Hand rash: an irritating response

There are many ways a person can get a hand rash, but all have some aspects in common. The skin is exposed to something irritating. It reacts with a rash. Hand eczema is another name for the same thing. Most hand rash cases are called "contact dermatitis" because they are caused by contact with substances found in the environment. A powerful irritant, like some industrial chemicals, acids or cleaning fluids, are obvious causes of contact dermatitis. More often, the irritant is milder and the problem starts out as dryness of the hands. A few of the more common irritants are over drying due to frequent hand washing, soaps, cleaning agents or even ingredients in skin and personal care products.

The inflammation appears as redness, swelling and itching. The skin looses its ability to serve as a barrier and keep the outside world out. It allows more outside irritants in. Until all the irritants are removed, the skin will not heal. Once skin becomes red and dry, even so called "harmless" things like water and baby products can irritate skin further. This is a cumulative irritant dermatitis, in that it is not one big irritant but a lot of small ones. The tendency to get skin reactions is often inherited. People with these tendencies may have a history of hay fever and/or asthma in combination with food allergies and a skin condition called atopic dermatitis or eczema. Their skin can turn red and itch after contact with many substances that might not bother other people's skin.

Less commonly, some cases of Hand dermatitis are allergic. This means after a period of exposure the substance caused sensitivity against it to develop in the skin to that, and only that, substance. The culprit could be anything, but rubber, metals and preservatives are common. Even prescription skin creams can do this. Then, afterward, whenever the skin is exposed to the same substance -- even slightly --it becomes inflamed. An example of an allergic reaction it is poison ivy dermatitis. The least common forms of hand dermatitis are often the most severe. Dyshidrotic hand dermatitis forms blisters under the skin, especially on the sides of the fingers and on the palms. It is internally produced, and seems to worsen with stress. Hyperkeratotic hand eczema develops thick scales and fissures. Either these may be forms of psoriasis, or at times psoriasis may look similar. These are more internally caused, and often also affect the feet.

Dermatologists use a combination of methods to heal the skin. A prescription ointment or cream will be prescribed. If this cream doesn't seem to be helping after 7 to 10 days, call the doctor. It's possible one may need an oral antibiotic if an infection is present. Patients with severe hand rashes may be given oral or injected steroids. Keep hands away from irritants. The next section will explain what to avoid while the skin is healing. Frequent hand washing and water contact should be avoided. To do this, protect hands by using gloves and creams as barriers. Dirty the gloves, not the hands. Take rings off to wash because they trap soap and water next to the skin. Use lukewarm water and rinse thoroughly after washing with soap. Use a mild soap (Dove, Basis, Olay, Cetaphil) or a soap substitute (Cetaphil lotion, Oilatum-AD). Blot the skin dry carefully.

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