Hand Eczema

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What Is Hand Eczema?

Hand eczema, also called hand dermatitis, is an inflammatory skin condition affecting the palms, fingers, backs of the hands or wrists. It can be short-lived, repeatedly flare or become chronic. Hand eczema is not contagious, but it can be painful and interfere with sleep, work and everyday tasks.

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What Causes Hand Eczema?

Hand eczema develops when the skin’s protective barrier becomes damaged or the immune system reacts to something touching the skin. It often has more than one cause, including repeated irritation, an allergic reaction and an underlying tendency toward atopic eczema. Water, detergents, solvents, friction, heat and cold can all weaken the skin barrier.

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Types of Hand Eczema

Irritant contact dermatitis results from repeated damage caused by substances such as water, soap, cleaning products or chemicals. Allergic contact dermatitis occurs when the immune system reacts to a specific substance, such as nickel, fragrances, preservatives, rubber chemicals or hair dye.

Atopic hand eczema is more common in people with current or previous atopic dermatitis. Dyshidrotic eczema, also called pompholyx, causes intensely itchy, fluid-filled blisters on the palms or sides of the fingers. Other patterns include thick, cracked skin on the palms, fingertip eczema and coin-shaped patches. Different types can occur together.

How Is Hand Eczema Treated?

Treatment starts with identifying and reducing exposure to irritants or allergens. Regular moisturizers and barrier-repair products help restore the skin barrier, while topical corticosteroids may be prescribed to reduce inflammation during a flare.

Other topical medicines may be used when corticosteroids are unsuitable or longer-term treatment is needed. Severe or persistent hand eczema may require phototherapy or medicine that works throughout the body. Treatment should be chosen with a healthcare professional because the appropriate option depends on the cause, location and severity.

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Gloves and Hand Protection

Protective gloves can reduce contact with water, chemicals and food, but the correct glove depends on the task and substance involved. Gloves should be clean, dry and replaced if damaged or contaminated.

Wearing gloves for long periods can trap sweat and worsen eczema. Cotton liners may help absorb moisture under waterproof gloves. A dermatologist or occupational health professional can help select suitable protection when work exposures are contributing to symptoms.

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Hand Eczema and Work

Hand eczema can make tasks involving washing, gripping, typing, food preparation or chemicals difficult and painful. Symptoms that improve away from work or worsen during particular tasks may suggest occupational hand eczema.

Early assessment can help identify safer products, protective equipment or changes to work practices. Avoiding the cause does not always require leaving a job, but temporary adjustments may sometimes be needed while the skin heals.

Risks

Anyone can develop hand eczema, but the likelihood is higher in people with a history of atopic dermatitis, asthma, hay fever or sensitive skin. Frequent handwashing, prolonged contact with water and repeated exposure to detergents, chemicals, food or protective gloves can also increase the risk.

Hand eczema is especially common in work involving frequent wet hands or irritating substances, including healthcare, cleaning, food preparation, hairdressing, construction and mechanical work. These risk factors do not mean that someone will definitely develop the condition.

Symptoms

Symptoms may include dry, rough or scaly skin, itching, burning, tenderness, swelling and changes in skin color. The skin may become red, pink, purple, gray or dark brown depending on skin tone and inflammation.

Some people develop small itchy blisters, weeping areas, crusting or thickened skin. Deep cracks can be painful, bleed and make it difficult to bend the fingers, wash, dress, cook or complete other daily activities.

Diagnosis

Diagnosis usually involves examining the hands and discussing symptoms, previous skin conditions, work, hobbies and products used at home. Because psoriasis, fungal infections and other conditions can look similar, additional testing may sometimes be needed.

Patch testing may be recommended when allergic contact dermatitis is suspected. Small amounts of common allergens are applied to the skin to identify delayed allergic reactions. Tests for infection or a skin sample may occasionally be required.