Contact dermatitis is a condition that arises when you use a new type of detergent or skincare product, which causes your hands to become inflammatory, dry, red, cracked, blistered, and irritated.
It arises a few hours or days after coming into contact with irritable chemicals or allergens. While many conditions of contact dermatitis on hands are not severe, there still are typical instances of chronic and acute eczematous disorders, which can affect the palmar and dorsal parts of the hand.
This post, therefore, compiles the common causes, symptoms, treatment and management, and warnings around the topic of contact dermatitis hands.
Causes of contact dermatitis on hands
1. Genetic factors
Contact dermatitis hands can occur due to genetic traits. Atopic eczema (atopic dermatitis) is a common type of inflammation, which is linked to genetic disorders across the family. Therefore, patients suffering from this condition can confirm with their relatives to determine if the cause could be genetic.
2. Allergic reactions
Allergic contact dermatitis on hands occurs after exposure to a foreign substance, which causes the body to release inflammatory chemicals. These substances can cause an itchy feeling and irritation on the hands. The most common sources of allergens causing contact dermatitis include gold- or nickel-made jewelry, latex gloves, and chemicals found in cosmetics and skincare products.
3. Irritant, toxic materials
Irritants, such as acids, detergents, solvents, cold, heat, and friction can cause damage to the stratum corneum, disrupting the barrier function of the skin. Atopic dermatitis, which is also caused by protein deficiency in the stratum corneum, also interferes with the skin-barrier function on hands, leading to water loss and easy entry of irritants.
Irritant contact dermatitis also arises when hands come into contact with less irritating materials, such as water and soap, too often. Healthcare workers, janitors, hairdressers, and bartenders, are for instance, highly exposed to the condition. These occupations expose workers to strong solvents or cutting agents, but the condition can still occur in anyone using irritating chemicals to perform household chores or hobbies.
Types of contact dermatitis on hands
1. Allergic contact dermatitis
Symptoms linked to allergic contact dermatitis hands include hives, redness, burning sensation on the palms, extreme itching, oozing blisters, and dry and scaly hands.
If not treated, allergic contact dermatitis can become chronic. Continued exposure to the causative agents can also cause long-lasting illness. A chronic condition is characterized by dry and thick palms and skin discoloration.
2. Irritant contact dermatitis
Common symptoms of irritant contact dermatitis hands are blistering, swelling, stiff or tight palms, open sores that form into crusts, and ulcerations.
3. Acute hand dermatitis
Contact dermatitis affects palms, the back of hands, or both. The condition can be very itchy, and when acute, it presents with swelling, fissuring, blistering, and red papules, macules, and plaques.
4. Chronic hand dermatitis
Chronic hand dermatitis features dryness and scale (flakes of the horny epithelium), and lichenification. Lichenification arises from constant rubbing, leading to skin thickening and increased skin markings.
How do you prevent and manage contact dermatitis on hands?
1. Keep off allergic triggers
The best treatment for contact dermatitis hands is avoiding the causative agents. Keep monitoring when you experience episodes of dryness and irritation, and which products you came into contact with before the outbreak. Read labels to identify common irritants and avoid buying those items with said irritants.
Additionally, look for commodities with the NEA Seal of Acceptance label as they are made for sensitive skin. You should also try to minimize contact with allergic metals found on jewelry. For instance, you can paint the inner parts of bracelets with clear nail polish or line them with clear tape.
2. Stay away from fragranced products
Buy products labeled “unscented” or “hypoallergenic.” If you notice irritation from newly bought unscented products, stop using them right away, and perform a spot test. You can apply the new product on your forearm, keep the area from coming into contact with water, and monitor the reaction 48 to 96 hours after application. If you see irritation or redness, stop using the product immediately.
Atopic dermatitis is mainly linked to fragrances. It is, therefore, recommended that patients suffering from contact dermatitis hands keep off various cosmetics, food flavorings, perfumes, and toothpaste.
3. Avoid contact with irritants
You can prevent contact dermatitis hands by minimizing contact with irritants, including water.
4. Observe sudden variations in temperature and humidity
External stimuli, such as heat, can trigger itching. Try to minimize exposure to extreme humidity and temperatures, as these can aggravate irritant contact dermatitis.
5. Don’t scratch hands
Avoid scratching by trimming nails. Scratching can worsen the irritation or even cause infection to the hands, which requires antibiotics. If scratching becomes irresistible, cover the itchy area with a piece of clothing or dressing.
6. Avoid stressful activities
Dyshidrotic eczema is a form of contact dermatitis hands often caused by sweating arising from emotional stresses. Stress increases the attention to sensations and reduces the spinal cord’s ability to inhibit itchy feelings. Avoiding stress can, therefore, help to control scratching and damage to skin tissues around hands.
How do you treat contact dermatitis hands?
a. Moisturizing/hydrating creams
Moisturize or sooth your hands by applying non-alcoholic creams. To choose products that use natural biometric plant lipid complexes to keep your skin’s oil levels balanced.
Additionally, look for hand creams that have a mix of natural skin relief ingredients like shea butter, argan oil, etc.
You can also use soaps and moisturizers without perfumes and dyes.
b. Clean hands and take lukewarm baths
If you come into contact with an irritable substance, wash it off as soon as possible. If you are not sure what could have caused the rash, then take a shower to minimize causative agents that could be lingering on the skin around your hands.
Use uncooked oatmeal or medication to soak and bathe hands, especially children’s. Ensure the water is lukewarm, neither hot nor cold. You can also mix baking soda with the lukewarm water.
c. Use vinyl gloves
Wear gloves to protect your hands from coming into contact with harmful chemicals. Unlike rubber, vinyl gloves are less likely to cause allergic reactions. However, you should ensure that the gloves are scrupulously clean and have no perforations.
Additionally, the vinyl gloves should not be worn for too long because sweating under them can cause dermatitis. Preferably, have them lined with an inner cotton-material for improved comfort.
d. Topical steroids
For chronic dermatitis, use an ointment made of the recommended steroid. If you have active dermatitis, apply once or twice daily for weeks on end, but with reduced frequency until the condition subsides.
e. Calcineurin inhibitors
Tacrolimus and pimecrolimus are also recommended for contact dermatitis treatment. These inhibitors are proven to cure hand eczema efficiently. They can also be used as steroid-sparing agents for smooth, healthy hands.
Oral antibiotics should be taken for secondary bacterial infection. Drugs, such as flucloxacillin, can be used to treat irritable, dry hands with atopic dermatitis.
Use oral antihistamines, such as Zyrtec or Benadryl for allergic dermatitis. Frequent episodes of contact dermatitis hands arising from minor allergies can also be treated with prescribed allergy medication.
Contact dermatitis can cause severe acute flares on hands, which can be treated with prednisone, a systemic type of steroid. Take this drug for 2 to 4 weeks.
i. Second-line agents
Treat chronic hand dermatitis using second-line drugs, such as azathioprine, ciclosporin, or phototherapy. Phototherapy refers to the use of specific types of electromagnetic radiation to treat skin disorders, such as dermatitis on hands.
What solutions for contact dermatitis on hands are off-limits?
Elidel and Protopic
Elidel and Protopic are drugs used in the short-term treatment of atopic dermatitis and eczema. However, these drugs come with risks and limitations, such as the possibility of causing skin and blood cancers. This concern prompted the U.S. Food and Drug Administration (FDA) to warn against their use, in 2006.
The FDA also noted the possibility of an increased risk of skin cancer for patients using cyclosporine. While this conclusion was founded on studies involving recipients of organ transplants and who were exposed to cyclosporine, it is still recommended that you avoid this drug if you are suffering from hypertension.
While milder topical steroids can be bought over-the-counter (OTC), it is essential to consult a doctor if the rash deteriorates or persists for more than 7 days. OTC topical antibiotics should also be used under the recommendation of an immunologist or allergist as they are frequent triggers for contact dermatitis hands.
How long does contact dermatitis on hands last?
According to a report by the Harvard Medical School, contact dermatitis hands can clear up within 2 to 3 weeks. However, patients should avoid agents causing irritation on their hands.
In the event of prolonged exposure to allergens or harmful chemicals, symptoms of chronic contact dermatitis can last for many years.
Contact dermatitis is a condition arising from exposure to irritable substances or allergens, which cause inflammation of the palms and the skin at the back of the hands.
You can prevent contact dermatitis hands using home-made remedies and OTC drugs, but it is recommended that you seek the doctor’s advice when rashes and itching persist or worsen. Avoid allergic triggers altogether, as well as solutions likely to have long-lasting side-effects.
Look for products that provide a natural mix of plant based lipid complexes and skin relief ingredients. Additionally, products that can protect your skin from bacterial and viral attacks along with moisturisation are highly beneficial.