Hand contact dermatitis

Preventive measures may reduce the risk of hand contact dermatitis; advise patients to avoid:

• direct skin contact with irritants (eg soap, detergents, water, oils, grease, hand sanitisers, washes and moisturisers containing perfumes and fragrances)
• cleaning jobs that require strong cleaning agents.

For general protection during household tasks, use rubber or polyvinyl chloride gloves (preferably worn with a cotton liner, or over cotton gloves). Remove gloves often because sweating may aggravate existing dermatitis.

For occupational tasks involving chemicals, the appropriate glove type depends on safety considerations and the type of chemicals being handled (obtain Safety Data Sheets from the patient’s employer for advice). Cloth or leather gloves are preferred when protection from dust, soil, friction, grease or certain oils is required.

Advise patients to frequently apply emollients (eg emulsifying ointment, glycerine-rich creams), particularly after finishing work, to improve symptoms and skin healing, and reduce the incidence of occupational dermatitis.

Topical treatment for contact dermatitis of the hands is the same as for atopic dermatitis on the fingers or feet.

When the dermatitis is severe and acute, oral corticosteroids may be required. Refer the patient to a specialist for assessment (eg patch testing) and diagnosis. While waiting for specialist assessment, use:

Hand contact dermatitis usually recovers slowly or incompletely because it is not possible to protect the hands against all irritants and allergens.