Why do I need to care for my hands?

Our hands come into contact with many substances which may irritate the skin on a daily basis. These include household detergents and cleaning products; personal cleansers including soaps, shampoos and wet wipes; food components such as fruit acids and plant chemicals and even plain water. These substances can strip the skin of the protective oils that keeps it moist and hydrated, leading to appearance of cracks, soreness, dryness, and inflammation. Frequent contact with water is one of the most common causes of skin irritation. Once the skin on the hands is damaged, it is prone to more damage and irritation, leading to inflammation or worsening of existing skin conditions on the hands (irritant contact dermatitis).

Will taking good care of my hands cure my skin condition?

No, but taking good care of your hands will help repair the skin and reduce damage. Good hand care  reduces the chance of skin conditions of the hands coming back and flaring frequently.

What are emollients and how do they work?

Emollients (or moisturisers) are substances, in the form of creams, lotions, or ointments, that are used to moisturise and soften the skin. They are an important part of skincare and can be especially helpful for individuals with dry, sensitive or damaged skin. Emollients smooth and hydrate the skin and form an artificial skin barrier. This helps lock moisture in the skin and keep it hydrated. The effects of emollients may only last a few hours, so they need to be reapplied several times a day.  There are many different types of emollients, and so it is important to find ones that suit you and are practical for your daily routine.

How should I apply emollients (moisturisers)?

You should apply emollients several times daily, whenever the skin feels dry and after every hand wash. This usually means keeping a supply at work, school, or at home. Good times to apply emollients on your skin are after a shower or bath, or when you are not using your hands (for example, relaxing, sleeping or watching TV). Cotton gloves can be worn at night after applying the emollient to keep the moisturiser on your skin . You may prefer to use a cream rather than an ointment during the day as these are less greasy. If your emollient is in a tub rather than a pump dispenser, it is best to scoop the ointment with a clean spoon or similar, to prevent introducing infection into the tub.

In people with inflamed skin such as eczema or psoriasis who use steroid ointments or other prescription treatments, they should be applied either 20 minutes before emollients, or 20 minutes afterwards (there is no evidence that one is better than the other). . Topical steroids should not be used to moisturise dry skin – they should only be used only as prescribed by a healthcare professional.

What are the side effects of emollients?

It is very uncommon for emollients to cause side effects. If the hands are cracked and sore, emollients can occasionally sting. Greasy emollients can also warm the skin which can increase itch This does not mean you have an allergy, and the stinging usually settles as the health of the skin on your hands improves.

Only very rarely do people become allergic to the ingredients in an emollient. It is much more common for people to find certain ingredients irritating to their skin. Paraffin-based emollients rarely cause allergy and are the best choice if you are worried that your emollients might be worsening your dermatitis.

Is there anything I should do or avoid whilst applying emollients?

Pure petroleum emollients are flammable and should never be used near a naked flame. Non-paraffin-based emollients may  aid the spread of fire if they have a high oil content, so caution is advised with all topical treatments. Your hands may be slippery after applying a greasy emollient, so allow time for them to soak in before driving or operating machinery. If you are doing paperwork you may prefer to use a less greasy cream or gel emollient. Pots of emollient should not be shared with other people.

How should I wash my hands?

Use warm water and a soap substitute. Your leave-on emollient can also be used as a soap substitute. If your hands are dirty, use a non-perfumed soap applied sparingly then rinse thoroughly. Remove rings if possible before washing your hands to avoid getting soap and emollient trapped underneath.

After washing, pat dry your hands carefully with a clean towel or paper towels, if possible, especially between the fingers, then apply your emollient.

Is there anything I can do to avoid or reduce the frequency of flares of skin inflammation on the hands?

• Avoid skin contact with detergents, cleaning chemicals and laundry detergent as they will all irritate your skin. Always wear gloves when in contact with these chemicals.
• Ask others for help with housework and gardening, if possible, to give your hands a chance to rest. Consider using washing machines and dishwashers where possible.
• Foods can irritate the surface of the skin so consider wearing gloves, or using food processors, when preparing foods including potatoes, tomatoes, citrus fruits, garlic or chillies.
• Don’t get liquid soap or shampoo on your hands. Use disposable nitrile gloves when you wash your hair or children’s hair. Do not apply hair lotion, hair cream or especially hair dye with your bare hands.
• If possible, rings should not be worn for work or housework until the skin has been clear for three months. Keep the inside of rings clean by washing them under running water.
• Wear gloves for messy tasks involving domestic and gardening work and occupation exposure to chemicals, oil and grease as well as most decorating chemicals. Do not use harsh cleaners or wire wool on the skin of your hands as they are very irritating to the skin. Fibreglass, plasterboard and cement are also highly irritant.

Health care workers should have a personal supply of emollient to wash their hands at work. If hands are not visibly dirty or soiled with blood or other body fluids, alcohol rubs can be used for decontamination, but this is not sufficient against Norovirus, COVID-19, or many gastrointestinal infections. Always follow the infection control and hand hygiene guidelines in your own workplace. Sometimes, alcohol rubs can sting, but this is not a sign of allergy. They are actually less irritating to the skin than washing with soap and water.

When should I wear gloves?

Use protective gloves for wet work and when handling chemicals or potentially infectious material. Wear gloves for as short a time as possible, ideally not more than 20 minutes, because sweating can make the damaged and inflamed skin worse. Make sure that your gloves are clean, dry and do not have holes. Use PVC or disposable nitrile gloves if possible as these are less likely than latex gloves to cause allergies. Use cotton lined gloves or separate cotton inner gloves to reduce sweating.

Clean the inside of multi-use gloves by turning them inside out and rinsing with warm water at least several times a week.

Replace worn out gloves immediately. Remove and replace gloves if they get wet inside.

Wear warm fabric gloves in cold weather to protect skin against the drying effects of cold air.

Where can I find more information?

Patient support groups providing information:

National Eczema Society

11 Murray Street

London NW1 9RE

Web: www.eczema.org

Tel: 0800 448 0818

Eczema Outreach Support
Bryerton House

129 High Street

Linlithgow EH49 7EJ
Web: https://eos.org.uk/

Tel: 01506 840395

 Weblinks to other relevant resources:

https://www.aad.org/public/everyday-care/skin-care-basics/care/skin-care-tips-hands

Jargon Buster: https://www.skinhealthinfo.org.uk/support-resources/jargon-buster/

Please note that the British Association of Dermatologists (BAD) provides web links to additional resources to help people access a range of information about their treatment or skin condition. The views expressed in these external resources may not be shared by the BAD or its members. The BAD has no control of and does not endorse the content of external links.

This leaflet aims to provide accurate information about the subject and is a consensus of the views held by representatives of the British Association of Dermatologists; individual patient circumstances may differ, which might alter both the advice and course of therapy given to you by your doctor.

This leaflet has been assessed for readability by the British Association of Dermatologists’ Patient Information Lay Review Panel

BRITISH ASSOCIATION OF DERMATOLOGISTS PATIENT INFORMATION LEAFLET
PRODUCED | JANUARY 2016
UPDATED | SEPTEMBER 2019, NOVEMBER 2023
NEXT REVIEW DATE | NOVEMBER 2026