Understanding Hand Eczema

Hand eczema, also known as hand dermatitis, is a common inflammatory skin condition that causes dry, itchy rashes on the hands. The condition is not contagious, meaning it does not pass from person to person. It frequently affects the palms but can involve other parts of the hand, including the fingers.

Eczema on the hands can act slightly different from other types of eczema. For instance, atopic dermatitis hands or atopic eczema hands are caused by a combination of genetic and environmental factors. External irritants often trigger other forms of hand eczema, especially irritant contact dermatitis. Symptoms of eczema on fingers and hands can vary depending on age, medical history, and life factors, but often begin with dry, chapped skin. Other common symptoms include cracking, dryness, itchiness, inflammation, and sometimes even blisters. In severe cases, the skin can become very painful, making it difficult to perform everyday tasks.

Causes of Eczema on Hands

The exact cause of hand eczema is unknown, but researchers believe that both genetic and environmental factors contribute to its development. Several triggers can worsen the condition, including frequent exposure to irritants such as solvents, detergents, and excessive heat. 

Repeated hand washing, especially with hot water and harsh soaps, can strip the skin of its natural oils, weakening the skin barrier and increasing sensitivity. Over time, this can make the skin more prone to irritation and allergic reactions, leading to conditions like allergic contact dermatitis. 

Stress is another key factor, as it triggers the release of hormones like cortisol and epinephrine, which can suppress the immune system and contribute to skin inflammation. Additionally, cold temperatures and dry air—particularly in winter—can dehydrate the skin, making it more susceptible to flare-ups. Abrupt temperature changes, such as moving from cold outdoor air to heated indoor spaces, can further exacerbate dryness and irritation.

Effective Hand Eczema Solutions

Hand eczema solutions focus on avoiding triggers and managing symptoms. Avoiding triggering irritants or allergens is a key initial step, sometimes aided by a patch test administered by a healthcare professional. A daily skincare routine is also crucial.

Medical hand eczema solutions may include:

• Topical corticosteroids: These help reduce swelling and irritation in eczema but should be used carefully to avoid side effects like skin thinning. 
• Calcineurin inhibitors: These can reduce redness and itching without thinning the skin. They are safe for ages 2 and up but should not be used in strong sunlight. 
• Antihistamine tablets: Some antihistamines make you sleepy, so they are best taken at night to help with itching. 
• Topical antibiotics: These treat infections in cracked skin from eczema. It is recommended you talk to a healthcare professional before using over-the-counter options.
• UV therapy (Phototherapy): Special UV light treatments can help with itching and swelling in more serious eczema but may have long-term risks. This is not commonly used in young children. 
• Emollients: These keep skin hydrated and help heal cracks. Use often, especially after washing your hands. 
• Biologics: These options help with severe eczema that doesn’t improve with other therapies. 
• Oral corticosteroids: Short-term use of corticosteroids may help severe flare-ups, but long-term use can cause serious side effects.
• Probiotics: Clinical studies show that certain strains of probiotics help to reduce the symptoms of eczema and atopic dermatitis.

Preventing and Managing Hand Eczema

Managing and preventing hand eczema flare-ups requires a combination of protective measures, skincare habits, and lifestyle adjustments. Read on to learn key tips to help minimize irritation and keep your hands healthy.

Identifying and Avoiding Triggers:

• Stay away from individual triggers; patch testing can help.
• Be aware that certain occupations with frequent contact with irritants may pose a higher risk for hand eczema.

Protective Measures:

• Wear protective gloves:
• Cotton gloves for dry chores.
• Vinyl gloves with cotton liners for wet work, ensuring gloves remain dry.
• Take off rings before washing hands or doing wet work to prevent irritants from getting trapped.

Proper Hand and Skin Care:

• Avoid excessive hand washing and minimize wet work.
• Use mild, perfume-free soaps and detergents.
• Apply moisturizer after every hand wash.
• Bathe and shower in warm rather than hot water.
• Apply moisturizer within three minutes of patting dry after bathing.
• Add colloidal oatmeal to baths for soothing effects.

Environmental and Clothing Considerations:

• Try using a humidifier to combat hot, dry indoor air.
• Wear cool, smooth-textured clothing and avoid rough, tight, or scratchy materials.
• Avoid harsh detergents and fabric softeners.

Managing Stress and Itching:

• Keep fingernails trimmed to minimize damage from scratching.
• Treat stress and anxiety, as they can worsen eczema.
• Manage stress and anxiety through relaxation techniques, behavior modification, or counseling.
• Avoid scratching itchy skin; instead, try pressing or patting it and cover it if needed.

When to See a Dermatologist for Hand Eczema

If you have hand eczema and notice new or worsening symptoms, talk to your dermatologist. They can properly diagnose your condition, possibly using patch tests, and suggest effective management options. Seeking medical help is especially important if your eczema becomes infected. Before deciding on a treatment plan, discuss your options with a healthcare provider who specializes in skin conditions. They can also help distinguish hand eczema from other similar skin problems.

References

Eczema.org: Hand Eczema

National Eczema Association: Hand Eczema: Causes, Symptoms and Treatment Options

Eczema Help: Treating Hand Eczema

Medical News Today: Eczema on Hands and Fingers: Symptoms, Causes, and More

Mayo Clinic: Atopic Dermatitis (Eczema) – Diagnosis and Treatment