Patient Query - Dermatitis

My hands have become extremely red and itchy. I have also developed painful cracks on some of my fingers

My hands have become extremely red and itchy. I have also developed painful cracks on some of my fingers. This has happened at a very inconvenient time as I have recently moved into a new house and need to get it cleaned up before Christmas. Have you any suggestions as what might have caused this and what are the treatment options?

Conventional remedy

You may be suffering from a common form of contact dermatitis. This skin problem is caused by an allergic or irritant reaction to certain substances coming in contact with the skin. This can occur either acutely or slowly over time. Contact dermatitis can cause redness, itchiness, blisters and swelling. The most common sites affected are the face, especially around the eyes, the genital area and the hands and feet. It is usually caused by irritants such as acids and alkalis, detergents, soaps, solvents and oils. You can also develop an allergic reaction to plants, perfumes and cosmetics as well as rubber, latex, resins, glues, dyes and some topical medications. Jewellery which contains nickel and chromate found in cement can also cause skin problems.

In the light of your recent house move you may be using an increased number of detergents and cleaning agents in order to clean the house. The use of these products with hot water can result in hands becoming red, sore and itchy. As in your case, cracking of the skin can also occur which is particularly painful.

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The best form of prevention is avoidance. Use a barrier cream and cotton-lined PVC gloves. Avoid direct contact with cleaning agents, white spirits, paints and thinners, detergents and soaps. Use a soap substitute and dry the hands gently and thoroughly after washing. You may require a cream or lotion with hydrocortisone if the hands are slow to heal. This has anti-inflammatory properties and will help reduce the redness and itching. Always use an unperfumed moisturising hand cream. If this is an acute problem which only developed with increased use of detergents, it will probably resolve with these measures but you should take care to protect your skin in the future.

If the condition does not clear up you should contact your GP as you may be in coming in contact with a substance through your work or hobbies which is causing the problem. He may refer you for further tests to try an establish the exact cause. He will also prescribe a topical medication to ease your symptoms.

Dr Muiris Houston

Alternative remedy

Contact dermatitis is caused by an allergic reaction and the fact that it is only on your hands would indicate cleaning products are the culprits.

Rubber gloves should always be used when handling household cleaning products. White cotton gloves worn inside the rubber gloves will prevent another flare-up. You should only use either unperfumed handcream or emulsifying lotion on your hands and make sure that you pat them dry rather than rub them.

The towels you use should be washed in a non-biological washing powder with no added fabric conditioner. You should also be careful of the soaps, shampoos and lotions you use as they may aggravate the condition while your skin is so sensitive.

To promote healing, you should use aloe vera gel. It is both anti-inflammatory and antiseptic. The best form is the fresh gel. Simply cut a slice off the top of the leaf and squeeze the gel directly onto the skin. Aloe vera plants are not expensive and are sold in many garden centres. Alternatively, you can make your own hand cream to use immediately. Add 40 ml of infused herb oil to 4 grams of melted beeswax. Store in a clean jar. To make the oil, simmer the leaves and stem of stellaria (a common garden weed) in cold pressed sunflower oil in a bain marie (or container placed in a saucepan of hot water) until the oil changes colour. Strain the oil onto a fresh batch of stellaria plant and repeat the process.

A mixture of glycerine and rose water with a few drops of lemon juice added is an old fashioned but very effective remedy to restore the acid coating on the skin. However, this cannot be used on very broken skin.

Because the skin on your hands has become hypersensitive, you will always have to look after them.

Amanda Hughes

Amanda Hughes is a registered Chinese Medicine Practitioner with the Acupuncture and Chinese Medicine Organisation, tel:01-4640444.

The advice in this column is not intended as a substitute for advice received directly from a medical doctor and/or alternative practitioner. Individuals should receive a thorough diagnosis of complaints before embarking on a course of treatment.