. Creates a protective barrier that seals in moisture
3. Helps heal raw, irritated skin caused by radiation treatments, facial resurfacing procedures and atopic dermatitis
4. Soothes and helps protect extremely dry, chapped or chafed skin and lips caused by winter weather or diabetes
5. Soothes and protects minor burns
6. Fragrance-free, preservative-free, non-irritating

K16 patient "Aquaphor - an ointment that soften dry callouses and smothes dry skin/chapped lips for those of us on an accutane. PCers can get this at their local pharmacy or online."


Bag Balm


Developed in 1899 to soothe the irritated udders of milking cows, the substance with the mild medicinal odor has evolved into a medicine chest must-have, with as many uses as Elmer's glue.

According to Bag Balm lore, the stuff went from barns to bedrooms when dairy farmers' wives noticed how smooth their spouses' fingers were after using it on cows' udders. The wives were jealous.

For over 100 years, Bag Balm® has been a fixture down on the farm. It goes on fast—and stays on! Used for over 100 years on cattle, horses and other domestic animals. It’s loaded with lanolin!

Helps soothe cuts, scratches, skin irritations, small injuries, rash chapping. Softens and moistens skin. It has been used for squeaky bed springs, psoriasis, dry facial skin, cracked fingers, burns, zits, diaper rash, saddle sores, sunburn, pruned trees, rifles, shell casings, bed sores, radiation burns and more.

Patient comments

??? patient "I use Bag Balm to help with my PC"


Callex Creme

[CalleX Ointment] thins and softens hardened skin and exfoliates dry, cracked heels. Its patented, natural enzymes selectively exfoliate only dry, cracked, thickened and scaly skin while its petrolatum base retains natural skin moisture.

K16 patient "I use callex creme that is a mix of urea and salicylic acid."


Heel Balm


Many patients find various creams (including products called 'heel balm') may help to combat dry, cracked and thickened skin on feet and in particular around the heels which may make care and removal easier. Under the 'heel balm' category, there are at least 30 different brands (including Felxitol mentioned below). These products are available at many drugstores as well as online sources.

Patient comments

K6a patient "[a heel balm I use is] made in Australia, but the company may be South African. I used all over my feet to keep them from cracking everywhere - it also seems to make the skin less visually noticeable too. If you have bad cracks you just put the cream on, wrap them up in cling wrap overnight and the next day they are so soft you can walk normal - then do that for a few nights and they go back smooth very quickly. You don't even have to trim the skin down, its very soothing too so it doesn't hurt or sting when used on open cracks. Then, after it has heeled the cracks you can trim the skin easily because its so soft."

??? patient "I find the Flexitol heel balm helps to soften the hard skin on the feet."



Informal comments from physicians on the IPCRR Physician Panel:

Dr. Peter Hull said "It is possible that the abnormal nails could become infected with fungi including non-dermatophytes. Lamisil would only work to get rid of dermatophyte fungi but the nail would remail abnormal if it was affected by PC."

Dr. Philip Fleckman said "Terbinafine (Lamisil) is a good drug for dermatophyte infections (but not Candida or other yeast infections) of the skin. Dermatophytes are a group of fungi that live in the top part of the outer, barrier layer of the skin (the stratum corneum of the epidermis). Dermatophytes cause athelete's foot (tinea pedis), jock itch (tinea cruris), and most types of nail fungal infections (onychomycosis). Because the nails in PC are thicker than normal, they are often mistaken for nail fungal infection and treated with terbinafine. Unless the nails or feet are infected, I know of no reason why terbinafine would improve PC."

It is possible for those with PC, to get a secondary fungal infection (such as a nail infection or athlete's foot, etc.) An antifungal treatment will not improve the PC condition; it may work well to treat a secondary infection. Most of these drugs are not designed for long term use; they are designed only to treat an infection.

K16 patient "Me on the other hand have it quite bad, well worst after the kids anyway. Now I am at the point where I don't even have PC in spots it is just raw skin and itches really bad. I also see that I am getting athletes foot or real bad itching on top of toes and between as well." Physician "It is possible she could have athlete's foot on top of her PC and if that is the case it should respond to to Lamisil which is a OTC medicine."

??? patient "I've been using Lamisil about 4 months & doctor asked me to stop taking it because it is not going to be get rid my problem."

K16 patient "While chatting with my brother, he told me his new doctor has been giving him Lamisil for his feet (fungal infection) and cordisone shots!! He just doesn't get it about his own feet....and apparently this new doctor hasn't a clue about what PC is!"

K6a patient "The doctor asked that we pick up an anti-fungal cream. She first thought lamisil, but changed to miconazole. At the store the only Miconazole was a 'vaginal' cream, but the pharmacist said okay to use on feet; they just didn't carry the 'foot care' package, but it would be the same. I started immediately to soak my feet with a capful of bleach and then applied the anti-fungal cream (Miconazole). I did that yesterday evening and today morning, and I would say it's already helping me a lot. Since the last 4 or 5 years my feet started to itches a lot, specially in the heels, and since I started with this medication it is not itching anymore. That's great!"



Original [NEOSPORIN® First Aid Antibiotic Ointment] provides long-lasting infection protection and may help minimize the appearance of scars. #1 Doctor Recommended Brand for over 25 years. No other triple antibiotic ointment kills more types of bacteria then even the leading prescription based in laboratory results.

NEOSPORIN® + Pain Relief Ointment & Cream

NEOSPORIN® + Pain Relief First Aid Antibiotic/Pain Relieving Ointment and Cream help prevent infection and provides temporary relief of pain or discomfort in minor cuts, scrapes, and burns. From the #1 Doctor Recommended Brand. Soothes painful cuts. Soothes the pain of burns.

K6a patient "Cracks on feet, sore and painful. Sometimes splits are in sores, sometimes extend to regular skin. Trim down callus carefully around split, put ointment like Neosporin into crack to keep soft. If gets dry it will split more and hurt more. Keeping cracks soft and not so deep seems to help them heal faster."


Phytex Paint

Phytex Paint for the treatment of fungal infection. Pain on to the affected areas, morning and evening and after washing.

K6a patient "I prefer hard skin to soggy blisters and soft skin. Phytex Paint which is for athletes foot, this works a treat to soak up the soft skin"

Phytex paint is available [Here]

Topical Ibuprofen

PC Project applied and received IRB approval for a study of topical ibuprofen believing these were approved over-the-counter products. However, the FDA has ordered all companies to stop marketing this product as it has not been approved for safety.

FDA News Release

FDA Warning Letters to each company selling topical ibuprofen

We know that several patients found this very effective. We are disappointed to not be able to go forward with the study at this time. We note that some companies are continuing to sell the product on-line and have included disclaimers regarding non-FDA approval.

Also, at the 2009 Patient Support meeting in Salt Lake City, one of the physicians suggested a similar product Soloraze gel which is by prescription only. Several patients are trying this on their own and will report feedback. We're gathering additional information and will post it when available.

Prescription Treatments

Anti-inflammatory medications

K6a patient "Anti inflammatories or enzyme inhibitors such as Vioxx or Celebrex. Takes one each night before going to bed. Cannot function without them."

K6a patient "An anti-inflammatory medicine that helped his feet for long walks and every day use of feet. Worked extremely well."


Bactroban is an antibiotic that treats or prevents infection that is caused by bacteria.

K6a patient "When I get feet infections I use Rx Bactroban."

See the PC Wiki section on infections for more information on treating and preventing infections associated with PC symptoms.

Dilantin (antiepileptic)


Phenytoin sodium is a commonly used antiepileptic. Phenytoin acts to dampen the unwanted, runaway brain activity seen in seizure by reducing electrical conductance among brain cells by stabilizing the inactive state of voltage gated sodium channels.

Patient comments

K6a patient "Dilantin or Phenytoin. Drug for sufferers of epilepsy. Used for 6 months to a year. Went off it to have unrelated surgery. After two weeks on drug, not one white blister and was able to spend 6 hours on feet. Still pain, but every time upped the dose, could tell a difference. All follicular keratosis on knees, elbows, bum and anywhere clothes rubbed disappeared. When on Dilantin "my head felt 'right'.. felt like I was more balanced in myself...It made me sleep like I have never slept before, I was zonked out before my head even hit the pillow." Downside: If forgot to take a tablet, would get emotional and a little bit unbalanced. When went off it bumps and blisters came back. Just recently went back on it but again off it again because we are deciding what to do about the kid thing (its a category D drug - ie can cause deformities). Apparently it works on the part of the brain that controls the central nervous system and someone i spoke to had a theory that it stops the body over-reacting to the skin build up. The best effect it had was that i had no white blisters and was able to stand for alot longer and walk longer too. Also made every single follicle bump disappear. Ever since I stopped it my feet have got slowly worse but i do wonder if it is related to me just doing more stuff now - or maybe i got used to doing more stuff while i was on it."

Fluocinonide Cream


"Fluocinonide cream USP 0.05% - Anti-Inflammatory is a prescription topical solution used to relieve symptoms and shorten recovery time of many common skin conditions. Doctors often prescribe the cream for eczema, poison ivy and oak exposure, and several other forms of dermatitis. Fluocinonide is a synthetic corticosteroid that works by stopping the immune system's inflammatory response and preventing further irritation. It is important for patients to follow their doctors' orders carefully when using the cream to achieve the best results and avoid potentially adverse side effects.

It is usually used over a short period of time and there is little or no data on extended use for chronic conditions.

Topical corticosteroids like fluocinonide cream are commonly used in the treatment of skin disorders, though medical researchers are unsure exactly why such drugs have anti-inflammatory properties. When the cream is absorbed into the skin, it constricts nearby blood vessels and halts the distribution of inflammation-inducing chemical signals from the immune system. Fluocinonide cream has proven very effective in relieving itching, redness, dryness, and localized swelling when it is used as directed by a physician.

Most people who use fluocinonide cream as instructed do not experience negative side effects, though it is possible for dryness and itching to actually worsen with frequent use. Some people are allergic to fluocinonide or inactive ingredients, and may experience hives, swelling, and skin irritation that are not limited to the area of skin on which the cream was applied. A severe allergic reaction can cause airway constriction and, in some cases, lead to dizziness and a rapid heart rate. An individual who experiences any adverse reaction should stop using the cream and seek immediate medical care.

Doctors are very careful when prescribing fluocinonide cream for infants and young children due to the possibility of serious health complications. Corticosteroids can cause hormonal imbalances in young patients, leading to delays in growth, weight changes, and high blood pressure. Some children acquire a blood disorder called Cushing's syndrome after taking corticosteroids. Children who are prescribed corticosteroids typically need to receive regular checkups so their pediatricians can make sure they continue to develop normally."What Is Fluocinonide Cream?" WiseGeek. Conjecture, n.d. Web. 14 Sept. 2012. <>."

Patient comments

K6a patient "I've been on a new medicine from my podiatrist. it's called Fluocinonide Cream USP 0.05%. It's made the calluses on my feet slowly go away and my feet are like new. I still have the thick ones on my heeks but the main flat portion of my feet feel amazing. Best I've felt in 43 years. I use it 2x a day (morning and evening) and can't thank my doctor enough for this."

More information on Fluocinonide topical cream

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