Allergies Skin Allergies Allergic Reactions to Hand-Washing By Daniel More, MD Daniel More, MD, is a board-certified allergist and clinical immunologist. He is an assistant clinical professor at the University of California, San Francisco School of Medicine and currently practices at Central Coast Allergy and Asthma in Salinas, California. Learn about our editorial process Daniel More, MD Medically reviewed by Medically reviewed by Sanja Jelic, MD on November 04, 2019 Sanja Jelic, MD is board-certified in pulmonary disease, sleep medicine, critical care medicine, and internal medicine. She is an assistant professor and attending physician at Columbia University College of Physicians and Surgeons in New York, NY. Learn about our Medical Review Board Sanja Jelic, MD Updated on February 18, 2021 Print Table of Contents View All Table of Contents Symptoms Causes Treatment Prevention Hand-washing certainly can reduce the transmission of infections and should be encouraged. However, many people who wash their hands multiple times a day, such as healthcare workers, develop rashes on their hands. Up to 30% of healthcare workers develop hand rashes as a result of repetitive hand-washing. We teach children at an early age that hand-washing is an important part of daily hygiene. We ask our children to wash their hands before meals, after using the restroom, and any time we think their hands might be dirty, such as after playing outside. We also hear from healthcare experts (including our own doctors) that frequent hand-washing can help reduce the spread of germs, especially during the cold and flu season. Verywell / Cindy Chung Symptoms People who get rashes from repetitive hand-washing may experience symptoms of redness, flaking, blister formation, cracking, and chronic skin thickening. Pain and itching may also occur. These skin changes usually occur on the back of the hands as well as the spaces between the fingers. The skin on the palms is much thicker and therefore more resistant to irritants and allergic rashes. These hand rashes may occur throughout the year, but are worse during the dry, cold winter months, possibly as a result of warm or hot water being used, which contributes to the irritant effect on the skin. Causes For people who wash their hands multiple times a day, hand rashes are usually caused by an irritant effect. In fact, in a study examining 1,300 people with hand rashes, 35% were caused by skin irritation. Nearly 20% had atopic dermatitis while only 19% had allergic contact dermatitis. While many people blame hand rashes on alcohol-based hand cleansers, these agents rarely cause contact dermatitis. Alcohol-based hand cleansers may cause burning and stinging, but this is usually due to the skin already being broken and irritated. Other causes of hand rashes that could worsen with hand-washing include contact dermatitis caused by chemicals in soaps and moisturizers (such as parabens) and atopic dermatitis limited to the hands and feet. The diagnosis of contact dermatitis is made with the use of patch testing while people with atopic dermatitis are often diagnosed with atopic dermatitis in childhood. Another form of eczema that may worsen with handwashing is dyshidrotic eczema (or pompholyx), which occurs on the palms and fingers and can be related to allergies or stress. Dyshidrotic eczema often has the classic finding of small bumps and blisters along the sides of the fingers, as well as the palms, which resemble tapioca pudding. Treatment Treatment of hand-washing rashes includes aggressive moisturizing, such as at the end of a work shift and before bed. Ointment-based moisturizers, such as Aquaphor, work the best in my opinion, and other similar brands can be found over-the-counter, often specifically labeled as being for dry hands. Topical corticosteroid creams and ointments may also be used, especially if contact dermatitis, atopic dermatitis, or dyshidrotic dermatitis is the diagnosis. Prevention The prevention of hand rashes includes reducing the irritant effects of repetitive hand-washing. While this may seem difficult, or even impossible, for people who need to wash their hands frequently, the solution is to increase the use of alcohol-based hand cleansers as an alternative. Alcohol-based cleansers should be used when disinfection is the goal, as they cause less irritation on the skin than the repetitive use of soap and water. Hand-washing with soap and water needs to occur when the hands are visibly dirty, and should not be used simply to disinfect the hands. Was this page helpful? Thanks for your feedback! Sign up for our Health Tip of the Day newsletter, and receive daily tips that will help you live your healthiest life. Sign Up You're in! Thank you, {{form.email}}, for signing up. There was an error. Please try again. What are your concerns? Other Inaccurate Hard to Understand Submit Article Sources Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. Centers for Disease Control and Prevention. Show me the science - why wash your hands? Updated September 17, 2018. Jones, K. Hand eczema common among health care workers. National Eczema Association. November 6, 2017. American Academy of Dermatology Association. Dry, scaly, and painful hands could be hand eczema. Updated 2019. American Osteopathic College of Dermatology. Hand rashes. Updated 2019. Meding B. Epidemiology of hand eczema in an industrial city. Acta Derm Venereol Suppl (Stockh). 1990;153:1-43. WHO Guidelines on Hand Hygiene in Health Care: First Global Patient Safety Challenge Clean Care Is Safer Care. Skin reactions related to hand hygiene. Geneva: World Health Organization; 2009 Rakel, D, Rakel RE. Textbook of family medicine. New York, New York: Elsevier Health Sciences; 2015. Berke R, Singh A, Guralnick M. Atopic dermatitis: an overview. Am Fam Physician. 2012;86(1):35-42. Additional Reading Kampf G, Loffler H. Prevention of Irritant Contact Dermatitis Among Health Care Workers by Using Evidence-Based Hand Hygiene Practices: A Review. Industrial Health. 2007; 45:645-652.