Managing Hand Eczema

Eczema can appear anywhere on the body, but it's particularly bothersome when it shows up on the hands. We use our hands daily and for so many things that having eczema on your hands can be uncomfortable and frustrating.

What other names is hand eczema called?

Hand eczema has been known by some other names like "dishpan hands," this name came about as people often developed rashes on their hands from having them in kitchen sinks filled with soapy waters. Other terms you may have heard are "tulip finger," which comes from a combination of both allergic and irritant contact dermatitis on the finger(s) or hands after coming in to contact with tulip bulbs. No matter what the name, getting evaluated by a healthcare provider is an important step so that you can determine what might be causing your hand eczema and what ways there are to manage and treat your symptoms.

What are symptoms of hand eczema?

Some symptoms you may experience with eczema on the hands, fingers, or webbed areas between the fingers are:

• Redness (rash)
• Itching
• Dry skin or scaling
• Pain (such as stinging or burning)
• Cracking or bleeding
• Blisters

What causes hand eczema?

Since our hands are exposed to so many things each day it sometimes can be a bit of a puzzle to determine what might be causing eczema on your hands. There are two types of contact dermatitis that could be the cause of your hand eczema: irritant contact dermatitis and allergic contact dermatitis.

Irritant contact dermatitis

Irritant contact dermatitis is the most common culprit of hand eczema. Irritant contact dermatitis is caused by prolonged and/or frequent exposure to substances that irritate the skin. Common irritants include chemicals, cleaning agents, some fabrics, soaps, cosmetics, and perfumes.

Allergic contact dermatitis

Allergic contact dermatitis is when the symptoms are due to an allergic response to a substance. Some common things that may cause allergic contact dermatitis are soaps, dyes, fragrances, rubber, or even a plant. Symptoms can intensify if there is prolonged exposure to the allergen.

Atopic dermatitis

Hand eczema could also be caused by atopic dermatitis. If you have symptoms that are beyond just the fingers and hands and impact other areas of the body, it may not be hand eczema, and instead may be atopic dermatitis.

Patch testing for allergens and irritants

First, it can be a good idea to talk with your healthcare provider. Your provider can determine what may be causing your hand eczema through tests, like a patch test. A patch may be helpful to rule out or determine if there are any possible allergies you may have and if the allergens are causing your symptoms. For example, a common irritant that can cause flare-ups on the hands is exposure to nickel. Patch-testing can check whether or not you have a nickel allergy. You would then know to avoid rings or other jewelry that may have nickel in it!

Cold compresses

A cold compress can help with inflammation and itchiness. To help reduce the urge to scratch, or to help soothe inflamed skin on the hands a cold compress can sometimes provide temporary relief. Scratching inflamed skin may make you at a higher risk for infection as you make leave small breaks in the skin, so trying to reduce scratching with things like cold compresses can be helpful.

Cotton gloves

Getting some cotton-lined rubber gloves can be a helpful way to reduce your exposures to irritants or allergens. Cotton gloves can be used while doing housework while cleaning or being exposed to chemicals. You can also wear waterproof gloves for cleaning or washing dishes, but you shouldn't wear these gloves for too long as the material can make it hard for the skin to breath causing dampness and sweat, which could also trigger a flare-up. If you use cotton-lined gloves, have multiple pairs!

Dry hands after washing

While you need to wash your hands throughout your day to remove irritants from your hands and clean them, know that frequent hand washing can be a reason why symptoms are worsening. When hands are wet or damp for too long this may put you at increased risk for symptoms to flare on the hands. Immediately after washing your hands or getting your hands wet, dry them off completely.

Use moisturizer

Finding and then regularly using a good moisturizer is an important part of preventing hand eczema flares. Know that not all moisturizers are created equal and some will be better for you and your hands than others, sometimes humectants or emollients are better. Keep an eye out for ingredients that could irritate your hands. Be prepared, keep a small bottle of moisturizer in your desk at work, in your car, and in your purse or backpack so you always have some close by!

Use "clean" soaps

Fragrance-free and dye-free soaps are your friend, artificial fragrances, perfumes or colors can be what exacerbates your symptoms, or it could be the irritant in the soap that triggers your hand eczema to flare. Another irritant in hiding can be antibacterial soaps, these may cause more harm than they benefit. The alcohol and chemicals in antibacterials soaps can trigger a flare.

Remove jewelry

If you know your hands are going to be exposed to allergens or irritants, remove your ring, bracelets or watch. Removing these items can make it so an irritant or allergen can't get stuck under the ring or bracelet/watch on your wrist potentially causing to an unexpected (and unwanted) flare later on!

Tend to open wounds

If you have any cuts on the skin of your hands or fingers or breaks in the skin, make sure to care for those injuries. Breaks in the skin can mean environmental allergens and irritants are able to penetrate which can make you more susceptible to infection. Make sure to keep the area clean, apply medication to the area if needed and cover the injured area if you can't avoid working with irritants.

Have experience with hand eczema? Share your tips by answering our community Q&A: Any tips for managing stubborn hand eczema?