Chronic Hand Eczema: A shadow pandemic

The pandemic has led to many significant changes in how we live our day to day lives, and a notable shift is the increase in frequency and duration of hand washing.  While hand hygiene is an important way to reduce the spread of germs, unfortunately for people living with chronic hand eczema (CHE), hand washing and hand sanitizing protocols have added a layer of complexity and suffering that is often overlooked.

ESC interviewed academic and clinical dermatologist Dr. Sonja Molin, MD, of Queen’s University in Kingston, and asked about the rise of a ‘shadow pandemic’ among Canadians with CHE.

“CHE is recognized as a condition distinct from atopic dermatitis (the most common for of eczema) and describes any irritation or form of dermatitis that appears on the hands.” says Dr. Molin. “We are seeing a rise in patients who are struggling with symptoms of CHE and it can often be attributed to frequent hand washing due to the pandemic.”

CHE is characterized by inflammation of the skin on hands which often leads to thickened skin that can crack, ooze, and bleed and in some cases, make the hands difficult to use. The hands may also be itchy, painful, and/or sore. An ESC survey on CHE revealed that more than half of respondents have suffered with the condition for 10 years or more, and 49% are not able to participate in certain activities or tasks due to their CHE. Basic activities like household chores, doing up buttons, and even self care can be difficult and painful. CHE is common among professions that work with their hands or have to wash/ sanitize their hands often including health care workers, hairdressers, mechanics, and florists.  Almost one third of respondents (31%) have had to change jobs due to their CHE.

When asked how CHE differs from other forms of eczema, Dr. Molin shared: “The pathogenesis of hand eczema is multi-factorial, which means there are a lot of different factors that can contribute to it.

The three most common factors I see in my practice include:

  1. Irritant damage: For example, are the hands in water often, or are they irritated from wearing rubber gloves all the time?
  2. Contact allergy: Is the individual allergic to something that their hands have touched?
  3. Atopic predisposition: Does the individual have an inherited skin sensitivity? Do they have other conditions like allergic rhinitis or food allergies?

In many cases, it might be a combination of all three factors, as well as an impairment in the skin barrier. The function of our skin barrier is to protect us from the outside, and if someone’s barrier is compromised, eczema can appear.”

If you are experiencing symptoms on your hands that do not go away despite frequent moisturizing, you may want to speak with a qualified health care professional for treatment advice. Additionally, if you suspect your hand eczema is related to your job, it is recommended to see a dermatologist as they can help identify if there is a connection and prevent symptoms from interfering with your work.

Dr. Molin adds: “It is important to remember that CHE can be treated and managed. New medications are being studied and we thankfully can expect new options and innovative treatments coming down the pipeline. This is welcome news, as the pandemic has unfortunately led to an increase in individuals struggling with this condition.”

ESC thanks Dr.  Molin for her time and contribution to this article. If you are struggling with eczema, speak with your doctor or dermatologist for guidance – they can tell help create a treatment plan to help manage your symptoms and determine which treatment options are right for you.