Atopic Dermatitis Can Commonly Affect the Hands—Here's What to Watch Out For
Different seasons can bring their share of favorable—and less-than-favorable—changes: Autumn, for example, usually means cooler mornings and pumpkin spice everything; while spring means the return of green leaves and longer days. But one thing both seasons can bring? Atopic dermatitis—aka eczema—or those dry, itchy, irritated patches of skin that can show up on your body.
"[Eczema] usually flares during springtime and fall, when there's a lot of pollens in the air and when the weather changes a lot," David Kim, MD, a board-certified cosmetic dermatologist, tells Health. Essentially, the temperature and humidity changes (which can affect your skin's moisture content) and excessive plant pollen (which is an environmental irritant) create the perfect conditions for atopic dermatitis to strike.
While you can get eczema almost anywhere on your body, atopic dermatitis can commonly show up on a person's hands, says Dr. Kim. Here's everything you need to know about the frustrating eczema subtype—including how to treat it.
What is atopic dermatitis on hands?
Atopic dermatitis on the hands is essentially eczema that flares up on your hands, Dr. Kim says. Per the American Academy of Dermatology (AAD), it can cause patches of itchy, discolored, irritated skin on the hands. "It usually involves both hands," Dr. Kim says, and it typically gradually develops over a period of days and weeks.
Atopic dermatitis on the hands is one example of "hand eczema," an umbrella term often used to describe inflammatory skin conditions that affect the hands, according to an article in the New England Journal of Medicine. Another such skin condition is contact dermatitis, says Dr. Kim. This is a rash caused by a reaction to something you've touched that you're allergic or sensitive to, per the Mayo Clinic. Like atopic dermatitis, contact dermatitis creates incredibly itchy, red patches on the affected area such as the hands.
Unlike atopic dermatitis, however, contact dermatitis only affects the area that came in direct contact with the irritant, Dr. Kim says. For example, say you're allergic to nickel and your right hand brushes against or holds something with nickel in it. After about 48 hours, you might develop an intense, rapidly-spreading rash on just that hand. Contact dermatitis is also acute (meaning it's short-term), whereas atopic dermatitis is chronic and often flares up at specific times of the year, he adds.
Dyshidrotic eczema is another example of "hand eczema," Dendy Engelman, MD, FAAD, a board-certified dermatologist based in New York City, tells Health. Per the AAD, this type of eczema causes small, itchy blisters. "It's on the hands and feet and is worsened by water," says Dr. Engelman. These blisters can be triggered by heat, stress, or contact with irritants. People who have dyshidrotic eczema often also have atopic dermatitis, but not always.
What are the symptoms of atopic dermatitis on hands—and what does it look like?
Atopic dermatitis can easily be confused for other skin issues that affect the hands. But here are some of the symptoms that what you're dealing with is likely atopic dermatitis on your hands—including what the condition most commonly looks like.
- Extremely dry skin. In severe cases, the skin will get so dry that it starts to crack between the fingers, Dr. Kim says.
- Rashy, discolored patches on your hands. On lighter skin, this rash will look red; on darker skin tones, it might look darker brown, purple, or grey, per the National Eczema Association.
- Itchy, burning sensation. Itching really is the hallmark of atopic dermatitis no matter where it strikes, Emma Guttman-Yasky, MD, PhD, Waldman professor of dermatology and immunology and system chair department of dermatology at the Icahn School of Medicine at Mount Sinai, tells Health.
- Itchy blisters. This can happen in more severe cases of atopic dermatitis on the hands, says Dr. Kim. These blisters typically crop up along the fingers, he says.
As you can see, some of these symptoms overlap with two of the above-mentioned skin conditions. But here are some other hints that what you're dealing with might be true atopic dermatitis and not something else:
- You've previously been diagnosed with atopic dermatitis. "If you have a history of eczema, then you can develop eczema anywhere on your body," Dr. Kim says. (More on that shortly.)
- Your symptoms have gradually progressed. Unlike contact dermatitis—which flares up within 48 hours—atopic dermatitis tends to be a slow burn, says Dr. Kim. It often starts with extremely dry skin, per the AAD, before progressing to other symptoms.
- It's seasonal. As mentioned, atopic dermatitis often flares up in the spring and fall. If you're noticing that a hand rash develops or returns during these seasons, it may be atopic dermatitis.
What causes atopic dermatitis on the hands?
In general, atopic dermatitis is a complex disease influenced by a few factors, no matter where it flares up on your body. But put simply, "atopic dermatitis is an inflammation of the skin," says Dr. Kim. "It's a genetic condition in which people's skin has a higher propensity to get compromised and they get inflammation from irritants that are in our environment more easily."
Getting atopic dermatitis on your hands is common, Dr. Kim says, "because we wash our hands so much." Washing your hands isn't inherently bad, but lots of washing can dry out your skin, which weakens your skin barrier and make it easier for irritants to affect your skin. And if you have eczema—which means your skin barrier is already compromised—that can make your hands even more vulnerable to a flare-up.
What are treatment options for atopic dermatitis on hands—and how can you prevent it?
Atopic dermatitis, no matter where it strikes, can be an incredibly painful and frustrating condition. But thankfully, it's super treatable with the help of a good dermatologist.
Anti-inflammatory topical steroids are the gold standard of treating atopic dermatitis, especially when it flares up on your hands, say Drs. Kim and Engelman. These drugs help calm the flareup (and the associated symptoms like itching) within a few days. Dermatologists typically prescribe people with the most potent strength of topical steroid for hand eczema, adds Dr. Kim. That's because the skin on your hands (particularly your palms) is fairly thick, so they absorb less and thus there is less concern about side effects like skin thinning and stretch marks, he says. That said, topical steroids are still only meant to be used in the short term—around a week at a time before tapering off, Dr. Kim says—to avoid dependence or other more serious side effects.
Dr. Kim says that the fact that people use their hands constantly definitely poses a challenge to treatment. That's why he often tells patients to apply the steroid all over their hands at night, followed by a layer of occlusive Vaseline and then cotton gloves, before going to bed. This allows the steroids to work overnight while you're sleeping, with the Vaseline and gloves helping to lock in all the medication and prevent it from spreading all over your sheets.
If you prefer to avoid steroids, there are some alternative drugs available such as Elidel or Protopic. Your doctor also might prescribe these options if you have previously been on steroids for at least a month without much improvement or if you had a lot of side effects with steroids. Just know that they're not as effective or fast-acting as traditional steroids, says Dr. Engelman.
If you're prone to getting atopic dermatitis on your hands, there are a few things you can do to help minimize flare-ups. First of all, always moisturize after washing your hands, says Dr. Kim. (This helps lock in moisture and protect your skin barrier.) He also recommends avoiding soaps or hand sanitizers with fragrance or artificial colors, as these additives can be particularly irritating to people with eczema.
When in doubt, look for skin-care products with a National Eczema Association seal—these products have been proven to be free of fragrance and other ingredients, such as formaldehyde and retinol, which can irritate eczema-prone skin. Examples include Cetaphil Healing Ointment, Curel HydraTherapy Itch Defense Wet Skin Moisturizer, and CeraVe Daily Moisturizing Lotion. (You can search the full database of certified eczema-friendly products here.)
Since atopic dermatitis on the hands requires prescription treatment—and can potentially be confused with other types of skin conditions—it's best to talk to your doctor or a dermatologist ASAP if you notice it flaring up. "A lot of patients will wait until it gets really bad to come see us," says Dr. Kim. But there's no need to suffer from that unbearable dryness and itch alone. Let your doctor give you a hand in calming down that eczema.
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