Hand eczema is a condition of itchy, scaly patches on the hands that may progress to become red, cracked, and painful. This eruption can occur at any time during one’s life but is more common under certain conditions.
- Personal or family history of Atopic eczema, asthma, or hay fever.
- Wet hands: water exposure at home or at work (e.g. bartender, hospital worker, housekeeping)
- Irritating chemicals at work or home
- Allergic reaction
- Chronic infection
Sometimes we can perform patch testing in the office to try to determine the cause of the hand eczema. Patch testing involves putting a pattern of chemicals on the skin in an attempt to get reactions. Also, a culture can be taken from infected hands to determine the organism causing the infection. Rarely, a skin biopsy may be necessary to differentiate a patient’s condition from problems which may mimic hand eczema (psoriasis, etc.).
- Wash your hands in lukewarm water. After rinsing, dry thoroughly.
- When using liquids, wear protective gloves, but try to minimize the amount of time you keep protective gloves on.
- If you keep protective gloves on for more than a few minutes, wear cotton gloves underneath.
- Avoid wearing rings. For example, don’t wear any rings at work.
- Apply petrolatum (e.g.: Aquaphor, Vaseline) over your hands during the day and after work. Don’t forget to cover the backs of your hands, between the fingers and the finger webbing.
- Wear warm gloves when it’s cold outside.
- Topical corticosteroids are often recommended but must be used with caution: side effects with prolonged usage may develop. Until recently, topical corticosteroids have been the mainstay for treating eczema.
- There are other non-steroidal topical medications that can be applied to the skin instead of the topical steroids.
- Oral and/or topical antibiotics can be prescribed if there is evidence of an infection.
- Oral antihistamines can be taken to try to relieve the itch that is often associated with hand eczema.
- Moisturizers should be applied several times per day to wet hands after washing or bathing. Eczema disrupts the skin barrier and these products can help with repair. The best moisturizer is petroleum jelly, also known as petrolatum. Some people feel this is too greasy and prefer cream based moisturizers. Note that cream based moisturizers usually contain more water than oil, and when the water evaporates, there is a net drying effect on the skin and hand eczema may worsen.
- Perfumes and preservatives in soaps and in household cleansers can cause hand dermatitis to worsen. When you wash your hands, use lukewarm water and a perfume-free liquid cleanser followed by a moisturizer. Look for the words “fragrance-free” – not unscented. Unscented items may contain a masking fragrance.
- Rings can hide water and soap between the skin and metal. Therefore, rings should be removed while washing or working with water and soap.
- Use a washing machine and dishwasher when possible.
- 100% cotton clothing should be worn on exposed surfaces. Cotton gloves can be found at many stores and on the internet. A simple internet search for cotton gloves will yield many sellers. Cotton gloves will absorb sweat and will ensure that your medication or moisturizer stays in contact with your skin.
- If you need to expose your hands to soaps or cleaning products or water more than a few minutes at a time, wear a pair of dry cotton gloves covered with a powder-free rubber or neoprene glove. If the cleanser or water gets inside the gloves, then a fresh, dry cotton glove should be worn under a new dry pair of waterproof gloves. This glove combination should not be worn for more than 20 minutes at a time. Wear this glove combination when shampooing your hair.