Hand Eczema

What is hand eczema?

Eczema is one of the most common skin conditions amongst Australians, affecting both adults and children. It may be referred to as ‘endogenous eczema’ or ‘atopic eczema’. It particularly affects the skin’s protective barrier.

Sometimes people use the words ‘dermatitis’ and ‘eczema’ to mean the same thing, which can be confusing, as they are different. We find it easier to refer to ‘eczema’ as coming from within the body and ‘contact dermatitis’ from outside the body. Eczema is often associated with asthma and hay fever, and is hereditary and tends to run in families. People with a history of eczema, even in infancy, are at higher risk of developing skin problems related to their work, particularly irritant contact dermatitis and contact urticaria.People with this history of eczema need to be vigilant about looking after their skin if they have contact with skin irritants, both at work and at home.

Eczema may affect all areas of the body, especially the skin folds in the inner elbows and behind the knees. However, there is a form of eczema which affects the hands and occasionally the feet as well. This is referred to as ‘hand eczema’. It was formerly called ‘dyshidrotic eczema’ or ‘pompholyx’.

This form of eczema often comes and goes in cycles, which vary both in the length of the cycle and the length between episodes.

Sometimes it is very difficult to know what is ‘hand eczema’ and what is ‘allergic’ or ‘irritant’ contact dermatitis. Sometimes there may be a combination of all these conditions.

What does hand eczema look like?

• Little bubbles or blisters under the skin
• Cracks and splits
• Dryness and flaking
• The skin is usually itchy

Aggravating factors in hand eczema

There are many factors that cause eczema or worsen existing eczema.
These factors include contact with skin irritants such as:

• Water, especially frequent wetting and drying of the hands
• Soaps, detergents and shampoos
• Household cleaning products
• Paper toweling
• Solvents
• Cement
• Oils and grease
• Sweating, often aggravated by wearing gloves worn for long periods of time
• Heat, from exposure to hot or warm environments

Other factors that may cause eczema to get worse include:

• Stress (in some individuals)
• Sometimes severe inflammatory tinea (fungal infection of the feet) may lead to hand eczema

Managing hand eczema can be difficult, especially when it may come and go by itself, no matter what treatment is being used.

Unfortunately there is no way to stop a person from experiencing hand eczema, but there are many measures that can be used to control it. There are no particular treatments that help all sufferers. No diets have been found to reliably help.

Managing hand eczema

A crucial part of managing hand eczema is looking after your skin by following a good skin care routine both at work and home. This should include:

• Use a moisturising cream regularly
• Use a soap substitute in the shower and to wash your hands
• Limit the amount of wet work and hand washing performed
• If possible, wash your hands in cool not hot water
• Wear appropriate gloves to protect yourself from skin irritants. However, beware that occlusive gloves (tight-fitting, waterproof type gloves) may cause heat and sweating. Cotton gloves underneath may be helpful. Also, change your gloves regularly.