Hand Eczema & Dermatitis

What is Hand Eczema?

Hand Eczema is an inflammation of the hands leading to a rash. These rashes can be very extensive and can often interfere with normal daily activities. It causes discomfort and embarrassment and can be very devastating.

Hand rashes are extremely common and often start with dry, chapped hands that later become scaly, red, and inflamed. Very painful cracks and fissures may develop especially in the joint creases and around the fingertips. The backs of the hands often become red, swollen and tender. The palms are often a red, smooth, shiny surface that split and crack with the slightest trauma.

Who gets Hand Eczema?

There is often a family tendency to develop this problem. Other people at risk include those who have a history of persistent, whole body eczema, those with dry, itchy skin, or those with a history of widespread atopic dermatitis (eczema) as a child. Many people also have a history of hay fever or asthma or may have food allergies as well.

What Causes Hand Eczema?

Usually the cause is either an externally triggered contact rash or an internally generated skin reaction. Often there is repeated contact with a particular skin irritant that is causing one of these two things to occur. Common skin irritants include:

  • Soaps and detergents, especially any with fragrances, as well as liquid soaps
  • Water, particularly very hot water with prolonged skin contact and repeated hand washing
  • All cleaning supplies
  • Petroleum products such as gasoline, oil, grease
  • Certain foods such as raw meat or citrus fruits
  • Low humidity air, such as in cold weather or contact with dry heat such as fireplaces

Other things could be involved such as a bacterial or fungal infection. Your doctor may want to do tests to determine if a bacterial or fungal infection is present or may want to test you for particular allergies.

How is hand eczema treated?

Most often, a combination of things may be needed to treat this problem. Oral antibiotics or antifungal medicines may be prescribed if an infection is present. Medicated ointments or creams may be given. Most importantly, though is to protect the hands from irritations. Keep these tips in mind:

  • Wash your hands as infrequently as possible using a very mild bar soap (Cetaphil ® Bar Soap, Dove® soap, or Lever 2000 ® antibacterial soap) or even using only lukewarm water. Remove rings as they may trap soap and water against your skin. Immediately after washing your hands, moisturize them with Vaseline or the moisturizer determined by your physician.
  • Shampoo wearing rubber gloves or have someone else do it for you.
  • Avoid direct contact with any cleaners or detergents. Use an automatic dishwasher whenever possible.
  • Protect hands with gloves as much as possible. Wear white cotton gloves and cover with rubber gloves when cleaning. Buy multiple pairs of cotton gloves and change them often.
  • When outside in cold weather, wear unlined leather gloves to prevent dry chapped skin.
  • Deep fissure treatment: Sometimes you may get deep, painful linear breaks in the skin. You can treat them by cleaning them with hydrogen peroxide on a Qtip and covering with an antibiotic ointment. Another way to treat fissures is to put some superglue over it after cleaning. This may sting at first but it will protect the underlying skin from becoming infected.

Often a topical steroid will be prescribed. Apply the prescribed steroid or cream as directed, 2 times per day to the abnormal skin. Apply when hands are well hydrated after a bath or shower, then cover with cotton gloves overnight.

Moisturizing is also very important. Suggested moisturizers include: Vaseline or Aquaphor® or excellent moisturizing creams like Cetaphil® moisturizing cream The thicker the product, the better the moisturizer. Apply frequently to moist skin!