Persistent redness, scaling, blistering or chapping of the skin of the palms or fingers is known as hand dermatitis. It is usually a chronic problem that can occur on and off for months or even years. There are many possible causes, including exposure to harsh chemicals or detergents, frequent hand washing and contact or systemic allergic reactions to things that either touch the skin or get inside the body's system (i.e. foods, medicines, infections). People with other allergy problems such as hay fever or asthma are more prone to hand dermatitis or eczema.
The first step in therapy is to eliminate any provoking factors by avoiding direct contact with any allergic or irritating substances. This is usually accomplished by wearing protective latex or work gloves. Since trapped sweat inside these gloves can worsen the dermatitis, it is sometimes useful to wear a thin cotton-lining glove beneath the protective glove. Hand washing should be kept to a bare minimum, using fragrance-free soaps (Dove, Cetaphil, Neutrogena). Most importantly, thick greasy creams, not lotions, should be smoothed onto the hand after each washing (SBR Lipocream, Cetaphil, Eucerin or plain petroleum jelly).
Most cases of hand dermatitis can be managed by intermittent use of superpotent prescription cortisone ointments. These ointments can be applied twice daily for 2-3 weeks to heal a flare, but then must be tapered back to just twice a week application if continued for long term suppression. Everyday use beyond 3 weeks may cause the skin to become permanently thin and red. More severe flare-ups of hand dermatitis are usually treated with cortisone shots or pills, but frequent use of internal cortisone can have many harmful long-term side effects on the body.
Some cases of hand dermatitis are short lived, but unfortunately for many people hand dermatitis can be an almost daily condition that is never resolved. However, with appropriate treatment strategies and strict attention to proper hand care, hand dermatitis can usually be successfully controlled.
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