WHAT IS HAND ECZEMA?

Hand eczema, or hand dermatitis, describes any type of eczema that develops on the hands.

Hand eczema is commonly job-related and can be made worse by factors including frequent hand washing and exposure to chemicals. Hand eczema may require specific testing and treatment.

It may cause itchy, dry, scaly patches of skin that crack and flake. This can occur acutely but may also be a condition referred to as chronic hand eczema (CHE) or chronic hand dermatitis (CHD). Hand eczema, and CHE can profoundly affect everyday living and one’s quality of life. Chronic hand eczema may not respond to traditional eczema management strategies such as frequent moisturizing, protecting the hands, and topical prescription treatments, and the appropriate treatment plan will depend on a number of factors.

WHO DOES IT AFFECT?

Hand eczema occurs commonly among health care workers, hair dressers, construction workers, cleaners, agricultural workers, food industry workers, and florists.

Hand eczema can happen to anyone; however, you are more likely to be affected if:

  • You had similar skin problems, eczema, hay fever, or other allergies as a child.
  • Your hands get wet a lot, whether at home, work or with leisure activities.
  • Your job exposes your hands to irritating chemicals or very frequent hand washing and disinfection.
  • You frequently wash your hands around the house or at work, which breaks down the skin’s natural protective barrier.

WHAT ARE THE CAUSES?

Often, the cause is unclear—however, there can be one or more conditions present. The three most common conditions related to hand eczema are as follows:

IRRITANT CONTACT DERMATITIS

The most common is Irritant Contact Dermatitis. Repeated exposure to irritants such as water, soaps, detergents, solvents, degreasers, lubricants, oils, coolants, fiberglass dust, food products, metals, and plastics can inhibit the repair of the skin barrier.

What are the signs and symptoms?

  • Affects the fingertips and web spaces.
  • Skin is dry and chapped, with areas of itchy, red, scaly, and swollen skin.
  • Skin may sting or burn when in contact with irritants, and may eventually crack and bleed.

ALLERGIC CONTACT DERMATITIS (ACD)

The second most common form of hand eczema is Allergic Contact Dermatitis. Common allergens include nickel, certain food additives and fragrances, and preservatives. Occupational allergens could include antibacterial soaps and solutions, organic dyes, rubber, plastic resins, and plants.

What are the signs and symptoms?

  • Soon after exposure, small blisters may appear with itchy, swollen, red skin.
  • Later, the skin may dry out with crusts, scales, and cracks.
  • Prolonged exposure to the allergen can cause the skin to darken and it may become thick and leathery.
  • Eczema may appear all over the hands and fingers, particularly on the inside of the hands and fingertips.

ATOPIC DERMATITIS

Atopic Dermatitis, whereby skin in other areas of the body is affected, can also cause hand eczema.

What are the signs and symptoms?

  • Intense itchiness
  • Acute skin lesions
  • The condition is chronic
  • Skin thickens

Speak with your doctor to get a diagnosis on your specific condition, and to talk about treatment options that are right for you.

HOW IS IT DIAGNOSED?

Without proper diagnosis and treatment, hand dermatitis can persist and become chronic. It can often become disabling because it affects one’s ability to perform at work and home.

Hand dermatitis may interfere with sleep, cause emotional discomfort, and negatively affect interpersonal interactions. A thorough history and physical examination are essential in helping to deduce the possible cause(s) of hand dermatitis. Medical, occupational and social history are important. It is often challenging to distinguish irritant contact from allergic contact dermatitis.

PATCH TESTING

Patch testing should be considered for everyone with chronic hand dermatitis. The gold standard method for diagnosis of allergic contact dermatitis is patch testing. This is an office procedure in which allergens are applied to the back. Your doctor should strongly consider patch testing if:

  • You have chronic hand dermatitis.
  • You are not able to manage your dermatitis.
  • Your dermatitis responds to treatment but flares immediately when you stop using your topical treatments.

See your doctor! The longer the condition goes undiagnosed and untreated, the more likely you are to suffer with chronic hand eczema.