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What is hand eczema?
Hand eczema or hand dermatitis (rash) is extremely common. It begins with dry, chapped hands that may become red, scaly, and inflamed. Numerous items can irritate skin including overexposure to water, too much dry air, soaps, detergents, solvents, cleaning agents, chemicals, rubber gloves, and even ingredients in skin and personal care products. Even “harmless” things like water and baby products can make this condition worse. The dermatologist will try to find what substance in your everyday routine could be causing or contributing to the problem. Your skin may get better by changing products or avoiding an ingredient completely.
A tendency to get skin reaction is often inherited. There may be a history of hay fever, asthma, and food allergies. The skin can turn red and itch, indicating an allergy after contact with such substances.
Type of Eczema
Most of the causes of hand eczema usually fall into one of two types: an internally generated skin reaction or an externally triggered “contact” rash. Atopic eczema (allergic), Dyshidrotic eczema (tiny blisters that form on the hands and feet), or Nummular eczema (form in scaly, coin-shaped patterns) are internally skin reactions. Hand rashes caused be substances are referred to as allergic contact dermatitis or irritant contact dermatitis.
Finding the culprit
A dermatologist will work with you to uncover and identify the possible cause of a hand rash. Could it be an allergy? Could it be irritation? Like a detective, the dermatologist will ask many questions. These may include information about previous rashes, whether you have any medical problems. The dermatologist will want to know what kinds of things your hands are exposed to all day long, what creams or lotions you apply to your skin, and whether or not you wear gloves. The hands, feet, and the rest of your skin will be examined to determine what is causing the rash. The dermatologist may do a skin scraping for a microscopic examination or culture.
A fungal infection called tinea manuum may be the source of a hand rash. It may affect both the hands and feet. Other common causes of hand rashes, such as psoriasis, must be excluded. Special tests may be done to see if you have a skin infection or other problems.
If the dermatologist suspects the rash is due to an allergy to some external substance, a patch test may be done. This involves testing the skin on your arms or back to see what specific ingredients might be causing the skin to react. If there is a positive reaction, a list of products that contains these ingredients and which ones should be avoided may be provided.
How is hand eczema treated?
A combination of methods may be used to heal and control your condition. Medicated ointments or creams, such as cortisones, tacrolimus, or pimecrolimus may be prescribed. The dermatologist will discuss things to avoid including keeping your hands away from other irritants.
Is hand protection important?
It may take months for your hands to return to normal. Regardless of the cause of your rash, you will want your hands to heal and to stay healthy. There are ways to pamper them, now and in the future, to lessen repeated episodes:
- Protect hands against soaps, cleansers, and other chemicals by wearing vinyl gloves. Have four or five pairs and keep them in the kitchen, bathroom, nursery, and laundry areas. Have other pairs for non-wet housework and gardening. Avoid rubber/latex gloves since many people are sensitive to them. Always replace gloves with holes. Dry gloves by turning them inside out between cleaning jobs. Wear gloves when folding laundry, peeling vegetables, or handling citrus fruits or tomatoes. You also may need to wear white cotton gloves under the vinyl gloves to offer more hand protection.
- Avoid hand washing dishes or clothes as much as possible and use an automatic dishwasher.
- When washing your hands, use lukewarm water and very little soap (lipid-free cleansers may be helpful). Remove rings whenever washing or working with your hands because they trap soap and moisture next to skin, which allows hand dermatitis to develop.
- When outdoors in cool weather, wear leather gloves to prevent dry and chapped skin. Always use a dermatologist-recommended moisturizing product to keep your hands soft and supple. Apply it as many times a day as you need it.
- If the type of work you do is affecting your hands, talk to your supervisor about ways that you and other employees can better protect their skin.
Hand eczema is not contagious. Although some fungal infections may look like eczema, it is important to have your rash checked by a dermatologist who can do the appropriate testing and give proper treatment. Try to remember which substance or what activity triggered the recent “flare-up” and discuss it with the dermatologist. Since many hand rashes can be stubborn, it is important to use the medication properly.
We apologize for not showing any photos here for ethical reasons. You may refer to the following website for before and after photos: www.aad.org
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