Dear Doctor
Only my right hand fingers are cracked always like that. I can’t be able to fold my fingers also. I have seen many doctors, but it is not cured.
Left hand is normal. Only right hand fingers cracked. Please give me a solution to this.
Dear Patient
This condition is known as occupational hand dermatitis or occupational hand eczema.
The fact that it only affects your right hand suggests that it is something that you are coming in contact with at your place of work assuming your right hand is the dominant one that you use to work.
Occupational Hand Dermatitis At Risk Occupations
Workers who are at risk for developing occupational hand eczema include cleaners, hair dressers, builders, cooks, nurses, laundry workers and mechanics.
Occupational Hand Dermatitis Causes
Substances that can cause occupational contact dermatitis include:
- Water
- Soaps and detergents
- Solvents like alcohol, turpentine and xylene as well as other industrial chemicals like degreasing agents and metalworking fluids.
- Cement
- Plants like ranunculus, anemone, clematis, hellebore and mustards.
- Cosmetics, skin care products, hair care products and fragrances
- Animal products
- Foods
- Metals like nickel and cobalt
- Additives used to make leather and rubber
Occupational Hand Dermatitis Symptoms
Symptoms of occupational hand dermatitis include developing an itchy or burning sensation on the skin of the hands when they come in contact with irritating substances.
This sensation is associated with erythematous (red) and hyperkeratotic (scaly) areas.
There may also be painful fissures or cracks which make it painfully difficult to use the hands or even fold them.
There may also be edema (swelling) on the affected areas.
Occupational Hand Dermatitis Treatment
The treatment of occupational hand dermatitis includes:
- Identify and Avoid the Irritating Substance
Identify the substance causing the skin reaction is the first step in treating occupational hand dermatitis. If you are not able to do it by yourself you can consult a dermatologist and have patch testing done.
After identifying avoid exposure to it by protecting your hands. For example you can wear cotton gloves inside vinyl gloves when working. You can also change your occupation as a last resort if you cannot avoid coming in contact with allergens in your line of work.
- Use Gentle Cleansers
Wash the hands with a gentle cleanser that does not contain harsh detergents like sodium lauryl sulphate. The cleanser should also be fragrance-free and dye-free. Mild skin cleansers like Aquanil and Cetaphil are good alternatives to soap.
- Use Effective Moisturizers
Moisturization is very important since it helps reduce the itching and scaling and makes the skin look and feel better. Therefore pat your hands dry and moisturize them immediately after washing them in order to lock the moisture into the damp skin.
You can use 100% pure petroleum jelly like Vaseline. You can also use bland barrier creams with dimethicone like Cetaphil or those which contain ceramide like Cerave to restore the epidermal barrier.
- Apply Topical Corticosteroids
Corticosteroids are applied on the skin are used to treat occupational hand eczema since they have anti-inflammatory properties. They also soothe the itching. Examples include amcinonide, fluocinolone and betamethasone (Diprosone).
- Systemic Antihistamines
Anthistamines that are taken by mouth are also used. Examples include the non-sedating fexofenadine (Allegra) and loratadine (Claritin) as well as the less sedating cetirizine (Zyrtec). The sedating diphenhydramine (Benadryl) and hydroxyzine (Atarax, Vistaril) are also used to reduce the itch if it disturbs sleep.
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