Chronic hand eczema is defined as a persistent – more than three months - non-infectious skin inflammation of the hands. Here are the common triggers and tips on managing sore hands.
Chronic hand eczema is a common disorder with different symptoms that present as either a pattern of acute dermatitis or chronic hand eczema. It has been debated whether lifestyle factors may be associated with chronic hand eczema, for instance. It is twice as common in women as men. Although genetic factors have been considered, constant exposure to wet work and hand washing is the most likely explanation of chronic hand eczema. In some cases, chronic hand eczema can have a devastating effect on some people’s quality of life, resulting in a change in occupation. (1)
The three main types chronic hand eczema include:
- contact irritant dermatitis
- allergic contact dermatitis
- atopic dermatitis (AD)
Potential chronic hand eczema triggers
If you have chronic hand eczema, you should consult your health provider. A careful history, and physical examination of the hands, nails, and skin changes can help identify a pattern for the trigger.
Clinical investigation of the presenting skin condition includes the following:
- known allergies, including asthma and hay fever, which are more common in people with atopy
- other pre-existing medical conditions (eg, arthritis that is more common with psoriasis)
- topical and systemic medications
- occupation
- swabs or scrapes of the skin on the hands to test and identify any secondary infections, fungus, including Staph (MRSA)
The individual’s history focuses on key information, such as:
- the onset and duration of the eruption
- any associated symptoms—itching, burning, pain
- presence of the eruption on other parts of the body; many disorders of the hands also involve the feet
- history of previous infections or other complications, such as lost time at work or inability to participate in hobbies or activities of daily living
Three types of hand eczema (contact dermatitis)
1. Irritant contact dermatitis
This is the leading cause of 80% of all chronic hand eczema. This type occurs when the skin comes in contact with a substance, for example, cleaning products, chemicals handled at work, with no protection.
An important factor in causing this type of contact dermatitis, is the number of irritants you are exposed to daily. For instance, it is particularly common with people whose job requires them to do a lot of wet work. For example, nurses, hairdressers, and those working in catering have higher hand eczema than other professions.
The constant exposure to workplace chemicals, can lead to a decrease in the skin barrier’s ability to function on the hands. As a result, the hands become dry from the loss of water content from the skin. This causes the hands to become drier and itchier over time, which leads to more inflammation. Furthermore, a defective skin barrier continues allowing harmful chemicals to penetrate the skin causing eczema flare-ups.
The only real solution is to avoid the source of the problem as much as possible.
2. Allergic contact dermatitis
This usually occurs when your skin comes in contact with a substance causing a skin reaction. The skin inflammation often flares up on the back of the hands, fingers, web spaces, and the wrists, where the skin is thinner and the allergen has more potential penetration. In more severe cases it results in blisters or small fluid-filled blisters forming on the hands.
Common substances that can cause irritation are nickel (in jewellery or watches), rubber, perfumes or preservatives used in some creams and cosmetics. People with a tendency for asthma, eczema and hay fever can develop this dermatitis more easily than others. It can be something as simple as proteins in fruit and vegetables that can cause an immediate allergic reaction, and as a result, lead to itchy skin swellings known as hives, which can aggravate your dermatitis.
3. Atopic hand dermatitis
The likelihood of this type of hand eczema increases when there is a personal or family history of hay fever, asthma, or eczema. There are a number of ways it presents on the hands. For example, in acute cases, blisters from on the sides of fingers and hands. These blisters present the potential risk of getting secondary bacterial infection like Staph, which will need immediate treatment to resolve.
How to manage hand eczema and dermatitis
Avoidance of triggers to reduce chronic hand eczema
The hands are routinely exposed to irritants and allergens in the work or home environments. Therefore, the avoidance of common irritants and allergens is key in the management of chronic hand dermatitis.
Anyone with hand eczema needs to protect their hands with heavy-duty vinyl gloves. This is because most people with chronic hand eczema are allergic to rubber and cannot tolerate rubber gloves. Most importantly, it is critical to discard any gloves that develops a hole. The use of washable cotton gloves as a liner under the vinyl gloves are also helpful.
If you have hand dermatitis you should avoid direct contact with lemons, oranges, potatoes, and tomatoes, which have irritant properties and are potential allergens. In addition, direct contact with paints, paint thinner, furniture, and shoe polishes should be avoided because they contain solvents.
Using an antibacterial hand wash
Anyone living with chronic hand eczema and dermatitis should wash their hands with lukewarm water and mild anti-bacterial body wash. Our body wash is a perfect pH formula that will not strip the skin of natural oils. They should remove the soap carefully from their web spaces and dry gently. Soaps provide an alkaline environment and are surface-active agents that are not gentle for the skin. Wearing jewellery, including rings on the fingers, is always a place for trapping of the allergens and retaining local moisture.
Soothing relief and hydration for hand eczema
Frequent use of a moisturiser provides protection and strengthens skin barrier function. An antibacterial moisturiser or emollient should be used in all people suffering hand dermatitis. Our antibacterial hand cream makes the skin soft, covering the skin with an antibacterial barrier to stop loss of moisture. More importantly, our Hand Cream helps to curb any staphylococcal bacteria, which occurs when the skin barrier is compromised.
Sources
1. https://nationaleczema.org/eczema/types-of-eczema/hand-eczema/
