Hand eczema

Hand eczema (also known as hand dermatitis) is very common, occurring in about 10% of women and 4% of men. It usually starts with mild dryness and redness. Scaling can increase, leading to fissuring and crusting. Affected skin areas can be very itchy. Initially, the fingers and web spaces are involved.

Hand dermatitis is often difficult to treat effectively. It is most commonly seen in individuals who do a lot of wet work at home or expose their hands to wet conditions at the workplace. In severe cases, this condition can be disabling and affect the ability to perform at work and home. Homemakers, parents with small children, bartenders, hairdressers, dental workers, and surgeons, as well as other occupations that require frequent hand washing or the use of irritating substances or chemicals are at higher risk. The common feature contributing to hand eczema is repetitive wetting and drying of the hands. Cold weather can also be an aggravating factor. Frequently, the hands of parents with newborns worsen after their baby is about 3-6 months of age. It is estimated that approximately 40% of individuals who had atopic eczema during childhood will experience irritant hand dermatitis. About 70% of these individuals will have hand involvement if their work exposes them to regular contact with irritants.

Common Variants

• Irritant contact dermatitis (35%)
• Allergic contact dermatitis (19%)
• Atopic dermatitis (22%)

Less Common Variants

• Hyperkeratotic dermatitis
• ID reaction (Autoeczematization)
• Frictional dermatitis
• Nummular dermatitis (Discoid dermatitis)
• Pompholyx (Dyshidrosis or Vesicular dermatitis)

Here is some practical advice if you have hand dermatitis:

• Use a long handled brush for washing the dishes.
• Consider using a dishwasher instead of hand washing.
• Avoid heating or cooling the skin. Sweating within rubber gloves can worsen the dermatitis, so cotton gloves should be worn inside loose-fitting rubber or vinyl gloves.
• Wear cotton gloves to do general housework, as they can be washed instead of washing your hands too often.
• Avoid the temptation of using very hot water, even if wearing gloves.
• While preparing food, try to minimize contact with fruit juices, fruits, vegetables, raw meats, onions and garlic.
• Avoid the use of household cleansers, deodorants, and antibacterial soaps and cleansers.
• If possible, wear vinyl gloves to shampoo hair. If this is not possible, use the hand which is less likely to be affected by the dermatitis.
• Keep hand washing to a minimum and maintain water at a lukewarm temperature. Always pat dry your skin.
• Avoid harsh or scented soaps, instead use mild liquid cleansers, such as Spectro Jel, Spectro Derm, Cetaphil, Seaquanil, Lipikar Syndet.
• Remove rings before wet work or hand washing, as they can trap moisture and irritants underneath.
• Apply moisturizers after washing, ointments that are clear and sticky seem to work the best, but they may not be practical due to their "greasy feel". Alternatively, try using a skin protectant with petrolatum or silicone, such as Spectro EczemaCare, Vaseline or Prevex.
• Scratching can worsen your dermatitis and cause cracks to form, allowing bacteria to enter and resulting in infection.
• To help manage itching, apply a cold compress to the affected area, keep fingernails short, and use over-the-counter (OTC) products containing hydrocortisone or clobetasone butyrate.
• Efforts aimed at reducing stress may also be helpful for managing eczema.