Eczema – Hand Dermatitis

May 14th, 2011

Hand Dermatitis is a very common form of Eczema that I encounter on a daily basis in both my The Woodlands dermatology and Conroe dermatology offices.  Clinically, the hands develop scaly red plaques that on the fingers and palms which can ultimately become very thick and develop cracks and fissures.  Excessive hand washing worsens Hand Dermatitis as does the use of alcohol based hand sanitizers.  Hand Dermatitis is extremely common in ICU nurses who have to wash their hands over 20 times per day.  In severe cases, small water filled blisters form beneath the skin which are due to inflammation and this condition is called Pompholyx or Dyshidrosis.  Emotional stress also exacerbates Hand Dermatitis in many patients.  The nails can become dystrophic if the Eczema involves the proximal nail fold of the distal fingers.  Treatment involves minimizing hand washing and using a gentle liquid soap such as Dove.  It is very important to use a moisturizing cream or ointment after each hand washing.  Aquaphor is an excellent ointment that improves Hand Dermatitis.  I typically prescribe an ultrapotent steroid cream to be used twice a day to minimize the inflammation.  In patients with fissures and cracks, these can be sealed with superglue and filed down smooth to limit exposure to external antigens and irritants.  Some patients have Hand Dermatitis due to occupational exposure or allergens/irritants they encounter during their daily activities.