Managing Hand Dermatitis

Hand dermatitis, also known as hand eczema, is a very common skin complaint. It has become even more common in recent times due to the increase in hand washing and sanitising practises associated with Covid-19.   The symptoms of hand dermatitis can range from mild to debilitating and can have a significant impact on your ability  to perform basic daily activities, including washing your hands, gardening, cooking and just about anything that involves hands! 

A history of eczema is a common risk factor, as are certain professions including child care, nursing, hairdressing, construction, hospitality and stay at home parents.  However, lately it seems that almost anybody is at increased risk.

Hand Dermatitis Management - Hand Washing

Presentation and Symptoms

Hand dermatitis may have “dry” or “wet” presentations.  Dry hand dermatitis typically presents as dry, flaky and cracked skin. It can be itchy and painful, particularly when there are splits in the skin. Wet hand dermatitis often presents as red, weepy and bumpy skin.  It can feel hot, burning, painful and itchy. Wet hand dermatitis has a significantly increased risk of bacterial colonisation with Staphylococcal aureus, which has been associated with an increased resistance to common treatments including antibiotics and topical steroids.  This is why a holistic approach that includes prevention, management and treatment can be so beneficial.

Our skin is our first line of defence against pathogenic infection and protecting the skin on our hands has never been so important.  Follow these useful tips on how to prevent and manage hand dermatitis so that you can get back to being hands on doing whatever it is you love the most!

Cracked Fingers

5 Handy Tips for Hand Dermatitis:

  1. The best treatment is to avoid the trigger:  Identifying and avoiding irritants or allergens that are triggering your hand dermatitis is key.  If you suspect a substance at home or work is triggering your skin, ask your doctor to organise a patch test.  If your trigger is unavoidable, pay close attention to steps 2-5.
  2. The right gloves for the right job – Gloves are an important tool to help protect the hands from common irritants/allergens, however if worn incorrectly can add to the problem.  Choose gloves made from vinyl or plastic, with thin cotton gloves worn underneath if possible.  Latex and rubber gloves are best avoided due to possible allergic reactions.  Long gloves are best for wet work, to avoid water entering the gloves – this will exacerbate the skin.  Avoid gloves with holes and make sure you wash in between use to remove any detergents and dry the gloves by turning inside out.  Leather gloves are great for heavy duty tasks such as gardening, work around the house and exercises that induce friction (such as weights or bike riding).
    It is best not to wear gloves for longer than 2 hours per day.
  3. Gently does it – It is important to keep up with regular hand washing to keep hands clean, hygienic and free of irritants.  It is therefore critical that you chose a hand wash that is gentle, hypoallergenic and moisturising where possible.  Blot the skin dry after washing and follow immediately with a moisturiser.  If you must use a hand sanitiser, avoid the cheap and nasties.  Hand sanitisers with a higher glycerine content are much gentler on the skin. 
  4. Moisturise frequently – Irritants remove protective lipids from the stratum corneum of the skin and moisturisers with a high oil content can replace these lipids and prevent or even heal hand dermatitis.  Whilst over the counter, hypoallergenic creams and lotions are well tolerated and help to keep the skin hydrated, few contain oils that help to restore essential lipids in the skin.   Chose a moisturiser that is hypoallergenic and contains nourishing oils compatible with the skin barrier and always remember to patch test first. 
  5. Get out of chores free card:  There are some household chores that can significantly irritate hand dermatitis, and therefore, doing a chore swap with another house member for a few weeks may be just enough to let the skin heal.  Common chores that can exacerbate hand dermatitis include washing (including dishes, babies, animals, car), cooking with food triggers (such as peeling or chopping garlic, onions, tomatoes, pineapple, kiwi and citrus), painting and gardening.  If there is no one to swap with make sure you use the right gloves for the right job.

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