Question:

“Doctor, my hands are in and out of water all the time and I have a very itchy hand rash, do you have any suggestions?”

Answer: Yes, here is help. Hand dermatitis, also known as hand eczema, is a common dry and sensitive skin condition that is worsened by frequent hand washing or exposure to water. Dry and Sensitive hand eczema sufferers experience extreme inflammation, irritation, burning, peeling, dryness, redness, cracking, itching, fissuring, and sometimes bleeding of the hands. Hand dermatitis is grouped into four basic types, and all four types may occur together, simultaneously.

First, allergic conditions may result in allergic contact hand dermatitis. An example is a nurse who wears latex gloves and develops an allergy to latex. Second, caustic or other harsh substances may cause a non-allergic hand dermatitis called irritant hand dermatitis. An example is a mechanic who works with gasoline and comes home every day with burning irritated hands. Third, emotional stress coupled with an innate predisposition may trigger a blistering itchy hand eczema called pompholyx. Pompholyx has tiny pinpoint bubble-like blisters on the sides of fingers and palms. Pompholyx blisters tend to run in certain families. The little blisters itch intensely and tend to increase with mental stress. Fourth, soapy hand washing can deplete the skin barrier lipids and can cause lipid-depleted hand dermatitis because the lipids are damaged.

In addition to the four types of hand dermatitis, the hands can also suffer from drying hand conditions such as: diabetes, atopic (eczema-prone) dermatitis, yeast or fungal infections, chronic bacterial infections, psoriasis, scabies, drug induced rashes, and other dry / sensitive conditions of the hands. Because soap strips skin lipids, soap is your #1 enemy. Dry air is big enemy #2. Thus, each of these drying conditions will benefit from daily ABC skin care.

ABC Daily Hand Care Moisturizing Method

If you are affected, here is a helpful twice a day ABC recipe for daily care of your dry and sensitive hands:

A: Avoid. Stay away from hand allergens. Cleanse your hands with lukewarm water rather than hot. To wash, you may use a gentle, lipid preserving skin cleanser such as Guitar Hands® Cleansing Lotion. To avoid soap in public places, carry your gentle cleanser with you wherever you go. Guitar Hands® Cleansing Lotion is nice because it is rinse optional. In other words, you can rinse with water, but you’re not required to rinse with water. Note, Guitar Hands® was made for guitar players, so it was designed for people who absolutely require healthy hands, but actually, anyone who wants healthy hands can use Guitar Hands®, and, you don’t need to play guitar to enjoy it.

B: Bathe. Bathe your hands. First, rinse with tap water, then, soak your hands in pure distilled water for three minutes. Let the distilled water penetrate the dry skin of your hands. After you cleanse, apply a heavy cream.

C: Cover. Liberally apply a heavy fragrance free cream like Neutrogena Hand Cream. Or, for more severe hand eczema, apply pure Vaseline. At night, apply cream and cover your hands with cotton gloves. Use cream. Do not use lotion, as lotion evaporates too easily and does not protect as well.

“How do I use my creams and medicines?”

When undergoing treatment, remember this very important point: Every time you wash your hands, you also wash away your important skin lipids, medications, and creams. So, don’t forget to reapply your creams and medications several times per day. Your doctor may prescribe topical cortisone. Ask your doctor how you should use your medications. Hands need continuous care. For severe hand rashes, patients should reapply their topical medications after each and every hand washing.

When the rash is better, I have my patients use the medicines less often. One mistake hand dermatitis patients often make, is that many use the steroid cream, forever as a moisturizer. A steroid cream is not meant for prolonged use. I warn against this, as steroids can thin your skin with long-term use. Once your hands improve, you should maintain frequent hand moisturization with a heavy cream like Neutrogena Hand Cream.

Hand Dermatitis Prevention

Three important tips to prevent Hand Eczema: 1. Only cleanse hands with a gentle cleanser like Guitar Hands® Cleansing Lotion. 2. Use hand cream, not lotion, twice a day whether or not your hands are dry. 3. Use gloves when needed. Ruin your gloves, not your hands.

Prevention begins at home and in your personal life. If you have an automatic dishwasher, use it. Wash your dishes by machine, not by hand. Avoid direct contact with cat or dog hair, grass, weeds, latex, gasoline, diesel, turpentine, paint, paint thinner, and floor, furniture, metal, and shoe polishes. Avoid irritating solvents. When working, wear vinyl or cotton, not latex gloves. Buy gloves at the hardware store and always wear them for protection. Do not let your hands contact soap or shampoo in the bath, at work, or in public restrooms. People with severe hand eczema may actually have to wear gloves when shampooing or when washing their body in the shower. Note: Rings collect soap, and can worsen hand dermatitis by trapping allergens. So, remove your rings when doing housework and before washing hands. Also, remember to cover your hands with cotton gloves whenever possible. Take care of your hands and they will take care of you.

After hand eczema has improved, continue daily hand care. There is no fast "magic" cure. Think ABC: A- Avoid: Avoid anything allergic: Hands can worsen again when exposed to nickel, perfumes, dyes, hair sprays, shampoos, anti-perspirants, grasses, plants, laundry products, dog and cat hairs, chemicals, aloe vera, acrylic nails, nickel, elastic, latex, diaper wipes, and leather. B- Bathe: Soak hands in distilled water for three minutes and cleanse with gentle cleanser such as Guitar Hands®. C- Cover: Apply a heavy fragrance free cream like Neutrogena Hand Cream several times a day and keep hands covered at night with soft cotton gloves.