Hand Eczema

What causes a hand rash?

A hand rash, also called hand dermatitis or hand eczema, may be caused by many things.

Hand rashes are extremely common. Many people start with dry, chapped hands that later become patchy, red, scaly, and inflamed. Numerous items can irritate skin. These include overexposure to water, too much dry air, soaps, detergents, solvents, cleaning agents, chemicals, rubber gloves, and even ingredients in skin and personal care products. Once skin becomes red and dry, even so-called "harmless" things like water and baby products can irritate the rash, making it worse. Your doctor will try to find out what substance in your everyday routine could be causing or contributing to the problem. Often your skin will get better by changing products or avoiding an ingredient completely.

A tendency to get skin reactions is often inherited. People with these tendencies may have a history of hay fever and/or asthma. They may also have food allergies and a skin condition called atopic dermatitis or eczema. Their skin can turn red, and itch, indicating an allergy, after contact with many substances that might not bother other people's skin.

Finding the Culprit

Your dermatologist will work with you to uncover and identify the possible causes of a hand rash. Could it be irritation? Could it be an allergy? Like a detective, your dermatologist will ask many questions. These may include information about previous rashes, whether you have any history of hay fever or asthma, or any other medical problems. The dermatologist will also want to know what kinds of things your hands are exposed to all day long, what creams or lotions you apply to your skin, and whether or not you wear gloves. The doctor may examine your hands, feet, and the rest of your skin to determine what's causing the rash. Your doctor may order special tests to see if you have a skin infection or other problems. Your dermatologist may do a skin scraping and a microscope exam while you wait in the office. Most of the causes usually fall into one of the three types: an externally triggered "contact" rash, an internally generated skin reaction, or a fungal infection.

If your doctor suspects the rash is due to an allergy to some external substance, a patch test may be done. This involves testing the skin on your arms or back to see what specific ingredients might be causing your skin to react. If so, you will receive a list of products that contain those ingredients.

How are hand rashes treated?

Your dermatologist may offer a combination of methods to heal your skin. It is possible you may need an oral antibiotic if an infection is present. Medicated ointment or cream may also be prescribed. Be certain not to use this in combination with other hand creams unless your doctor approves. If the prescribed cream doesn't seem to be helping, tell your doctor right away. You can speed up the healing process by keeping your hands away from other irritants. Discuss with your doctor what to avoid while your skin is healing.

Is hand protection really important?

It may take months for your hands to be normal. Regardless of the cause of your rash, you'll want your hand to heal and to stay healthy. There are ways to pamper them now, and in the future, to lessen the chance of getting a rash again:

  • Protect hands against soaps, cleansers, and other chemicals by wearing vinyl gloves - available at local grocery stores and pharmacies. Have four or five pairs and keep them in the kitchen, bathroom, nursery, and laundry areas. Have other pairs for non-wet housework and gardening. Avoid rubber/latex gloves since many people are sensitive to them. Always replace any gloves that develop holes. Dry out gloves between cleaning jobs. Wear your gloves even when folding laundry, peeling vegetables, or handling citrus fruits or tomatoes.
  • Use an automatic dishwasher as much as possible. Avoid hand washing dishes or clothes as much as you can.
  • When you wash your hands, use lukewarm water and very little soap. Remove rings whenever washing or working with your hands because they trap soap and moisture next to the skin.
  • When outdoors in cool weather, wear unlined leather gloves to prevent dry and chapped skin. Always use a dermatologist recommended product to keep your hands soft and supple. Apply it as many times a day as you need it.
  • If the type of work you do is affecting your hands, talk to your supervisor about ways that you and other employees can better protect your skin.

Hand eczema is not contagious. Although some fungal infections may look like eczema, it is important to have your rash checked by a dermatologist who can do the appropriate testing. Hand rashes sometimes temporarily look worse while they are healing - and sometimes rashes just come back. Try to remember which substance or what activity triggered the recent "flare-up." Let your doctor know about it. Since many hand rashes can be stubborn, it's important to keep up with your medication, stay in contact with your doctor, and not get discouraged.