Thickened skin keratinization of the knuckles is considered to be knuckle pads, which can usually be improved by topical medication and physical therapy. 1. Medication: You can soak your hands in warm water and then use some topical medications, such as retinoic acid cream, to remove or soften the keratin and relieve the symptoms. Or intradermal injection of tretinoin and other drugs, also has a certain effect. 2. Physical therapy: liquid nitrogen freezing, X-ray irradiation and other physical methods can be used for treatment. If the patient appears to have thickened skin keratinization of the knuckles, it is recommended to go to the hospital in time, after clarifying the cause of the disease, the doctor will carry out targeted treatment for it. Drugs should be used in accordance with medical advice.