How Is Hand Dermatitis Diagnosed
Hand dermatitis is usually straightforward to diagnose and classify by history and examination, considering:
- Acute, relapsing, or chronic course
- Past history of skin disease
- Dermatitis on other sites
- Occupation and hobbies.
However determining the cause of a hand dermatitis can be complicated as it may be multifactorial.
Patients with chronic hand dermatitis may require patch tests to detect contact allergens.
A punch biopsy and skin scrapings may be necessary to exclude other causes of inflammation of the hands.
When To Seek Professional Help
Eczema that continues to worsen over time and does not improve with usual treatment like steroid medication can be an indicator of a bacterial or viral infection, especially when accompanied by pain, warmth, swelling, increased redness, blisters, and pus.
If any of these signs and symptoms are present, see your doctor immediately to determine if you have an infection. Early diagnosis and treatment are crucial to prevent serious complications.
What Are The Treatments For Severe Hand Eczema
If your hand eczema is severe, discuss the possibility of a dermatology referral with your GP. The referral may be for diagnosing contact allergy or for treatment, which may include a short course of oral steroids or immunosuppressants . Alternatively, dermatology departments may recommend alitretinoin or phototherapy, as described below.
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Dont Hesitate To Reach Out To Your Dermatologist If You Are Having Troublesome Symptoms
Many healthcare professionals are using telemedicine to consult with patients during the COVID-19 pandemic, notes Elbuluk. This can involve video chat, text messaging, or inbox messaging with your doctor. It may also include uploading photos or videos of your affected areas of skin. Find out which portal or app your doctor uses and whether it is HIPAA-compliant, which will protect the privacy of your health information.
The U.S. Department of Health and Human Services notes that during the COVID-19 pandemic, doctors may have more leeway to communicate with patients using non-HIPAA-compliant platforms like Apple FaceTime, Facebook Messenger, Google Hangouts, or Skype without government penalties. After all, not all medical practices were set up for current telemedicine needs before the pandemic.
Hand Dermatitis In Healthcare Workers
Because healthcare workers must wash their hands frequently they sometimes get dry, cracked or red skin that can also be painful.
Some Causes of Hand Dermatitis:
- Frequent, prolonged contact with water
- Harsh soaps
What can you do to decrease the risk of this condition?
- Use lukewarm water to wash your hands – never hot
- Use the least harsh soap available
- Good brands are Basis and Dove for sensitive skin
- Avoid soaps with fragrances or botanical oils
Self-care tips to protect and treat your hands if they become irritated:
Keywords: dermatitis, skin
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Some People Wrongfully Think Its Contagious
Another issue with hand eczema is that it can elicit unnecessary judgment and preconceived opinions from others. Some people who see a red, bumpy rash on someones hands may automatically think that it is contagious, and that the person with the rash should be avoided like the plague.
Of course, eczema is not contagious. It is primarily caused by the bodys hyperactive immune response to allergies and triggering factors. But this very fact doesnt stop judgmental people from having negative opinions. Shame on them.
Do Stay Hydrated Inside And Out
Stay indoors with a humidifier. Keep your ambient environment moist so that the moisture will help your skin, advises Desai, adding, Drink lots and lots of water. Dehydration can lead to dry skin, which in turn can compromise your skin barrier, notes the NEA, making you more vulnerable to flare-ups if cracks and fissures form.
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How To Prevent Hand Eczema And Rashes Due To Increased Hand Washing During The Lockdown
The global pandemic scare has taken over the entire world. And while this situation is quite scary, there is no reason to panic. Why, you ask? Well, simple measures such as maintaining personal hygiene and avoid social contact are the best ways to avoid contracting any infections.
If you catch yourself diligently washing your hands for 20 seconds or sanitizing them with an alcohol-based cleanser every time you touch a foreign surface, sneeze or cough, well, begin by applauding yourself, because you are doing it all right! But that much soap, warm water, alcohol-based sanitizing can definitely leave your hands feeling dry, cracked and susceptible to eczema or rashes. Here a few handy tips you can follow to keep your hands soft and supple, while also keeping them sanitised.
Further Help And Advice
“If you have severe hand dermatitis or suspect an infection – for example, your skin is oozing – you may need advice from your GP and prescription treatments to reduce inflammation,” advises Levell.
GP practices and pharmacies are far busier at the moment but many are offering online or telephone appointments.
If you don’t have an ongoing skin condition, but you have dermatitis as a result of frequent hand washing and sanitising, your pharmacist may suggest short-term use of a mild topical steroid such as hydrocortisone cream.
The British Association of Dermatologists and the British Skin Foundation have more information and resources on their websites.
This article was updated on 15th April 2020 following a change in guidance from the British Association of Dermatologists on the use of soap substitutes for handwashing.
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Common Types Of Eczema On Hands
A few types of eczema can affect your hands, depending on the cause:
- Irritant contact dermatitis happens when you come into contact with something that irritates your skin, like dust or chemicals. You might even get it after washing your hands a lot. These things can cause problems with the protective barrier of your skin, leading to eczema.
- Allergic contact dermatitis is caused by an allergic reaction to something around you. Common causes include nickel, fragrances, rubber, and certain plants.
- Dyshidrotic dermatitis causes itchy, watery blisters, usually on your palms and the sides of your fingers. You can have this along with a different kind of eczema in another spot on your body. It may come in cycles and is most common before age 40. Doctors arenât sure what causes it. But things like metals, allergies, stress, heat, and sweating can make it worse.
Relief Requires Finding The Cause
Effective treatment begins with finding the cause. Anything that irritates your skin can cause hand eczema. Even something as harmless as water can irritate your skin if you often have wet hands. Many people who frequently have wet hands throughout the day, such as nurses, hair stylists, and plumbers get hand eczema.
Working with chemicals like solvents, detergents, or cement also increases the risk. Hand eczema is common among construction workers and machinists.
Chef with hand eczema
Anything that irritates your skin can cause hand eczema. For example, whenever this chef handles garlic, hand eczema develops.
Hand eczema can also be caused by an allergic reaction. Some health care workers get hand eczema from wearing latex gloves.
You also have a higher risk of developing hand eczema if you had atopic dermatitis as a child.
Because so many things can cause hand eczema, finding the cause can be tricky. Until you find the cause and avoid it, hand eczema can worsen.
Thats why it can help to see a dermatologist. These doctors have the expertise needed to track down the cause, as Marks* story illustrates.
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Take Short Showers Or Baths Using Lukewarm Water
The duration of a shower or bath should be limited to 10 minutes. We recommend using lukewarm water, rather than hot water as it can dry out the skin. However, there is no clear consensus on the recommended shower frequency. We currently recommend taking one shower per day to clean any irritant, scale, or allergen from the skin. Its important to use a hypoallergenic and non-fragrant soap. Do not forget to apply a moisturizing cream right after!
Excessive Hand Washing Causing Skin Irritation
The skin works as a shield protecting the body from germs. Its outermost layer has oils and wax to help maintain the skins natural moisture.
Using soap and constant scrubbing when washing can irritate the skin barrier, leading to the loss of its natural oils. Many soaps contain ingredients that can trigger dermatitis. This is especially a problem for people with sensitive skin, eczema or a history of allergies to cosmetic products. With time, the skin might develop dryness, redness, itching, flaking, and, in some cases, cracks.
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Use Gentle Cleansers And Soaps
Soaps and skin cleansing products that contain fragrances, alcohol, and other irritants could cause eczema on your hands to flare up. When you wash your hands, use soaps and cleansers that dont contain these substances. Avoid using anti-bacterial hand sanitizing products, since these usually have alcohol and other irritants. Using gentle products allows you to clean your hands without having to worry about itchiness and other eczema symptoms afterwards.Our Gentle Foaming Hand Soap gently cleanses and soothes skin.
Wear Disposable Gloves When Preparing Food
Certain foods, such as onions, potatoes, citrus fruits, and garlic, can trigger hand eczema symptoms. When youre preparing these foods, wear a pair of disposable gloves. You can toss the gloves out when youre done working with these foods, and use a new pair the next time around. If youre unable to wear gloves while handling these kinds of foods, wash your hands afterwards to reduce the risk of having eczema occur.
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Avoid Harsh Detergent For Washing
Washing and cleaning are our daily activities. Unfortunately, most detergent powder contains toxic chemicals, artificial fragrances, preservatives, and chemical dye. These entire components react to our skin and make it drier.
As a result, eczema and skin rash are quite a regular occurrence. So choose your laundry detergent wisely, which is chemical-free.
Eczema Handwashing And The New Coronavirus : Protecting Yourself And Your Skin
Proper handwashing is one of the best ways to prevent spreading viruses, like the new coronavirus and the flu. But when you have a skin condition like eczema , washing your hands often can lead to dry and cracked skin, itchiness, pain and possibly infection. So how can people with eczema protect their skin while protecting themselves from the coronavirus?
The Asthma and Allergy Foundation of America asked Dr. Jonathan Silverberg, a member of our Medical Scientific Council, what people with eczema and other skin conditions need to know about handwashing and COVID-19.
The World Health Organization and Centers for Disease Control and Prevention are recommending frequent handwashing to protect from the flu and COVID-19. But this can cause flare-ups for people with eczema. What do you recommend people with eczema do to prevent eczema flares on their hands while practicing good hygiene?
My personal and professional experience has been that handwashing is generally better than hand sanitizer, especially when you apply moisturizer right after. Applying moisturizer after each handwashing can offset much of the drying effects of handwashing. I typically recommend my patients carry a pocket tube of moisturizer that would allow them to apply it anywhere.
Are there certain types of soaps people with eczema should avoid? Should they avoid hand sanitizer too?
What are the steps people with eczema should take to properly moisturize after washing their hands?
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Get Rid Of The Thing That Caused It
As mentioned earlier, eczema or dermatitis is primarily caused by the sufferers hyperactive immune response to allergies and irritants. In short, you have to know your triggers and get rid of them.
Is it something you touched? Is there a presence of known allergens in your home? Is there an ingredient in the food you ate that caused the flareup? These are just some of the questions you need to ask.
For people who have asthma and hand eczema at the same time, the triggering factors tend to be the same between the two conditions. It is helpful to take note of what triggers your asthma, and avoid those same triggers for eczema.
You may also consult your doctor and request a patch test to know which substances and irritants yo are allergic to.
Choose Your Body And Facial Products Carefully
Cosmetics, soaps, hair products, perfumes, scented lotions, and shaving creams may contain ingredients that can irritate your skin and trigger eczema outbreaks. The best way to know which products are best for you is to test them on a small area of skin before using them regularly. Leave the product on your skin for at least 24 hours, then check if youve had a reaction.
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Gentle Soaps And Detergents
Laundry detergent can contain harsh chemicals that aggravate eczema.
Many body washes and cleansers contain detergents, which help provide a soapy lather. Detergents and other lathering agents can dry out the skin, especially in people with eczema.
Bar soaps can also be harsh on the skin because of their alkalinity.
Try using a gentle, no-lather, fragrance-free cleanser. Avoid products with rough particles for scrubbing or exfoliating, as these can further irritate the skin.
Many people with eczema also find that switching to a more gentle, fragrance- or color-free laundry detergent can help improve symptoms.
Try skipping fabric softener, which lingers on clothes and often contains fragrances and chemicals that can cause skin irritation.
Sitting next to a fireplace or near a furnace may feel good, but it can make eczema symptoms worse. The hot, dry air can dehydrate the skin and aggravate the itchiness of eczema.
Use a humidifier during the dry winter months and avoid getting too close to heaters and fireplaces.
What Type Of Moisturizer Is Good For Hand Eczema
Mild hand eczema on the knuckles
The more water there is in a lotion or moisturizer, the more likely it is to worsen your hand eczema. Moisturizers usually contain more water than oil, and when the water evaporates it can dry out the skin. The best moisturizer for hand eczema is a greasy ointment, such as petroleum jelly. Be sure to read the label to determine which moisturizer has the least amount of water.
The NEA Seal of Acceptance directory has a list of moisturizers specially formulated for eczema skin.
Apply the moisturizer to your hands immediately after you bathe and each time you wash your hands.
Remember that it can take a few months for a flare-up to clear. Even if your hands appear eczema-free, you will sometimes need to take special care with them to avoid a return of symptoms.
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Wash Your Hands With Care
Washing your hands is an important part of preventing germs from spreading, but it can also cause you to have eczema symptoms. When you wash your hands, make sure you use lukewarm water instead of hot water. Wash with a gentle soap or cleanser, then blot your hands dry on a towel. Avoid rubbing your hands to dry them, since this can irritate your skin and cause eczema symptoms to occur.
Identify & Avoid Known Irritants
With eczema on hands, irritants vary person to person. Some may have a nickel allergy while others are unable to handle foods that contain gluten. Finding your triggers and irritants can take some time and you have to be diligent, but this is an essential step to treat eczema on hands and most other locations on your body. Consider an elimination diet to see if any foods are triggering your symptoms. Specifically look to eliminate gluten, dairy and eggs since these tend to be common issues for many people with eczema.
You also want to evaluate the products that you use regularly to see which might be problematic. Consider swapping your cleaning and hygiene products for those that are all-natural. What is important is that the products are free from artificial fragrances and colors since such ingredients are a trigger for a number of people with eczema on hands. Consider moving to a natural laundry detergent for eczema as well.
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Why Does Eczema Appear On The Hands
There can be a variety of reasons why eczema appears on the hands. For example, the hands can be affected by irritant or allergic contact dermatitis or both at the same time.
Coming into contact with irritants such as dust, detergents, cleaning agents, airborne sprays or even just frequent hand-washing can cause irritant hand eczema . The skin on the palms of the hands is much thicker than elsewhere on the body and is normally able to withstand a great deal of wear and tear. But in people who regularly immerse their hands in detergents or solvents, the protective barrier of the skin breaks down, and eczema may develop. People who have this form of hand eczema often have a history of eczema in childhood.
Allergic hand eczema arises as a result of an allergic reaction to a particular substance in the environment. It is possible to be allergic to a number of different substances, but common causes of contact sensitivity include nickel, fragrances, preservative chemicals, rubber and various plants, amongst other things. Once a persons immune system has identified a substance as harmful, they will react to the substance every time their skin is exposed to it, and this reaction becomes more severe on every exposure to the allergen.
When an allergic reaction of this kind is suspected, your GP should refer you to a dermatologist, who will normally perform patch tests to try to identify the allergic cause.