How to Care for Your Hands to Prevent Flareups
Since the start of the COVID-19 pandemic, people have been urged to wash their hands often. Hand hygiene is considered one of the key ways to avoid spreading or getting COVID-19. The need for clean hands will likely continue even when COVID-19 becomes endemic.
However, if you have a chronic inflammatory skin condition like eczema (also known as atopic dermatitis) — cleaning your hands can worsen symptoms. Frequent handwashing or use of hand sanitizers dry and irritate the skin and lead to cracks in the skin barrier.
Frequent handwashing can even be a source of stress and anxiety, which can also lead to an eczema flare.
Here is important information to protect your hands when you have eczema and need to frequently clean them.
Can you get eczema from washing your hands too much?
You can’t get eczema from washing your hands, but if you have eczema, frequent hand washing can cause it to flare.
Hand washing is important because it removes harmful bacteria and viruses and prevents illness. But frequent hand washing can dry out your skin and cause eczema to flare up. Symptoms may include:
- Flaky, dry skin
- Patches of red, dark brown, gray or purple skin (depending on your skin color)
- Scaly skin
- Skin inflammation
- Itchy skin or blisters
- A burning sensation
- Deep painful cracks
- Bleeding skin
Washing your hands too vigorously or drying them too forcefully can also irritate eczema and cause skin irritation.
Handwashing can also lead to other conditions like hand dermatitis (sometimes called irritant contact dermatitis). Hand dermatitis usually results from coming into contact with irritating chemicals. Finding ways to not only protect your hands but also your overall health is essential.
How do you wash your hands if you have eczema?
The American Academy of Dermatology recommends the following steps when washing hands:
- Wash your hands with a gentle soap for at least 20 seconds.
- Don’t forget to wash between your fingers and around your nails.
- Use lukewarm water rather than hot water.
- Rinse thoroughly so you don’t leave any soap residue behind.
- Pat dry your hands with a soft, clean towel or a disposable paper towel. Or you can let your hands air dry.
- Moisturize immediately. Keep your hands a little damp after pat-drying them and then apply a generous amount of moisturizer.
It’s best to get in the habit of applying and reapplying moisturizer regularly. This can help keep your hands hydrated throughout the day and protect the skin barrier. Place moisturizers around sinks in your home and carry a small tube with you wherever you go.
You may want to consider wearing cotton gloves after putting moisturizer on your hands. This may help protect your hands when cooking, folding laundry, or performing other household chores. Do not use latex gloves as these can cause allergies.
For people living with eczema, it is important to be knowledgeable about the pros and cons of soaps, moisturizers and hand sanitizers. This empowers you to make choices to reduce the risk of eczema flares and maintain good disease control.
Choosing the right soap for hand eczema
There is no specific eczema hand wash or soap. What works for one person with eczema may not work for another. Finding the right soap may involve a bit of trial and error. Here are some tips that may help guide your choices:
- Look for hand washes that are formulated for people with sensitive skin.
- Avoid fragrances or deodorants.
- Check the label for allergens.
- Look for dye-free cleansers.
- Avoid alkaline or other harsh soaps.
- Ask your dermatologist or healthcare provider for recommendations.
Should you use soap if you have eczema?
Keeping your hands clean is an important way to stay healthy and avoid infections. So, while frequent handwashing can lead to skin damage and exacerbate skin conditions like eczema, it is one of the most effective ways to prevent illness. However, soap is not necessary for good hand hygiene. You can use a “soap free” hand wash as they normally do not contain sodium lauryl sulfate, which can be an irritant.
Does antibacterial soap help eczema?
Many antibacterial soaps contain alcohol or other harsh ingredients. These ingredients may cause dry skin. And since dry skin is already an issue for people with eczema, avoiding cleansers which may worsen the issue is crucial. So, rather than using a harsh antibacterial soap, it is more important to use proper technique to wash away bacteria and other germs.
Which hand soap is best for eczema?
There is no “best” soap for people with eczema. And remember, soap is not actually needed as many soap-free hand washes are available which may be gentler on the skin.
Choosing the right hand sanitizer for eczema
Handwashing and the subsequent use of a moisturizer is recommended over hand sanitizers. But what if a hand sanitizer is the only option to ensure clean hands?
Hand sanitizer has become more common during the COVID-19 pandemic. It’s a quick alternative to washing hands with soap and water. But choosing a hand sanitizer that is both effective at killing germs while not causing eczema flare ups is important.
Let’s look at some tips for choosing the right one for you!
Is hand sanitizer safe for eczema?
Hand sanitizers act quickly to kill bacteria and germs on hands. They are safe for people with eczema as long as they apply moisturizer afterward.
When using hand sanitizer, be sure to check the label for the list of ingredients. The U.S. Food and Drug Administration (FDA) has not approved any hand sanitizers, so avoid brands that make this claim.
The American Academy of Dermatology suggest the following when using hand sanitizer:
- Use an alcohol-based hand sanitizer that contains 60% alcohol. Do not use hand sanitizer that contains methanol, which can irritate the skin.
- Make sure there is not dirt, food or other matter on your hands.
- Apply a dime-sized amount of hand sanitizer to your palm.
- Rub your hands together, covering surfaces.
- Apply moisturizer immediately after applying hand sanitizer.
Moisturizers do not interfere with the effectiveness of a hand sanitizer.
Do not wash your hands with soap after applying an alcohol-based hand sanitizer as this can cause irritation.
Can you use sanitizer if your hands are showing signs of an eczema flare?
You can use hand sanitizer if you are showing signs of an eczema flare, but make sure you are partnering that with a good moisturizer afterwards. If your skin is actually cracked, the alcohol in the hand sanitizer will be very painful, so you may be more comfortable with a gentle hand wash and moisturizer instead.
Are any alcohol-based hand sanitizers unsafe if you have eczema?
Alcohol-based hand sanitizers are the most effective and killing germs and they are safe for people with eczema. However, you should avoid products with fragrances, which is a common trigger for eczema. Also avoid products with glycolic acid and salicylic acid, which dry skin.
Is it unsafe to use non-alcohol based hand sanitizer for COVID-19?
According to the U.S. Centers for Disease Control and Prevention (CDC), the most effective hand sanitizers should contain at least 60% alcohol. If they do not contain at least 60% alcohol, they may be less effective in killing certain germs and they may only work to reduce germ growth rather than kill germs.
What do I do if I get a rash or other reaction to hand sanitizer?
If you develop a rash or other reaction to a hand sanitizer, the first step is to stop using it and wash your hands with a gentle hand wash.
Other tips include:
- Make note of the ingredients, to identify any potential allergens.
- Apply a moisturizer after your hands are washed and dry.
- Contact your healthcare provider for severe symptoms and discuss if steroid creams are an appropriate treatment.
Is there a hand sanitizer that doesn’t dry out your hands?
Since the CDC only advises the use of alcohol-based hand sanitizers as effective hand cleansers, there is not really one that won’t dry out your hands. In general, ethyl alcohol-based products are less drying than isopropyl alcohol-based ones.
Choosing the best moisturizer for hand eczema
With all this talk about handwashing, you may already feel your hands drying out. One of the most effective ways to prevent eczema flares, or handwashing-induced dermatitis, is through the use of a good moisturizer.
Let’s explore moisturizing ingredients.
What’s the difference between a cream, emollient, lotion, oil, and ointment as a hand moisturizer?
Walking down the skin care aisle at your local pharmacy or grocery store, you may feel overwhelmed with all the options and terminology. Let’s take a look at some of the common terms used in skin care.
Lotions – contain more water than oil, contain alcohol, and are thinner. As a result, they dissolve quickly, making them less effective. They are often best for people with normal or oily skin. Many doctors do not recommend lotions for people with eczema.
Creams– equal parts oil and water and are thicker than a lotion. They often come in a tube or jar as they are too thick for pumps. They also may contain heavier ingredients.
Ointments – contain 80% oil, 20% water. They are often greasy so some people prefer to apply them at night under a pair of cotton gloves.
Emollients – fats or oils used in skin care products that help soften the skin.
Oils – used in skin care products to help soften the skin. Used alone, they can be very greasy. Do not use olive oil as a moisturizer — this can ham the skin’s protective barrier.
What moisturizers are best for eczema?
Moisturizing your hands can help heal dry, cracked skin. It can also keep harmful bacteria and germs from entering your body and worsening eczema.
Similar to hand washes, there is no specific “best” moisturizer for eczema. Typically the creams and ointments with a higher oil or emollient ratio provide the best relief. It may be a bit of trial and error to find the product that works best for your skin.
Avoid products with fragrances or anything to which you are allergic. Speak with your dermatologist regarding products they recommend for patients.
Are there certain ingredients to look for in a moisturizer?
Look for an emollient based moisturizer that contains natural oils. If it feels greasy, that means it contains plenty of oil. The more oil it contains, the more likely it is to help with your eczema. Thicker ointments or creams tend to be better. Mineral oil and petroleum jelly may be helpful at night because they tend to work longer.
Natural oils that may be helpful for people with eczema:
• Sunflower oil
• Coconut oil
• Chamomile oil
• Jojoba oil
• Borage seed oil
• Shea butter
• Cocoa butter
Are hand creams good for hand eczema?
Hand creams contain plenty of mineral oils to seal in moisture, but less than ointments. If the greasy feel of ointment moisturizers bothers you, hand creams may be better a better choice.
Are lotions good for hand eczema?
Lotions tend to contain the least amount of mineral oil. Most of them are water-based which dissolves quickly, making them less effective. Many allergists and dermatologists do not recommend lotions for people with eczema.
What ingredients should you avoid in a moisturizer?
Do not use olive oil as a moisturizer. This can harm the skin’s protective barrier.
Avoid moisturizer products that contain fragrances, perfumes or dyes. Remember: just because a product says its unscented does not mean it does not contain fragrances. Check the product label to confirm what’s in the moisturizer.
Is a healthcare provider at higher risk for hand eczema?
Healthcare professionals are at higher risk for eczema flares due to the need to sanitize their hands often. In a 2021 study, healthcare workers with atopic dermatitis reported increased irritation, dryness and other skin issues due to frequent hand washing. The study was conducted at National Jewish Health in Denver during the COVID-19 pandemic.
Healthcare workers who need to wash hands frequently can wear cotton glove liners to help protect their hands. They can then wear washable plastic or vinyl gloves over the cotton gloves.
How can you treat a flare-up of your hand eczema?
Partner with your doctor, allergist, or dermatologist to develop a treatment plan for a flare up of eczema. Your healthcare provider may suggest over-the-counter products and prescription medications as treatments for eczema.
The keys to eczema treatment include:
- Know your triggers
- Develop a regular routine for cleansing and moisturizing
- Utilize over-the-counter and prescription medications as directed
- Watch for signs and symptoms of a skin infection
While hand hygiene is important to protect yourself from illness, there is no reason you can’t stay safe while managing your eczema.
Jacqueline Eghrari-Sabet, MD, FACAAI, is board-certified in allergy, immunology and pediatrics. She is the Medical Director of Telehealth for Allergy & Asthma Network. Dr. Eghrari-Sabet is the founder of Family Allergy & Asthma Care and the FAAR Institute in the Washington, DC area, where she has been in private practice since 1994. Dr. Eghrari-Sabet is Assistant Clinical Professor at George Washington University School of Medicine and Health Sciences where she mentors the next generation of doctors. She is also President of White Coat Resources, a health education consulting service.