What is Hand eczema?
Eczema is a common group of skin conditions in which the skin is inflamed (angry) causing itchy, dry or oozing skin.
This common skin disease has many names, including:
Cheiropompholyx (affects the hands)
Dyshidrosis
Dyshidrotic dermatitis
Pedopompholyx (affects the feet)
Pompholyx
Vesicular eczema
Vesicular palmoplantar eczema
Who gets hand eczema?
Adults in the age group of 20 to 40 yrs are more prone to hand eczema.
It often affects people who work in cleaning, catering, hairdressing, healthcare and mechanical jobs where they may come into contact with chemicals and other irritants.
It is seen in family suffering from running nose (hay fever), Wheezing (Allergic Bronchitis), dry skin eczema (Atopic eczema). Sweaty or moist hands Patients receiving immunoglobulin therapy
Why do you get it?
Both genetics and contact allergens and irritating substances play a role in “triggering” this form of eczema, though exact cause remains unknown.
How does it appear?
All types of eczema cause itching and redness of the skin. But some like hand eczema, look and act slightly different than others.
It presents as redness, itching, pain, dryness, to the point of peeling and flaking, cracks, blisters. The blisters usually clear in 2 to 3 weeks or sooner with treatment. As the blisters clear, the skin is often dry and cracked. It may peel. If you have frequent attacks, the skin can start to thicken, feel scaly, and develop deep, painful cracks. There can be a secondary infection presenting as pain, swelling, crusting and pus-filled blisters.
What are the most common triggers?
Intense stress or worrying
Body infection
Warm weather, when heat and humidity rise
Wet work (having wet hands frequently throughout the day)
Contact with irritants like soap, detergents, dettol hand wash & other harsh liquid soap, hand sanitizers, metals, cement, dust, fevicol, gum, kerosene, diesel, grease, paint, clay, cutting some sour vegetables & fruits etc.
How is it diagnosed?
A dermatologist can diagnose it by looking at your skin.
A detailed medical history, work, hobbies, and recent stress level.
If your dermatologist thinks that the hand eczema could be due to an allergy, an allergy test called patch testing may be recommended.
What is the treatment?
The best treatment for hand eczema is avoiding causative factor.
Knowing which substances trigger your hand eczema and protecting your hands at home and at work, can help guard your skin against further irritation.
Soaks and cool compresses: Soaks or cool compresses that you apply 2 times a day can be very effective for drying blisters. You apply these for 15 minutes at a time. After each soak or cool compress, you’ll likely need to apply a medicated cream or ointment, such as a corticosteroid.
Corticosteroid creams:
This can reduce the inflammation and clear the blisters. For a severe case, a corticosteroid pill or injection may be prescribed.(all medications under dermatologist supervision) Wear gloves to protect your hands: cotton lined PVC gloves
Anti-itch medicine:
An antihistamine pill or other anti-itch medicine can reduce scratching. Anything you can do to reduce scratching is helpful because scratching tends to worsen DE.
Moisturizer or a barrier repair cream: These can reduce dryness and flares.
Antibiotics:
Sometimes hand eczema can get infected. Before prescribing this medicine, your dermatologist will first determine what type of infection you have. It’s important to apply the product after each shower, bath, and hand washing.
Draining large blisters in the office. Draining blisters is safe and effective when performed in a dermatologist’s office, but you should not drain your own blisters. Attempting this at home can lead to an infection, which can worsen DE and prevent clearing.
Light treatments: This treatment exposes the skin to ultraviolet (UV) light for a prescribed amount of time. Under a dermatologist’s care, light treatment can be a safe and effective treatment. It’s extremely important to get these treatments at a hospital, clinic, or your dermatologist’s office. Trying to treat your skin by using a tanning bed is not recommended.
General measures:
Wash skin gently
Remove rings: Always remove these before washing your hands. If the skin beneath your ring gets wet and stays damp, the DE can flare.
Use lukewarm water
Wash with fragrance-free syndet soaps (neutral Ph)
Avoid contact with all irritants:
Soap, detergents, dettol hand wash & other harsh liquid soap, hand sanitizers, metals, cement, dust, fevicol, gum, kerosene, diesel, grease, paint, clay, cutting some sour vegetables & fruits(tomato, onion, garlic, potato, orange, pomegranate, pineapple, moosambi). If you have to cut these vegetables or fruits, make sure that its juice doesn’t fall on your hands & wash hands with water immediately.
Avoid squeezing lemon (use lemon squeezer), Avoid squeezing tamrind (use tamrind powder)
Avoid washing clothes & dishes
If you have to wash dishes or clothes, use gloves to protect your hands- cotton lined PVC gloves(handy plus gloves)
Apply moisturizer frequently: After washing and throughout the day when your skin feels dry.
Reduce stress
Try to avoid scratching: Anything you can do to reduce scratching( like applying white petrolatum jelly) is helpful because scratching tends to worsen hand eczema
Avoid dry environments and hot conditions that cause you to sweat a lot Wear moisture-wicking socks: If you have hand eczema on your feet, this will help keep your feet dry.