Do You Have Itchy, Red Hands?

By Ronald Vender, MD, FRCPC

The Problem of Hand Eczema

Do you have itchy, red hands? You are not alone, this very common condition affects about 10% of women and 4% of men. It's most common for people that do a lot of work in a wet environment. If you are a homemaker, mechanic, parent, bartender, hairdresser, dental worker or surgeons, you've probably experienced this condition, as constantly wetting and drying your hands is a common thread amongst people with hand eczema.

About 75% of people with eczema have what's called contact dermatitis; which can be either irritant or allergic dermatitis. Sometimes it is difficult to differentiate between the two. Patch tests are used to determine if it's allergic contact dermatitis. Irritant dermatitis usually develops through contact with detergents, cleansers, water, metals, food or rubber.

The severity of hand eczema varies from person to person; however, it usually starts with mild dryness and some redness and initially can be found on the fingers and in-between. As it develops, your skin can get very itchy and scaly and can develop blisters, cracking and swelling. The condition can also spread to other areas such as the arms and feet.

Key Facts About Hand Eczema That You Should Know:

• The common feature is repetitive wetting and drying of the hands
• Cold weather can aggravate your eczema
• Regular contact with any kind of hand irritant will also make this condition worse
• The hands of parents with newborns usually get worse after 3-6 months
• If you had atopic eczema as a child, there is about a 40% chance that you will develop hand eczema as an adult
• If you have psoriasis, you may also be prone to develop this condition (see Psoriasis Guide. ca for more information)
• Your chances of developing hand eczema increase if you have a history of asthma or hay fever.

Practical Advice For Hand Care:

• Avoid washing dishes by hand
• Rubber gloves can cause sweating and make things worse unless you wear cotton gloves inside of loose fitting rubber or vinyl gloves
• Avoid heating or cooling the skin: for instance, using very hot water even if wearing gloves
• Try wearing cotton gloves to do house work as this stops you from washing your hands too often and getting in contact with cleaners
• Minimize your contact with fruit juice, fruits, vegetables, raw meat, onion and garlic
• Try to avoid using household cleansers, deodorants, and antibacterial soaps and cleansers
• Use vinyl gloves to shampoo hair
• Keep hand washing to a minimum, and keep the water temperature lukewarm
• Avoid harsh or scented soaps. Soapless cleansers may be the best to use such as Spectro Jel, Spectro Derm, Cetaphil, Seaquanil, Lipikar Syndet (See www.MildCleanser.ca for information on gentle cleansers.)
• Take off rings before wet work or hand washing to avoid moisture and soap from getting trapped underneath
• Don't rub. Patting dry is best
• Apply moisturizers after washing your hands.

Unfortunately, it is sometimes difficult to treat this condition, but your dermatologist will be able to recommend the best treatment based on your medical history and the type and stage of hand eczema that you have.

About the author:
Dr. Ronald Vender is affiliated with Hamilton Health Sciences Corporation. He is Associate Clinical Professor of Medicine in the Department of Dermatology at McMaster University. He is also Active Staff and Head of the Service of Dermatology at St. Joseph's Hospital, Department of Medicine.

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