The characters on the HBO series Game of Thrones are not the only ones who dread the Winter. Your hands also may be gearing up for the insult of the harsh Winter weather. Hand eczema (an irritation rash) is a very common skin condition that is aggravated by dry, cold, irritating environments. The word eczema refers to dehydrated, rough and inflamed skin. While young children and some adults have chronic eczema conditions year round, a subset of people develop hand eczema in the right environment. Signs and symptoms of hand eczema include itch, superficial small itchy bumps under the skin, dryness, cracks and fissures, and possibly pain or soreness. Secondary skin infections of the affected skin are also possible if the skin barrier is compromised enough.
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Here are some things that you should know and can do to help protect your hands this cold season:
1. Avoid over-washing your hands with oil-stripping soaps, cleaning wipes, and alcohol-based hand sanitizers. Liquid soaps can be more moisturizing and hydrating over bar soaps.
2. If frequent hand cleaning is necessary at home or work, hydrate the hands immediately afterwards with a good topical moisturizer or hand cream.
3. Good hand moisturizers typically have good hydrators that protect the skin barrier and minimize water loss ( ceramides, urea, or soothing oatmeal). Examples of brands with these ingredients include Eucerin Smooth Repair, Cetaphil, Aveeno, and Cerave. Heavy creams and ointments will provide more hydration to protect the skin barrier than lotion-based moisturizers.
4. Protect your hands with cloth-lined gloves in dry, windy, cold weather. If possible, avoid wool-lined gloves since these can promote hand dehydration and itch.
5. Purchase an over-the-counter hydrocortisone 1% cream if hands remain itchy even with good moisturization. While this is a very mild topical steroid, there are minimal corticosteroid-related side effects from using it for the season. If this does not help, you may need a prescription-strength topical corticosteroid to treat hand inflammation, irritation, and itch.
Mimics of common hand eczema include allergic contact dermatitis and psoriasis. If diligent moisturization and avoidance of aggravators does not improve the quality of your hands, please consult a health care provider to better confirm the diagnosis or prescribe needed anti-inflammatories and/or antibiotics.