What is hand eczema?

Hand eczema is also known as hand dermatitis. The hands are one of the most common parts of the body to be affected by eczema - it has been reported that up to 10% of the population (1 in every 10 people) may suffer from hand eczema. So, if you have hand eczema, you’re not alone. Hand eczema is even more common in certain professions - up to 30% (almost one third) of people in high-risk occupations, such as nursing, are affected. If you have had the condition for some time, it is known as chronic hand eczema. The term ‘chronic’ simply means long-standing.

The reason why hands are so commonly involved is that we do so much with them in everyday life, exposing them to the climate, water, soap, harsh chemicals and the wear and tear of manual work and hobbies, such as gardening.

When the hands are affected with eczema, the skin usually becomes red, dry, itchy and even blistered. Cracked skin can be painful and even a small amount of eczema on the fingertips can be surprisingly troublesome. It is very itchy and sufferers repeatedly scratch and rub their skin to get relief. Unfortunately, this damages the protective surface layer of the skin, leaving it open to infection.

Hand eczema varies in severity, from a mild condition affecting a small area of skin, to severe blistering affecting the whole hand. The severity of hand eczema differs from person to person and can even differ at different times in the same person. You may have had a severe attack of hand eczema in the past, but now have very mild symptoms. Alternatively, you may have had mild hand eczema in the past and now be experiencing a more severe attack. You may have had one period of hand eczema, treated it successfully, and had nothing ever since, or you may have had repeated attacks. If you suffer from hand eczema, and if it is left untreated, or if you don’t find a treatment that works adequately for you, it can develop into chronic hand eczema. The earlier you spot your eczema, the earlier it can be treated, which could stop it getting worse.

However, just as every person’s experience of eczema is different, so there are a variety of ways to manage and treat hand eczema.

What causes hand eczema?

The causes of hand eczema may vary from person to person. Several different types of eczema can affect the hands, and more than one type can occur in the same person at the same time.

People with atopic eczema, the most common type of eczema, are born with a tendency to develop allergic reactions affecting their skin. They may suffer from eczema on other parts of their body, as well as on their hands. Atopic eczema is also linked with a tendency to food allergy in early childhood as well as asthma and hay fever. These ‘atopic’ conditions often run in families. Atopic eczema now affects about 1 in 5 young children in the UK but many people ‘grow out’ of their condition as they become adults but the condition can persist or return in adulthood.
Atopic eczema can be set off by external trigger factors or stressful situations.

• Extremes of temperature
• Pollen, house dust mites
• Skin infections
• Stress
• Other allergens

Allergic contact eczema often affects the hands and occurs when you become allergic to specific substances, perhaps after repeated contact with them over a period of time. You may have been using or wearing something for some time with no skin problems, then one day you develop allergic contact eczema where the trigger substance or ‘allergen’ has touched the skin. The skin reaction may not appear immediately but a day or two after contact with the allergen. Sometimes this delay can make it difficult to work out exactly what has caused the problem.

• Chemicals in hair dye
• Chromate, which is used in the tanning of leather and in cement
• Latex found in rubber gloves and shoes
• Nickel, which is often found in jewellery
• Perfumes found in fragrances and toiletries
• Plant extracts found in cosmetics, or plants in the house and garden
• Preservatives found in cosmetics and toiletries

Irritant contact eczema may develop after frequent contact with things that irritate the skin. The protective outer layers of the skin become inflamed and sore, dry and chapped. Some people’s skin is more easily upset than others. Many people develop irritant contact eczema at work, but household cleaning products can also cause it, and mothers with young babies are often affected because of constant washing and cleaning. The problem is usually worse in cold, dry weather.

• Acids, e.g. citrus juice and vinegar, and alkalis, which are the opposite of acids, e.g. toothpaste, baking soda and oven cleaner
• Frequent contact with water
• Handling certain foods
• Oils and grease
• Soap, shampoo and detergent
• Solvents

Eczema treatments

Although eczema cannot be cured, there are a number of things which can be done to help manage and control it. The aims of eczema treatment should be to heal the skin, keep it in good condition and manage the symptoms of an attack or ‘flare’ when they appear.

Over-the-counter medicines

There are treatments available over the counter from your pharmacist which may help you to manage your condition, including:

Emollients - Emollients are the most common treatment for eczema and consist of creams, lotions or ointments which are applied as a protective film to the skin helping to soothe it and reduce water loss. They should be used every day, even on those days when your symptoms are fewer or your eczema appears under control.

Apply emollients liberally and often because their effects are short-lived and their benefits will be lost with washing or rubbing caused by clothes. A good time to use emollients is just after a bath, while the skin is still moist. Oils or washes are also available which can be used in the shower or added to bath water, but avoid scented bubble bath products, soaps or shower gels as these can cause skin sensitisation, dehydrate the skin and make your symptoms worse. The degree of greasiness of emollients generally determines the amount of moisture-holding ability they will have. Greasier preparations will be better for dry, cracked and thickened skin. They can be applied thickly overnight to help hydrate the skin, but this can be messy. Thinner creams and lotions are absorbed into the skin more easily, but their benefits don’t tend to last as long. You will need to apply large quantities of emollient on a regular basis throughout the day to keep your skin as hydrated as possible. Regular use of emollients should help to reduce the frequency and severity of eczema flares. Remember, it is not possible to overuse emollients and you should continue to use them, even if your healthcare professional decides that you need a prescription treatment in addition to help manage your condition. If you have any questions about emollients, including how often you should be using them, please speak to your healthcare professional.

Mild steroid creams

Mild steroid creams - Mild steroid creams (e.g. hydrocortisone) are used to calm the symptoms of an eczema flare up by suppressing the body’s inflammatory response (steroid drugs that reduce inflammation are also known as corticosteroids). You should seek advice from your pharmacist regarding the strength (potency) and length of treatment that is best for you. In the UK, steroid creams are graded into one of four groups according to their strength or potency as mild, moderately potent, potent and very potent. Patients are generally advised to use the weakest effective potency for the shortest duration of time to bring their ‘flare’ under control.

Prescription medicines-

If emollients and mild steroids are not sufficient to bring your condition under control, there are a number of other treatments that your healthcare professional may consider prescribing for you. They will advise you on how and when to use these medicines. Be patient, it may take time before you and your healthcare professional find the best treatment for you.

Please be aware that you should not use a combination of these products at the same time, unless instructed to do so by your healthcare professional, as this may be harmful. It is, however, acceptable and advisable to continue to use emollients whilst receiving these prescribed products.

Always read the pack leaflet carefully for any product you are prescribed and follow the instructions it contains. If you are unsure about any of the information contained in the leaflet or anything else about your treatment, ask your doctor or pharmacist to explain.

Complementary medicines

A variety of complementary medicines, including evening primrose oil supplements, borage oil, homeopathy and Chinese herbal medicines, have been employed with varying degrees of success in the treatment of atopic eczema. However, there is little clear evidence of the effectiveness of some of these options and the safety of others. Certain herbal preparations can be harmful if used in combination with prescription medicines. Always talk to your healthcare professional before using any new treatment for your eczema which has not been prescribed for you.

Tips for Managing Hand Eczema

There are some things that you can do to help prevent and manage your hand eczema. Some of these are listed below, but please check with your healthcare professional before trying any of them, and remember that what works for one person, may not work for someone else

• Use the treatment your healthcare professional has prescribed
• Protect your hands by moisturising them regularly with emollients (soothing and softening skin products), but use products that are free from fragrances and preservatives - the fewer ingredients, the better
• Talk to people about your concerns - don’t suffer in silence
• Feel in control by finding out all you can about your condition - download questions to ask your healthcare professional
• Protect your hands at work if you work in a job that is associated with a high risk of hand eczema

• -  In catering, use a dishwasher rather than washing up by hand, try not to handle food with your bare hands, wear non-latex gloves when you can, and make sure you dry your hands thoroughly after contact with liquids.
• -  In the construction industry, eliminate or substitute substances or activities that could cause hand eczema. Wash and dry your hands properly, use pre-work creams and wear protective gloves.
• -  In hairdressing, wear disposable non-latex gloves when rinsing, shampooing, colouring and bleaching hair, change gloves in between clients and make sure that your gloves are in good condition. Dry your hands thoroughly after contact with liquids.
• -  In the health services, including dentistry, try to use machinery and tools to clean equipment, rather than your hands. Use hypoallergenic gloves rather than latex gloves and make sure that you have rinsed off all soap and that your hands are thoroughly dry after washing your hands.
• -  In the metal machining industry, limit your contact with substances that may cause hand eczema, use pre-work creams to help make removing fluids easier and wear appropriate protective gloves.
• -  In the motor vehicle industry, avoid or minimise contact with irritant substances, clear up spills promptly, keep workrooms and hands clean, but don’t use aggressive cleaners, dry hands thoroughly, use pre-work and after-work creams and wear protective gloves.
• -  In the printing industry, wear protective gloves and avoid touching chemicals that may cause hand eczema.
  Remember that using pre-work creams can help make removing fluids easier, but that these don’t provide a barrier and are no substitute for gloves

• If you don’t have to sanitise your hands, but still want to clean them, try using a moisturising hand cleanser and blot it off rather than washing with water
• Wear cotton gloves to do household chores if your skin is sensitive
• Wear hypoallergenic waterproof gloves to do the washing up, or when you are preparing food
• If your gloves get a hole in them, replace them immediately
• If water leaks through your gloves, take them off and blot your hands immediately
• Take gloves off after 15 or 20 minutes to avoid excessive sweating
• Wear thick cotton or unlined leather gloves to do outdoor work, or during dry, windy or cold weather
• Wear cotton clothes and use cotton bed linen
• Avoid getting very hot and sweaty
• Avoid contact with things you know irritate your skin, such as metal jewellery or washing powder
• Don’t scratch your skin, even if it is itchy - apply emollient cream instead

Article Date: April 2009

Source: myhandeczema.co.uk

Some of the products that may help with hand issues: DermaSilk Adult Gloves Gloves in a Bottle Salcura Hand Hydrator