Atopic Dermatitis Can Commonly Affect the Hands—Here's What To Look 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. You may also notice changes in your skin when the seasons change.

"[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, told Health.

Atopic dermatitis—aka eczema—is a skin condition that causes dry, itchy, irritated patches of skin that can show up on your body—including your hands.

Here's everything you need to know about the frustrating eczema subtype—including how to treat it.

Other Types of Hand Eczema

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. Here's a breakdown of two other types of eczema that can show up on the hands.

Contact Dermatitis

Another such skin condition is contact dermatitis. This is a rash caused by a reaction to something you've touched that you're allergic to or sensitive to. 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. For example, say you're allergic to nickel and your right-hand brushes against or holds something with nickel in it. You might develop an intense, rapidly-spreading rash on just that hand.

Contact dermatitis can be acute, or short-term, or it can be chronic when the allergen remains in your environment. Atopic dermatitis, on the other hand, is chronic, or long-term, and often flares up at specific times of the year.

Dyshidrotic Eczema

Dyshidrotic eczema is another example of "hand eczema," Dendy Engelman, MD, FAAD, a board-certified dermatologist based in New York City, told Health. This type of eczema causes small, itchy blisters. "It's on the hands and feet and is worsened by water," said Dr. Engelman.

These blisters can be triggered by:

• Heat
• Stress
• Rising temperatures
• Contact with irritants (like personal care products, nickel, or cobalt)

You are more at risk for developing dyshidrotic eczema if you have other types of eczema, especially atopic dermatitis.

Symptoms of Atopic Dermatitis on the Hands and Fingers

Atopic dermatitis can easily be confused with other skin issues that affect the hands. Here are some of the symptoms of 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 and bleed.
• 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.
• Itchy, burning sensation: Itching really is the hallmark of atopic dermatitis no matter where it strikes.
• Itchy blisters: This can happen in more severe cases of atopic dermatitis on the hands, said Dr. Kim, adding that the blisters typically crop up along the fingers.

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. These factors can include:

• Family history of atopic dermatitis, food allergies, asthma, or hay fever
• Your immune system
• Where you live
• Your environment
• Exposure to stress, pollution, and tobacco smoke

Genetics plays a big role in the cause of atopic dermatitis because the condition causes gaps in the outer layer of the skin. This condition can be inherited in your genes.

Getting atopic dermatitis on your hands is common, said Dr. Kim, "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.

Treatments for Atopic Dermatitis on Hands

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.

Use Topical Steroids

Anti-inflammatory topical steroids are the gold standard for treating atopic dermatitis, especially when it flares up on your hands, said both Dr. Kim and Dr. Engelman. These drugs help calm the flare-up and the itching.

Dermatologists typically prescribe people with the most potent strength of topical steroids for hand eczema, added 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, said Dr. Kim.

That said, topical steroids are still only meant to be used in the short term—around a week at a time before tapering off, said Dr. Kim—to avoid dependence or other more serious side effects.

Add Petroleum Jelly at Night

Dr. Kim said that the fact that people use their hands constantly definitely poses a challenge to treatment. That's why Dr. Kim often tells patients to apply the steroid all over their hands at night, followed by a layer of occlusive Vaseline or petroleum jelly and then cotton gloves, before going to bed.

This allows the steroids to work overnight while you're sleeping, with the petroleum jelly and gloves helping to lock in all the medication and prevent it from spreading all over your sheets.

Phototherapy

If you are experiencing atopic dermatitis on not only your hands, but also on various parts of your body, then creams or ointments may not be the best treatment since it's widespread.

Phototherapy uses ultraviolet A or B light waves to treat symptoms of atopic dermatitis. This type of treatment is best for people who have severe rashes all over their body and if their symptoms aren't responding to creams or ointments.

Try Other Medications

If you prefer to avoid steroids, or corticosteroids aren't a good option for you, there are some alternative medications available such as:

• Topical calcineurin inhibitor (TCI)
• Crisaborole ointment
• Ruxolitinib cream
• Coal tar
• Biologics (an injection)
• JAK (janus kinase) inhibitors
• Methotrexate

A healthcare provider also might prescribe these options if you have previously been on steroids without much improvement or if you had a lot of side effects with steroids.

See a Healthcare Provider ASAP

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 a healthcare provider or a dermatologist ASAP if you notice symptoms.

"A lot of patients will wait until it gets really bad to come see us," said Dr. Kim. But there's no need to endure that unbearable dryness and itch alone. Let a healthcare provider give you a hand in calming down that eczema.

How To Prevent Atopic Dermatitis on Your Hands

If you're prone to getting atopic dermatitis on your hands, there are a few things you can do to help minimize flare-ups.

Moisturize Your Skin

Always moisturize after washing your hands, said Dr. Kim. This helps lock in moisture and protect your skin barrier. Dr. Kim also recommended avoiding soaps or hand sanitizers with fragrances or artificial colors, as these additives can be particularly irritating to people with eczema.

Avoid Your Triggers

You should also try to avoid anything that triggers your symptoms. If your atopic dermatitis is caused by an allergen—such as latex or fragrance—you can find ways to avoid the trigger. Some people, like plumbers, nurses, and hair stylists, work in an environment where their hands are constantly getting wet. If this is you, think about wearing gloves or taking a break from work to let your hands heal.

You can work with a dermatologist to identify your triggers which can help you minimize your exposure to those triggers.

Use Products That Have a National Eczema Association Seal

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.

You can also search the association's database of eczema-friendly products.

Living With Atopic Dermatitis

Since atopic dermatitis is a chronic condition, you may have to make some adjustments to manage it. Atopic dermatitis, especially when on your hands, can make it challenging to work or do everyday activities.

Here are two tips that can improve your overall well-being for living with atopic dermatitis.

Practice Good Skincare

Caring for your skin is important to prevent flares. When you bathe, make sure the water is lukewarm, and use a mild, unscented bar soap. After bathing, dry your skin by patting it dry and moisturizing it shortly after your skin is dry. You want to make sure to lock in moisture to prevent your skin from getting dry.

Manage Your Stress

Managing your levels of stress can be beneficial to not only your mental health but also to your symptoms. You can try different stress management and relaxation techniques. If you are finding it difficult to manage your stress, reach out to a mental health professional who can help you find ways to reduce your stress. You can also seek support from friends, family, and support groups.

A Quick Review

Atopic dermatitis, also called eczema, causes itching, dry, and painful skin rashes that can develop anywhere on the body—including your hands. Hand eczema can make it difficult for someone to work and accomplish everyday activities.

Hand eczema can be caused by constantly exposing your hands to water, genetics, or other triggers. Treatment can include corticosteroids, moisturizers, and other creams. Although atopic dermatitis can be painful and bothersome, treatment and preventative measures can help. Talk to a dermatologist or healthcare provider if you're experiencing symptoms of atopic dermatitis.