Hands and feet in systemic sclerosis

Many problems that affect the hands and feet affect the skin more generally too. We would recommend visiting our page on Skin in Systemic Sclerosis.

How to look after your hands

Finger exercises

Practice making a fist and then stretching all your fingers out like a star.

Touch each one of your fingertips with your thumb tip. Now gently slide your thumb tip down the side of each finger.

With your hands face down on a table lift each finger up in turn.

Blocking exercises (fingers have 3 joints)

Using a block (edge of table, other finger, matchbox, etc.) work the individual finger joints by “Blocking Off” before the end crease, actively bend the end of the finger and assist with the other hand to gain full bend. Straighten out fully, assisting if necessary. Repeat with the block placed before the second

How to look after your feet

Moisturise your feet as often as you can, ideally three or four times a day, being careful not to leave any cream between your toes. People tend to find their own choice of moisturising cream which suits them but something quite simple such as aqueous cream or E45® are popular choices (these may be bought at the chemist or may be available on prescription).

Inspect your feet daily – As you moisturise or put on your footwear, take a note of any changes in the skin. If you are concerned seek medical advice.

Choose footwear which does not rub and allows plenty of room for adequate socks/ tights. A thick sole may help protect against the cold, and the use of a thermal insole is recommended if your footwear can accommodate one.

Ask to be referred to NHS podiatry services for a full podiatric assessment.

Nail care

The nails can be affected in several ways. We know from looking after many patients with systemic sclerosis that the bones at the end of toes may alter their shape (be re-absorbed), which in turn alters the shape of the nail. This may lead to an increased incidence of ingrowing toes nails, which can be both painful and prone to infection.

Ideally cut your nails in a line straight across the free edge of the nail. Nails may become thicker or you may experience difficulty managing to physically reach down and manipulate clippers, in this case you may seek help from professional services such as chiropody or podiatry.