#SkinSchool: How to tell if you have hand eczema – harpersbazaar.com

As coronavirus fears continue to circulate and we see rising cases in the UK, it only makes sense to follow current recommendations surrounding the importance of hand hygiene and washing practices. However, repeated cleansing and use of alcohol gel has resulted in nearly all of my patients this month in suffering with some degree of either excessive dryness or very active hand dermatitis (eczema).

Repeated use of soaps, detergents and alcohol gel are a common and important cause of what is known as irritant contact dermatitis. These products can damage proteins in the upper layer of our epidermis (the stratum corneum), cause changes in the lipids or fats in our skin, prevent skin cells sticking together appropriately and reduce the water binding capacity of our skin. In extreme cases, changes may occur to our skin microbiome resulting in secondary bacterial infection (for example colonisation with bacteria such as Staphylococci).

The hands can become red, rough, scaly, dry, cracked, and small cuts can appear in the skin

Clinically, the hands can become red, rough, scaly, dry, cracked, and fissured (where small cuts appear in the skin). You may feel the hands have a burning or tingling sensation or feel itchy and irritated. In severe cases the skin may become blistered, painful and form crusts. This problem can develop in anyone who is frequently washing their hands which is probably all of us right now! Those at high risk often have a background of eczema already, or work in an occupation which involves frequent hand washing already (such as healthcare professionals) or exposure to chemicals or irritants (like hairdressers, beauticians, agricultural workers).

So what can you do when hand washing is key in reducing transmission of disease? Well, there are measures which can be taken to reduce the risk of hand dermatitis developing as well as appropriate treatment if the problem has already occurred.

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Make sure you carry a non-fragranced hand cream at all times and get into the habit of moisturising after washing. Products I like include the CeraVe Reparative Hand Cream, Norwegian Formula Concentrated Hand Cream, and La Roche Posay Cicaplast Baume Hands. Fragrances can potentially worsen dermatitis so as a rule of thumb, if it smells good, unfortunately you probably want to stay away from it for active hand eczema.

Where possible, opt to wash you hands with an anti-microbial hand wash, such as Dermol 500 Lotion. Use this instead of soap as a cream wash and rinse off as normal. It doesnt have the convenience of alcohol gel when you are out and about but use it at home or decant a small amount into a travel container and carry it with you for use during the day this is normally what i recommend to my eczema patients.

CeraVe Reparative Hand Cream

La Roche-Posay Cicaplast Baume Hands

Neutrogena Norwegian Formula Hand Cream Concentrated

Dermol 500 Lotion

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Buy some cotton gloves and before sleep bed apply a generous layer of hand cream to both hands before placing them into the gloves whilst you sleep overnight. This is almost like doing an intense 'hand mask' providing relief for chapped skin.

If you are cleaning or washing-up then protect the hands from irritants or chemicals and wear gloves. Try not to get the hands wet or irritated any more times than is absolutely necessary.

The weather is still cool right now and cold air and exposure to the elements can further worsen dryness and hand eczema. The rest of our body is protected by clothing but our face and hands bear the brunt of environmental exposure to cold, wind and pollution.

Once hand eczema becomes problematic, it may require treatment with a short, sharp burst of topical steroid treatment which requires prescription. When used for appropriate periods of time under expert guidance you should not suffer with any long-term side effects of steroid use. The purpose of the steroid ointment is to reduce inflammation and allow the skin to heal and recover. If treatment is not offered, the eczema will not only cause discomfort, but may restrict your daily activities and the skin becomes vulnerable to infection as it is no longer functioning appropriately as a barrier.

Contact Dr Anjali Mahto, consultant dermatologist, at the Cadogan Clinic and follow her on Instagram.

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#SkinSchool: How to tell if you have hand eczema - harpersbazaar.com