How to Treat Hand Eczema and Dry Hands

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Updated: 08/10/2020

Summary:

Dry hands and hand eczema can be caused by a variety of factors, most notably, triggering substances that cause skin irritations. In order to properly treat hand eczema and dry hands, you must first avoid the cause, as well as properly care for your hands with the appropriate soaps and moisturizers.

Dry skin on the hands:

Dry skin, also referred to as xerosis, occurs when there is a loss of moisture from the skin causing rough, scaly or flaking skin. Dry skin is most often found on the hands involving the palms, fingers and fingertips.

Causes of Dry Skin:

The outermost layer of the skin, also known as our protective skin barrier, functions as the ‘bricks' of a home, protecting our body from outside stressors. These protective skin cells excrete lipids including ceramides and cholesterol which function as the ‘mortar’ and prevent further water loss. These protective skin cells also contain a substance called Natural Moisturizing Factor (NMF) which helps to seal in moisture, reduce water loss and maintain skin hydration1 . When exposed to certain external aggressors, such as cold weather, hot water, chemical irritants, soap, sun exposure or air pollution, the protective skin barrier may be compromised which could lead to more skin moisture loss.

Dry Hands vs Hand Eczema:

Can dry patches be a sign of underlying skin inflammation or rash? The most common culprit is hand eczema. Hand eczema often mimics and is easily mistaken for dry skin.

In both dry hands and hand eczema, dry chapped skin is often the first and most prominent sign. Individuals with dry skin on the hands may experience mild itching from time to time. However, in hand eczema, the skin is inflamed and this results in more intense and persistent itching. In contrast to dry skin, hand eczema may cause pink-red irritated rough patches and in skin of color individuals, even darker patches 2.

Hand eczema, unlike dry skin, can cause swelling, small fluid-filled blisters, deep painful skin cracks, open wounds, bleeding, crusting, and at times, weeping and pus-filled drainage3 .

Causes and triggers of hand eczema:

Hand eczema can affect both adults and children, but most commonly affects adults between the ages of 20 to 404 . It is estimated to affect 10% of Americans and cannot be spread from person to person5.

There are two main causes of hand eczema: genetics and environmental factors6 . An immediate family history of eczema and environmental exposure equally play an important role in triggering skin inflammation and hand eczema.

Environmental factors that may trigger hand eczema include:7

Triggering substances:

These are substances that we may be exposed to on a day-to-day basis that may trigger hand eczema. Most commonly, hand and dish soap, shampoo, cleaning agents (surface cleaners and disinfectants), body washes, detergents, and fragrances. Certain professions are more likely to be exposed to higher concentrations of these potentially irritating substances. For example, caterers, hairdressers, childcare workers, construction workers, janitors, domestic cleaners and healthcare professionals are more at risk of hand eczema.

Stress:

Physical and emotional stress may trigger hand eczema. Stress can impact the skin in different ways including harming the skin barrier, reducing skin hydration, increasing the number of bacteria on the skin and slowing down the healing of cuts and wounds8. Stress can cause an increase in the primary stress hormone, cortisol, which causes more inflammation, itching and redness.

Change in climate:

Exposure to cold weather and low humidity (dry air) are two common hand eczema triggers. For this reason, hand eczema flares most commonly occur during cold, dry winters.

Moisture:

Moist hands from prolonged exposure to water or excessive sweating of the palms can cause a hand eczema flare. Excessive sweat can be irritating to the top layer of the skin and may trigger skin inflammation and rough patches.

DERMATOLOGIST TIPS FOR HOW TO TREAT HAND EZCEMA AND DRY HANDS

The first step in treatment is avoiding or minimizing exposure to potential triggers. Understanding what are the triggers for your hand eczema and protecting the hands will help reduce further skin irritation9.

Here are some helpful tips to treat hand eczema and help reduce the occurrences of flares:

1. Avoid frequent hand washing if possible

If you need to wash your hands, use lukewarm water, gentle cleansing soaps or cleansers that are free of botanical ingredients and/or fragrance. Look for cleansers or soaps that contain good humectant and hydrating ingredients such as Shea Butter and Glycerin.

2. Remove jewelry when washing your hands

Trapped soap and water underneath rings and other jewelry may cause skin irritation. Eliminating moist, enclosed environments may also help minimize skin bacteria.

3. Avoid or minimize exposure to antibacterial soaps, wipes and cleansers.

These contain alcohol and other chemicals that are drying, irritating and may cause skin burning and itching.

4. Moisturization is essential.

Frequent moisturization with a fragrance-free hand cream after exposure to water, irritating substances, showers and throughout the day will help reduce skin redness, scaling and inflammation and help minimize prevent new patches from forming. Ointments and creams with rich, nourishing formulas such as Cicaplast Hand Cream & Lipikar Eczema Cream can be more effective in locking in skin moisture

5. Glove up at bedtime.

Wearing cotton gloves over a damp moisturizer or prescription topical medication will help the cream penetrate better, creating an enclosed seal.

6. Protect your hands while at work.

Always carry your own travel-size hand cleanser or soap and moisturizer.

7. Cover open cuts or wounds.

Skin bacteria can invade open cuts and fissures (linear cuts in the skin) causing slow wound healing and worsen skin inflammation.


If your hand eczema does not improve with topical moisturizers and/or develop weeping rashes on the skin, contact your board-certified dermatologist for further evaluation.


Written in partnership with Board-Certified Dermatologist, Dr. Rina Allawh

Reference
  1. Robinson M, Visscher M, LaRuffa A, Wickett R. Natural moisturizing factors (NMF) in the stratum corneum (SC). I. Effects of lipid extraction and soaking. Journal of cosmetic science. 2010;61(1):13.
  2. Desai N, Alexis AF. Atopic dermatitis and other eczema. Dermatology for skin of color. New York: McGraw-Hill Companies. 2009:163-6.
  3. Desai N, Alexis AF. Atopic dermatitis and other eczema. Dermatology for skin of color. New York: McGraw-Hill Companies. 2009:163-6.
  4. Hanifin JM, Reed ML, Prevalence E, Impact Working Group. A population-based survey of eczema prevalence in the United States. Dermatitis. 2007 Jun 1;18(2):82-91.
  5. Silverberg JI, Hanifin JM. Adult eczema prevalence and associations with asthma and other health and demographic factors: A US population–based study. Journal of Allergy and Clinical Immunology. 2013 Nov 1;132(5):1132-8.
  6. Abuabara, K., Magyari, A., McCulloch, C.E., Linos, E., Margolis, D.J. and Langan, S.M., 2019. Prevalence of atopic eczema among patients seen in primary care: Data from the health improvement network. Annals of internal medicine, 170(5), pp.354-356.
  7. Kang K, Polster AM, Nedorost ST, Stevens SR, Cooper KD. Chapter 13–Atopic dermatitis. Dermatology. London, New York: Mosby. 2003.
  8. Chen Y, Lyga J. Brain-skin connection: stress, inflammation and skin aging. Inflammation & Allergy-Drug Targets (Formerly Current Drug Targets-Inflammation & Allergy). 2014 Jun 1;13(3):177-90.
  9. Kang K, Polster AM, Nedorost ST, Stevens SR, Cooper KD. Chapter 13–Atopic dermatitis. Dermatology. London, New York: Mosby. 2003.

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