HAND ALLERGIC CONTACT DERMATITIS

 

If your dermatologist or allergist has diagnosed you with allergic reactions of the hand, the information below will provide more guidance on what substances to avoid and how to avoid them.


How do I protect against irritation of the hands?
Our hands come into constant contact with many substances and chemicals that can cause damage to the skin. This includes the obvious: chemical cleaners, foods like raw meat and tomatoes, and even many types of plants. It also includes the less obvious: hand soaps, dishwashing soap, and frequent hand washing. Even just keeping your hands in water for a long time can cause irritation. This is why the proper skin care is so important.


1. Avoid direct contact with these irritating substances.


2. When washing hands, use lukewarm water and a small amount of mild soap. Avoid soaps with fragrances and disinfectants. See the list of recommended products below.


3. After washing, always gently pat dry your hands instead of rubbing. Try to avoid rough paper towels.


4. Remove jewelry when washing hands, as these can trap irritating soap and water.

5. With any kind of wet work or contact with cleaners, you must double-glove. You may also need to double-glove when gardening or even cooking. Use a pair of 100% cotton white gloves. [sold at many drugstores or allerderm.com] Over these, you may use vinyl gloves. Sweating makes hand eczema worse, which is why the use of cotton gloves against your skin is so important. The thick gloves will protect your hands from the water, while the cotton gloves will protect your hands from the irritation and sweating that can be caused by the vinyl gloves.


6. Moisturize your hands frequently during the day. You should always carry a moisturizer with you and apply it to your hands each and every time you wash your hands. Ointments are the greasiest. They are the best for hands that are severely affected, but may be difficult to use during the day when working. They can still be used at night, though. Creams are less greasy. Lotions are the least moisturizing, and are hardly ever recommended for persons with hand eczema. See below for product recommendations.


7. If your doctor prescribes a topical steroid ointment for the treatment of hand eczema, use it only on the affected areas in a thin layer. The medication should be applied first, and is usually prescribed to use twice daily. Next you should apply a moisturizing cream or ointment to the entire area of the hands. When your rash improves, you should stop using the prescription ointment. However, you will always need to use a moisturizing cream and continue following the other recommendations, since many people with hand eczema are prone to repeat rashes.

 

What is allergic contact dermatitis (ACD)? Why is it so hard to diagnose?

ACD is a type of allergic reaction. In this type of allergy, a substance contacts the skin, and later results in a rash. The rash from poison ivy is one example. The rash classically occurs 2-3 days later, but it may happen just a few hours later, or one week later. This delay is what makes ACD so hard to figure out.


Once the rash occurs, it may last for weeks, and sometimes up to 8 weeks. People may stop using the offending product for 1-2 weeks, but that’s usually not long enough to see results.


What are some of the most common substances that trigger ACD of the hands? How can I avoid them?

1. Fragrance additives and preservatives in skin care products, such as liquid soaps, bar soaps, lotions and creams. The products listed below will avoid many of the most common triggers.

2. Antibiotic ointments. Many people apply Neosporin or Polysporin when they develop cracks in their skin. The antibiotics in these, neomycin and bacitracin, are actually one of the most frequent causes of ACD. For cuts in the skin, it is better to apply pure Vaseline petroleum jelly to the cut, and medication to the surrounding area. If the skin is actually infected, your doctor can prescribe an antibiotic.


3. Gloves. Some people with hand eczema actually become allergic to the protective gloves that they wear. The common triggers are latex rubber gloves, latex-free rubber gloves [such as nitrile gloves], leather gloves, and the dyes in dark neoprene or cloth gloves. White 100% cotton or vinyl gloves may be used instead.


4. Nickel. This is a metal. It is cheap and durable, so it’s used in many metal objects, such as scissors, cell phones, certain coins, and keys.


What products should I use?

The products below do not contain any of the common triggers of ACD. They do not contain any synthetic fragrance additives, natural fragrance additives, botanicals, formaldehyde, methylchloroisothiazolinone, or lanolin. Some are available at major retailers, and others must be ordered via phone or website.


Note that every product must contain some additives, and some people are allergic to less common substances. Therefore, if these recommendations do not help, then you may require further testing. It can take up to 8 weeks of allergen avoidance for your skin to recover. Your physician will prescribe a medicated ointment to use on your hands during this time to help with the inflammation.

 

Cleansers:
Liquid cleansers: Cetaphil gentle skin cleanser [liquid only], Cerave hydrating or foaming cleanser, Free and Clear liquid cleanser

Bar soaps: Neutrogena fragrance-free bar soap, Aveeno fragrance-free bar soap, Vanicream bar soap [1-800-325-8232]
Cleansers to remove grease: Albolene gentle cleanser [This product is often used to remove make-up and as a cleanser for very sensitive skin. It is also helpful to remove grease]


Moisturizers:

For bedtime: Pure Vaseline petroleum jelly [no added fragrance or flavoring]
Other moisturizers [from most greasy to less greasy]: Theraplex emollient [theraplex.com], Neutrogena Norwegian Formula Hand Cream, Aveeno Eczema Therapy cream, Cerave cream


Laundry detergent: All Free and Clear, Cheer Free, or Tide Free

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© 2019 by Rajani Katta MD