Hand Dermatitis: Causes, Symptoms, and Treatment of Hand Eczema

Hand dermatitis — also known as hand eczema — is a common and often chronic condition that interferes with work and everyday activities. Learn how to prevent and treat this condition.

Hand dermatitis causes a range of symptoms, from mild to severe, and affects as many as 1 in 10 people in the United States. Also known as hand eczema, hand dermatitis has many different causes, often job-related, and may account for up to 80 percent of all job-related skin conditions.

Although anyone can develop hand dermatitis, it’s most common in women, partly because women are more likely to be employed in jobs like nursing and hairdressing, which require frequent hand washing or exposure to solvents and chemicals that damage the skin’s protective oily barrier. It’s estimated that up to one-third of nurses have hand dermatitis.

If you have this stubborn condition, which often begins with chapped hands, progresses to red, scaly, and itchy skin, and can lead to blistered skin that cracks and weeps, don’t despair. Although hand dermatitis can adversely affect your quality of life, it usually responds to a combination approach that includes lifestyle modifications and medical therapies.

Risk Factors for Hand Dermatitis

You’re more likely to develop hand dermatitis if you’re exposed to common irritants that dry the skin, such as soaps, cleaning agents, and ingredients in skin and personal-care products. Among the most common offenders are products containing glycerin and rose water. Although these ingredients are meant to moisturize skin, they actually can dry skin in people who have allergic eczema, also known as atopic dermatitis. You’re at an even higher risk of developing hand dermatitis if you’re exposed to irritants such as industrial chemicals and cleaning fluids.

Although irritants are the most common cause of hand dermatitis, allergies are a close second. You’re more likely to develop hand dermatitis if you have an allergic condition such as hay fever, asthma, or atopic dermatitis, which increases the likelihood that you’ll become sensitive to such common allergens as latex, metals (especially nickel), and balsam of Peru (an ingredient often added to fragrances, foods, and skin-care products).

Other risk factors include stress; exposure to low humidity and cold weather, which can dry hands; and conversely, exposure to humid and hot weather, which can encourage excessive perspiration.

Home Treatments for Hand Dermatitis

If you have hand dermatitis, certain triggers may likely make your condition worse. Keeping a “dermatitis diary” may help you identify such triggers so you can avoid or minimize your exposure.

Flare-ups may be associated with exposure to such irritants as soaps and cleaners, wool and synthetic fibers, certain perfumes and cosmetics, dust or sand, cigarette smoke, substances such as chlorine and mineral oil, or solvents like gasoline and turpentine. They also may be associated with allergies to certain foods or to other allergens such as dust mites, mold, pollen, or dog or cat dander.

Although avoidance is a cornerstone of hand dermatitis prevention, other effective strategies include:

• A daily bath or shower. Use only mild soaps such as Dove, Basis, or Oil of Olay, keep water cool or lukewarm, and limit bath time to 15–20 minutes.
• Moisturizing. Within three minutes after bathing, and then throughout the day, use a plain, fragrance-free ointment or cream to seal in moisture and protect skin from allergens and irritants. Many dermatologists recommend a thick, oily moisturizer such as petroleum jelly (Vaseline). Newer alternatives include barrier-repair creams that not only moisturize the skin but also help rebuild it with an active ingredient called ceramide. Some ceramide-containing creams such as CeraVe and TriCeram are available over the counter, while others such as Atopiclair and Mimyx are available by prescription only. Per-container costs range from $15 to $100. In a small study published in 2002, researchers at the University of California at San Francisco found that TriCeram significantly improved stubborn atopic dermatitis lesions within three weeks.
• Appropriate use of gloves. Use plastic gloves — preferably with a cotton liner to wick away perspiration — whenever you use harsh soaps, cleaners, and other chemicals. Use an automatic dishwasher to minimize exposure. Also use gloves during cold and dry temperatures, or when handling laundry, because fabrics can deplete the skin of moisture.

Medical Treatments for Hand Dermatitis

If home treatments fail, consult a doctor, dermatologist, or allergy specialist. He or she may recommend additional avoidance strategies, help you develop a good skin-care routine, and prescribe medical treatments such as:

• Phototherapy, which involves exposure to ultraviolet light
• A combination of phototherapy and a drug called psoralen
• Oral antihistamines
• Tar treatments, which use itch-reducing chemicals
• A short course of oral corticosteroids
• Immunomodulators. Two such drugs — Elidel and Protopic — are approved for treating moderate eczema, but they’re recommended only for patients for whom other treatments have failed. In 2006 the U.S. Food and Drug Administration began requiring a “black box” warning on product packaging to alert doctors and patients to potential cancer risks.

Also ask your doctor about wet-wrap therapy, which involves the application of wet bandages after applying moisturizers and prescribed medication. Some studies suggest that one or two weeks of wet-wrap therapy applied before bedtime may help rehydrate and calm skin affected by severe eczema.

Although hand dermatitis can seem like an intractable problem, it doesn’t have to permanently affect your fingers and palms. With appropriate self-care — and medical treatments if necessary — you can rid yourself of this common nuisance and restore your hands to their normal condition.