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BVHS Weekend Column: Contact Dermatitis on the Hands

Contact Dermatitis on the Handsby Kelly Koenig, MD, FAAD , Blanchard Valley Medical Associates – Dermatology

Kelly Koenig, Dermatology Resident

Many people suffer from various rashes to their hands. We use our hands in countless ways throughout the day, so itchy, painful and sometimes blistering or cracked skin on our hands can have a huge impact on our daily activities. Fortunately, there are solutions.

Hand dermatitis can have several causes. For instance, some individuals suffer from ongoing chronic issues related to an existing skin condition such as eczema or psoriasis. During the winter months with lower humidity, these conditions often worsen. Most commonly, however, newly onset dry skin on the hands is classified as “irritant contact dermatitis.” This condition can result in dry, cracked, painful skin anywhere on the body but is commonly found on the hands due to frequent washing and exposure to various chemicals in our environment.

Overly dry skin on the hands can result from the overuse of harsh soaps and cleaning agents, frequent hand-washing, dry heat and low humidity in the air, or lack of moisturizing to help repair the skin barrier after these insults. Washing hands with mild, moisturizing and non-foaming cleansers is one measure to reduce the risk of contact dermatitis on the hands. Additionally, using hand sanitizers, which are less irritating that soap and water, throughout the day when the hands are not visibly soiled and moisturizing the hands with a heavy emollient cream or ointment that is fragrance-free immediately after they become wet may also help. White petrolatum (plain Vaseline), CeraVe cream, Neutrogena Norwegian Formula, Aquaphor, Vanicream, Eucerin cream and other similar products are favorable moisturizing options.

Less commonly, individuals can be affected by “allergic contact dermatitis.” This results when an allergen or chemical in the environment comes in contact with the skin and causes itchy, red, raised and sometimes blistering rashes that appear two to seven days or more after exposure. A common example of this type of reaction is poison ivy.

Many chemicals can also cause allergy including fragrances, metals such as nickel, gold and cobalt, preservatives such as formaldehyde, quaternium-15 and MI/MCI, or topical antibiotics such as neomycin and bacitracin. Because these reactions typically occur several days after exposure, it can be difficult to correlate and decipher the actual cause. If the hands do not improve by using gentle soaps and moisturizers listed above, then further allergy testing such as “patch testing” can be completed to help identify any chemical source contributing to the problem.

Overall, for dry, itchy skin, using mild and fragrance-free cleansers, hand sanitizers when appropriate and moisturizing immediately after washing and throughout the day can help reduce irritation. Prescription cortisone creams can also provide relief for extreme cases, and ultimately further testing is sometimes required. A board-certified dermatologist can provide guidance if despite these measures, individuals continue to experience severe contact dermatitis.  

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