Can U Get Eczema At Any Age – [For more information on hand care while Covid-19 remains a threat, please go to our Covid-19 & page.]
The hand is one of the most common types (also called “dermatitis”). It mainly affects the palms, but can also affect other parts of the hand. The main symptoms are dry, itchy and red skin that affects the entire hand, including the fingers. Other symptoms may include cracking, pain, and bleeding. Blisters may occur in some cases. The skin is generally dry, scaly and thickened, and the fingers can become quite swollen when it flares up. If it is heavy for a long time, the hands can become very painful, making it difficult to perform everyday tasks such as pressing buttons, holding a pen or using a computer.
Can U Get Eczema At Any Age
The skin is part of the immune system and helps protect against infection. Not only does it provide a physical barrier, but the skin layers contain specialized cells that destroy invading foreign proteins (antigens) such as bacteria and viruses. In humans, the immune system overreacts on the skin, making it red and itchy.
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The reasons for appearing on the hands can be different. For example, the hands may be affected by irritant or allergic contact dermatitis, or both at the same time.
Contact with irritants such as dust, detergents, cleaners, aerosol sprays, or even frequent hand washing can cause hand irritation (irritant contact dermatitis of the hands). The skin on the palms of the hands is much thicker than on other parts of the body (except the soles of the feet) and can usually withstand a lot of wear and tear. But in people who regularly immerse their hands in detergents or solvents, the skin’s protective barrier breaks down and can develop. People who have this hand shape often have a childhood history.
Allergic hand (allergic contact dermatitis of the hands) is caused by an allergic reaction to a certain substance in the environment. It is possible to be allergic to a number of different substances, but common causes of contact sensitivity include nickel, fragrances, preservative chemicals, rubber, and various plants, among other things. Once a person’s immune system recognizes a substance as “harmful,” they will react to that substance each time their skin is exposed to it, and this reaction becomes more severe with each exposure to the allergen.
When such an allergic reaction is suspected, your GP should refer you to a dermatologist, who will usually do patch tests to try to identify the cause of the allergy.
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Pompholyx (also known as dyshidrotic/dermatitis) is another type of condition that affects the hands (and feet). Pompholyx typically involves the development of intensely itchy, watery blisters that primarily affect the sides of the fingers, palms of the hands, and soles of the feet. Some people have pompholyx on the hands and/or feet along with other parts of the body. This condition can occur at any age, but is most common before the age of 40.
Onset can be very sudden and the cause is unknown, although factors such as stress, sensitivity to metal compounds (such as nickel, cobalt or chromate), heat and sweating are thought to aggravate the condition. The skin is very itchy at first, and if you scratch, the blisters burst, causing pain and weeping. The skin will then become dry and often scaly. Pompolix may occur as an isolated event or may come and go in cycles. For more information, please see the National Society’s Fact Sheet on Pompholyx.
It is important to avoid relevant irritants or allergens and to use emollients and topical steroids as needed.
Emollients are medicated moisturizers (ointments, gels, and creams) available over the counter and by prescription. They should be used frequently throughout the day, even when it’s not active/flare up, to keep the skin hydrated and dry. Creams are effective for very dry skin, but they can be too greasy for daytime use. If so, use the cream at night under a pair of cotton gloves and reapply frequently throughout the day. A fabric softener or a fabric softener soap substitute should be used for washing, as soap strips the skin of oil and can also be irritating. It’s a good idea to carry hand sanitizer around to use for washing your hands during the day so you can avoid washing your hands with detergents. For more information and practical tips on emollients, see the National Society’s Emollients fact sheet.
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Topical steroids treat active by reducing inflammation; it will reduce red, sore and cracked skin. The hands usually require stronger steroids (palm skin is thick), so strong topical steroids (moderately strong for children) are usually prescribed. They should be used for short-term treatment, generally for 2 weeks. If the skin is infected, you may be prescribed an antimicrobial treatment in the form of a cream or even a tablet. For more information, see the National Society’s Topical Steroids fact sheet.
Wearing gloves can help protect your hands from irritants and allergens, although you should still establish a good skin care routine using a soap substitute and emollient cream or lotion. Make sure the gloves provide full protection and the inside stays dry. For general purposes and household work, rubber or PVC gloves with a cotton lining or PVC gloves worn over cotton gloves are sufficient. Even when cleaned, hands can remain very sensitive, so using cotton gloves over rubber gloves can be helpful when performing wet tasks.
Some workplaces may recommend the use of barrier creams to protect workers’ hands. We recommend that people with hands always use protective gloves (which should be provided by their workplace) and never barrier creams. Discuss any concerns with your Occupational Health Department who will provide the correct gloves to protect hands in the workplace.
If your hand is severe, discuss a dermatology referral with your GP. The referral may be for contact allergy diagnosis (patch testing) or for treatment, which may include a short course of oral steroids or immunosuppressants (eg, azathioprine, cyclosporine, or methotrexate). Alternatively, dermatology departments may recommend alitretinoin (Toctino) or phototherapy, as described below.
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Toctino is an oral treatment licensed for use in adults with severe chronic hands that have not responded to treatment with strong topical steroids. Toctino is not known to be useful in treating any other part of the body.
The active ingredient in Toctino is alitretinoin, a type of chemical that occurs naturally in the body and is known as a retinoid (because it is related to vitamin A). Toctino comes as a capsule in two strengths, 10 mg or 30 mg, and is taken once daily with a meal. Your doctor will decide which strength you need. Toctino has been shown to be effective in patients with severe hand conditions. It works by reducing the inflammation that is associated with it as well as reducing the immune system’s response. The treatment period is usually 12-24 weeks, depending on how your condition responds to this treatment.
Side effects: The most common side effects are headache, dry lips and skin, flushing, changes in blood fats (such as cholesterol), and decreased thyroid hormone levels. Not everyone will experience them, but if you notice any side effects while taking Toctino, you should discuss them with your doctor, who may lower your dose.
WARNING: Toctino should not be taken by women who are pregnant, breastfeeding, or trying to conceive. The drug can be prescribed only if the pregnancy test is negative. Regular pregnancy tests will be performed during treatment. You must avoid becoming pregnant during treatment and for 1 month after stopping treatment (for example, by using two effective methods of contraception). Patients receiving concurrent treatment with a specific antibiotic group of “tetracyclines” should not take Toctino due to the risk of drug interactions.
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Phototherapy (UVB or PUVA), using UVB or UVA rays delivered through a special foot/hand light box, may be recommended if this treatment option is available to you. Assessment and treatment (2-3 times a week) usually takes place in the dermatology department. In some areas of the UK, you may be able to borrow a light box so that you can carry out your treatment at home, although you will continue to be monitored by the dermatology department. Before the treatment, your hands are coated with a light-sensitive solution called psoralen (the “P” in PUVA). Phototherapy treatment usually lasts several months until the diarrhea is gone.
To obtain the information on this page in PDF format, please download our Handout Information Sheet below.
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