HAND ECZEMA

AT HOME, AT WORK OR OUTDOORS - OUR HANDS ARE THE MOST IMPORTANT TOOLS IN EVERYDAY LIFE AND DESERVE SPECIAL ATTENTION.

ARE YOUR HANDS SENSITIVE? DO YOU SUFFER FROM ITCHING OR HAVE BLISTERS? DRY, FLAKY AND THICK, ROUGH SKIN? IT COULD BE HAND EXCEMA.

YOU CAN FIND ALL INFO ABOUT THIS SKIN DISORDER HERE.

 Photo: © casi – stock.adobe.com

• What is hand eczema?

• How do I recognize hand eczema?

• What types of hand eczema are there?

• What causes hand eczema?

• What type of diagnosis is necessary?

• What other skin disorders can produce similar reactions?

• What type of treatment is available?

• How can I prevent hand eczema?

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What is hand eczema?

Hand eczema is basically a disruption of the skin barrier. Due to a corresponding disposition and/or external stimuli, the balance in the skin is negatively affected.

If our hands frequently come into contact with irritants or sometimes even just with water, the natural protective mechanisms of the skin can be disturbed. Bacteria, fungi and allergenic substances can penetrate through the reduced protective shield.

If this skin disorder is not treated quickly, it can persist for months or years. There are often relapses due to repeat assults on the skin. It is therefore important to seek prompt and consistent treatment in order to avoid long-term suffering.

How do I recognize hand eczema?

Most patients have dry and sometimes flaky skin on their hands. In addition, there is often redness and small cracks in the skin. With some types of eczema small blisters can appear, accompanied by itching.

In many patients, the feet are also affected at the same time.

What types of hand eczema are there?

Hand eczema is divided into three subtypes. A patient can suffer from just one isolated subtype, but often mixed types are found. In order to be able to make an exact diagnosis, it is recommended that you consult a dermatologist.

Allergic hand eczema

This type arises from contact with allergy-causing substances in the environment. It often starts with itchy skin and sometimes small blisters appear on the sides of the fingers and palms. The symptoms develop relatively quickly after contact with an allergen. There are many substances, e.g. in household products, cosmetics, fragrances, paints, adhesives, lubricants or plastics, which can trigger allergic contact eczema.

Irritant-toxic hand eczema

This common type of eczema is caused by irritant substances. These can be chemical substances such as soap, disinfectants or certain foods. Frequent hand washing, working in wet conditions and wearing gloves during work lead to swelling of the epidermal layer that disrupts the skin barrier. The reaction often starts on the fingertips or the back of the hand and then gradually spreads.

Atopic hand eczema

There is a connection here with atopic dermatitis and genetic predisposition. Above all, the immune system and a tendency to allergic reactions play a role here. The genetically weakened skin barrier makes the skin more susceptible to external influences. Affected patients sometimes also suffer from hay fever or asthma and have skin eczema in areas typical of atopic dermatitis, such as the crooks of the arm. Atopic hand eczema is often found on the palms or on the back of the hands.

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What causes hand eczema?

There are many causes of hand eczema, depending on the subtype, different triggers can be considered. It is important to discuss exactly which irritating substances or potential allergens a patient comes into contact with. Often the skin disorder is related to the patient’s profession. Certain jobs such as hairdressers or medical staff (care, masseurs) are more at risk by constant contact with moisture and chemicals. Stress can also make eczema worse.

What type of diagnostic is necessary?

In order to provide long-term assistance, a detailed assessment must be carried out. It is important that the patient thinks carefully in advance and explains precisely to the doctor which substances he comes into contact with in his private and professional environment. This also includes leisure activities. For further clarification, it is important to know which substances are chronologically related to the reactions.

Do the symptoms decrease after a long absence from work or after a vacation, or do they stay more or less the same? Are there connections between certain activities?

Questions such as these contribute to optimal treatment and should be clarified as precisely as possible with the doctor.

If an occupational cause of eczema is suspected, the occupational physician must be informed in good time.

If an allergy is suspected, an allergy test can be carried out. Hand eczema is usually a contact allergy. In special cases, further tests will be required, which we can arrange in our practice or in the allergy outpatient clinic.

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What other skin disorders can produce similar reactions?

A rash on the hands can also occur due to certain fungi or bacteria. A weakened barrier allows the pathogens to nestle and multiply. An infection can be ruled out with a smear test.

Psoriasis can also be the reason for alterations to the skin on the hands. Accurate diagnosis and targeted treatment are important here.

What type of treatment is available?

Treatment is organized in stages:

Consistent care is very important to stabilize the skin barrier

Creams and ointments with cortisone support the healing of the alterations to the skin and are used briefly in an acute attack, then slowly withdrawn again

Light therapy in a light clinic. In this case, the affected areas are treated using phototherapy with UV radiation several times a week and for several weeks

Oral treatment is approved in severe cases of chronic hand eczema. It is a special form of high-dose vitamin A. This treatment lasts for several months and is an effective option for severe cases

How can I prevent hand eczema?

Primary prevention is the simplest. By avoiding contact with allergens in work equipment or materials, the chance of hand eczema appearing is significantly reduced. It is therefore important to train people who have not had any skin problems to date in the right skin protection for their professional and general environment.

Secondary prevention is aimed at people who already suffer from hand eczema. The aim here is to find a suitable long-term treatment and to inform those affected about the right skin protection and care for hand eczema.

It is important to avoid direct skin contact with all irritating and eczema-causing substances. Suitable skin protection is particularly important here; the use of protective skin creams or the wearing of gloves is recommended. Treatment will be ineffective in the long term as long as activities that stress the skin or regular contact with allergens take place. We are very well aware that changes especially in the professional environment are difficult, and are therefore happy to advise which options you have in your particular situation.

The use of mild lotions to clean hands will avoid excessive drying out and irritation to the skin. After each wash, the hands should be covered with a suitable cream (free of fragrances and preservatives).

Certain occupational groups are particularly hard hit by allergic and cumulative-subtoxic hand eczema. Especially if you have atopic dermatitis, we advise against doing jobs in which the hands are frequently exposed to irritants.

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