What is irritant hand eczema?
Irritant hand eczema occurs when water, soap, solvents or other chemicals damage the skin surface faster than its repair mechanisms can restore it. It is not an allergic reaction, although allergy may later develop more easily through the damaged barrier. This form of hand eczema is extremely common.
What does it look like?
The backs of the hands are often affected first. Skin becomes red, rough and scaly, with painful fissures over the knuckles that may bleed. More extensive inflammation can cause oedema. Bacteria can enter broken skin and cause secondary infection, with worsening redness, soreness, crusting or discharge.
Who is at risk?
Frequent occupational exposure to water, soap, cleaning agents or solvents creates the greatest risk, including work in cleaning, healthcare and floristry. Severity depends on how long and how often contact occurs, the concentration and composition of the irritant, individual susceptibility to eczema and the season. Winter dryness commonly makes the problem worse.
Treatment and prevention
Reducing contact with irritants is essential but may be difficult at work. Substitute gentler products where possible and use task-appropriate protection without allowing moisture to remain trapped against the skin. A doctor may prescribe a topical corticosteroid for a severe flare. For long-term repair and prevention, apply a rich emollient several times daily, especially after handwashing.
Relationship to contact allergy
Allergens penetrate damaged skin more easily and can reach immune cells, increasing the chance of sensitisation. A new allergic contact eczema may then develop on top of the original irritant damage. Persistent disease may therefore require patch testing as well as review of exposures.
When to see a doctor
Seek care for deep fissures, bleeding, significant swelling, signs of infection or eczema that persists despite protection and emollients. Occupational symptoms need early review. A clinician can prescribe anti-inflammatory treatment and decide whether contact allergy testing or workplace adjustments are needed.