What is hairdresser’s eczema?
Hairdressers have a relatively high chance of developing eczema complaints on the hands. They use their hands all day, come into frequent contact with water and irritating substances, and use products known to be able to provoke allergic reactions. A large proportion of hairdressers (especially those doing women’s hair) regularly have hand eczema, or have had it in the past. In many cases the complaints are so severe that working is temporarily impossible, and very severe hand eczema sometimes forces someone to give up work as a hairdresser.
What causes hairdresser’s eczema?
Sometimes a single factor can be identified as the cause, but usually several factors play a role:
- Inherited predisposition. A large part of the population has an inborn tendency to develop eczema, called atopy. As children these people often have atopic (constitutional) eczema or asthma, and they can develop hand eczema more easily.
- Water contact. Frequent contact with water degreases the skin and slowly dries it out further. In dry, cracked skin, eczema can strike more easily, and the barrier function of the skin decreases, so irritating or allergy-causing substances can penetrate more easily and cause inflammation. Hairdressers work a lot with wet hair and liquids and are therefore at greater risk.
- Irritating substances. Many substances used in hairdressing can provoke skin irritation, particularly soap components, alcohol (in gels and lotions) and substances used to bleach hair (for example hydrogen peroxide).
- Allergy. Hairdressers come into daily contact with many substances that can in principle cause an allergic reaction. Some are very specific to the trade — components of dyes, bleaching agents and perming fluids. Other allergens are also common in the general population, such as fragrances and preservatives used in shampoos. Nickel allergy is common; there is always debate about how far nickel in scissors actually contributes to eczema, since only limited nickel is released from the metal, but hairdressers often have moist hands, which lets allergens make contact and penetrate more easily. To protect the skin, hairdressers sometimes wear latex gloves for certain tasks, but latex is itself an important potential allergen — it is better to wear plastic (vinyl) gloves. Gloves do not protect against all allergens, however, as some can penetrate through the glove.
What does it look like?
The eczema shows as redness of the skin with scaling and cracking. In acute eczema, blisters with wound fluid can also develop. There is always pain and itch, and with cracks even the simplest hairdressing tasks are painful.
How is hairdresser’s eczema treated?
Allergy testing. When someone working in hairdressing sees a dermatologist, testing usually begins alongside starting treatment. These are patch tests, in which the substances to be examined are applied to the back under special patches. Besides the European standard series (the substances Europeans are most often allergic to), the special hairdressing series is also tested, including agents such as ammonium persulfate, ammonium thioglycolate, cocamidopropyl betaine, glyceryl monothioglycolate, para-aminophenol, para-phenylenediamine (PPD), para-toluenediamine, pyrogallol and resorcinol.
Treatment. For severe eczema the dermatologist will usually advise temporarily stopping hairdressing work. A corticosteroid ointment is usually prescribed, together with a moisturising cream or ointment for the hands to calm the skin, and sometimes a course of antibiotics if a bacterial infection is suspected. For very severe eczema, a short “burst” of prednisone is sometimes prescribed at the start of treatment to suppress the inflammation as quickly as possible. For chronic eczema, UVB light therapy can also be prescribed.
The long term
Hairdressers with hand eczema often have regular relapses. To limit these as much as possible, avoiding substances you are allergic to is essential, and the hands must be protected from the irritating effects of water, soaps and chemicals, for example with gloves, while limiting the skin’s exposure to water and liquid hairdressing products. With such measures and good guidance from the dermatologist it is often possible to control the eczema enough to continue working, especially when the cause is skin irritation. When an allergy to one of the specific hairdressing products is the main cause, avoiding the allergen is often not easy if colleagues keep working with products containing it, since spray and spread through the workplace make these products hard to avoid. People with a history of eczema and/or an atopic predisposition who are considering training as a hairdresser should bear in mind that they have a greater chance of developing hairdresser’s eczema later, and it is wise to weigh such risks in their career choice.
When to see a doctor
See a doctor if you work with your hands and develop red, scaly, cracked or blistering hand eczema, so that patch testing can identify any allergens and treatment plus skin-protection measures can keep you working where possible.