Allergic Reactions to Hand-Washing

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Hand-washing is important for many reasons—including preventing contamination of food and reducing transmission of infections. However, many people, such as health care workers, who wash their hands multiple times a day, can develop a rash on their hands. Up to 30% of healthcare workers develop hand rashes as a result of repetitive hand-washing.

There are some ways to figure out if your rash is caused. by hand-washing and to take steps to treat and prevent a rash on your hands—without sacrificing your hygiene.

Is Hand Washing Giving You a Rash?
Verywell / Cindy Chung

Symptoms 

Hand rashes may occur throughout the year, and they are often worse during the dry, cold winter months. You may also notice them when you have been washing your hands more often or when you use certain products.

People who get rashes from repetitive hand-washing may experience:

  • Redness
  • Flaking
  • Blister formation
  • Cracking
  • Pain
  • Itching
  • Chronic skin thickening

A rash from hand washing usually occurs on the back of the hands and can affect the spaces between the fingers. The skin on the palms is much thicker and more resistant to irritants and allergic rashes.

Causes 

For people who wash their hands multiple times a day, hand rashes are usually caused by an irritant effect or an allergy. Warm or hot water can contribute to the irritant effect on the skin as well.

Sometimes contact dermatitis caused by irritation or allergies to chemicals in soaps and moisturizers can cause your rash. And atopic dermatitis (also known as eczema) of the hands and feet may worsen with hand washing as well.

  • The diagnosis of allergic contact dermatitis is made with the use of patch testing
  • Atopic dermatitis is often diagnosed during early childhood based on the clinical history and physical examination.

Another form of eczema that may worsen with handwashing is dyshidrotic eczema (or pompholyx), which occurs on the palms and fingers and can flare with 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.

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, usually on skin that's already broken and irritated.

Treatment

Treatment of hand-washing rashes often involves moisturizing, such as at the end of a work shift and before bed. Ointment-based moisturizers, such as Aquaphor, are especially effective. Other over-the-counter products that can be effective are those that are specifically labeled for dry hands. Make sure to use a moisturizer that doesn't cause additional irritation.

Topical corticosteroid creams and ointments may also be used, especially for the treatment of severe or persistent contact dermatitis, atopic dermatitis, or dyshidrotic dermatitis.

Make sure to avoid touching your face and eyes with moisturizer. Some moisturizers can cause red eyes, tearing, or breakouts on your face.

Prevention

The prevention of hand rashes includes reducing the irritant effects of repetitive hand-washing. Hand-washing with soap and water is important when the hands are visibly dirty, but this isn't the best way to disinfect your hands if it causes you to develop a rash.

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. When using these products, it's important that you rinse well before handling food.

If soap-based cleansers cause you to develop a rash, you can use alcohol-based hand cleansers as an alternative to soap. And if your hands feel dry, consider applying a moisturizer to prevent chapping and cracking.

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Article Sources
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  1. Centers for Disease Control and Prevention. Show me the science - why wash your hands? Updated September 17, 2018.

  2. Jones, K. Hand eczema common among health care workers. National Eczema Association. November 6, 2017.

  3.  American Academy of Dermatology Association. Dry, scaly, and painful hands could be hand eczema. Updated 2019.

  4. American Osteopathic College of Dermatology. Hand rashes. Updated 2019.

  5. Nichol K, Copes R, Spielmann S, Kersey K, Eriksson J, Holness DL. Workplace screening for hand dermatitis: a pilot study. Occup Med (Lond). 2016 Jan;66(1):46-9. doi:10.1093/occmed/kqv126

  6. Rakel, D, Rakel RE. Textbook of family medicine. New York, New York: Elsevier Health Sciences; 2015.

  7. 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

  8. Berke R, Singh A, Guralnick M. Atopic dermatitis: an overview. Am Fam Physician. 2012;86(1):35-42.

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