Every so often, I experiment with different products to treat my digital ulcers. Most of the time, I end up going back to tried and true. This happened recently when I found a product for healing diabetic ulcers, which sounded great, but ended up macerating my skin and setting me back a few days.
So, here’s what has been working well for years (I have no promotional relationship with any of these products):
- I use Coverlet, which I buy online, because they are not available in any brick-and-mortar store that I know of. They are fabric, without any plastic coating, so they breathe well. Downside: if they get wet, the damp can seep through the dressing. So I’m just careful and use hand sanitizer to avoid that issue.
- They come in different shapes and sizes, but my favorite size is 3″ x 1¾”, which I cut in half lengthwise to dress my ulcers with overlapping layers. The small oval size is useful, too. The bandages designed for fingertips, which have kind of a butterfly shape, are a waste of money, IMHO.
- Like most bandages, they are light beige. One of these days, some smart entrepreneur will make bandages in a true range of skin tones. But I digress . . .
- Aquaphor has been my go-to for decades, originally recommended by a dermatologist when I was just starting to deal with ulcers. A thin layer is essential. Too much ointment, and the skin will break down.
- I also use Medihoney gel, which is a great healing salve. It has antibacterial properties. However, it can sting if the ulcer is deep. Use with caution, thin layer. If my ulcers last a long time (usually for many months), I find that switching back and forth between the two can improve my outcome.
- I apply ointments with cotton swabs, never with another finger, to carefully manage the amount and to keep from spreading an infection that hasn’t yet made itself known.
- Medline Avant Gauze provides a breathable layer between ointments and bandage. I cut this into small rectangles as needed. It’s lightweight and very soft, and helps to keep my ulcers from getting too moist, which will break down the skin and impede healing. I discovered this gauze when I was healing my hands from surgery several years ago via a hypobaric oxygen chamber.
- Another great, but expensive product, is Mepiform, which comes in 4″ x 7″ sheets, but you can cut it into small pieces as needed, to stretch your inventory. It is a breathable film with a gentle adhesive backing that you peel off. I learned about this from wound care experts, and it’s very helpful to protect superficial ulcers that don’t yet need ointment but need coverage to prevent deterioration. Also works as ulcers are nearly healed, and you need to wean them from bandages.
- Washing ulcers after you remove bandages can really hurt. I find that Cetaphil, or the drugstore generic, works best. Very gentle on very sore skin.
- After I wash my hands and dry them, and before I put on a new dressing, I use small alcohol wipes to clean off any residual bandage adhesive that I might have missed.
- I always wear exam gloves when I cook or do any housework that could dirty or dampen my bandages. I avoid brands that have powder inside. I do not have a latex allergy, so that’s not an issue for me. Since the pandemic, they have become much more expensive, so I go by what’s available for a reasonable price. Right now, my favorite brand is Diamond Grip, because they are easy to get on and off, and they don’t tear. I used to favor Curad, but can’t find them anymore.
I hope you find this helpful. Digital ulcers are extremely hard to heal with scleroderma, especially when you have severe Raynaud’s, as I do, and resulting poor digital circulation. It takes a lot of patience and a good partnership with your team of physicians. Be well, and if you use other products that work for you, please share.