If there’s one thing everyone is uniting over during this pandemic, it’s washing their hands. The constant 20 seconds under the water results in dryness for most of us but for some people, it can be even more serious. One of our follower’s and a doctor, Hena Haq, thinks that it can trigger for some people, a form of eczema called Irritant Contact Dermatitis (ICD). Scroll down to read more about it:
What is ICD?
It is a form of eczema that is characterised by red, dry, cracked, itchy and/or inflamed. The skin may blister or bleed and it can be quite painful. Due to the nature of presentation, it can sometimes be difficult to distinguish ICD from other forms of eczema or dermatitis. This is the type of eczema most people might see due to the excessive use of water, soap, hand sanitisers, alcohol, bleach and detergents during the pandemic of 2020.
Irritant Contact Dermatitis is what its name says. ‘Derma’, as in skin, and the suffix ‘itis’ as in inflammation: skin inflammation caused by substances that have come in contact with the skin. At times the exact irritant cannot be identified and people can have a combination of different types of dermatitis too. People who already have eczema, asthma, or hay fever in the family have a higher tendency to get hand dermatitis.
So if the problem is caused by stripping away oils, would the treatment be by just adding it back? In a way, yes. In essence, what you are trying to do with the treatment is to retain as much water and moisture as possible so that the skin can come back together to form its natural barrier, and heal. Other treatments like steroids may be added to decrease the inflammation/redness, and help in the repair and healing of skin.
The key to treat this form of eczema, and most other eczemas, is emollients. They work by creating a protective layer on top of your skin so as to trap water and prevent irritants from entering and damaging skin cells further. In doing this, emollients work to soothe and smooth the skin.
Different Types Of Emollients
Emollients can come in the form of lotions, creams, ointments, or even oils. Lotions and creams are usually less potent, but they work well particularly for areas with hair on them, and are better for daytime use in a hot climate. Whereas ointments and oils, due to the chemical makeup are quite thick, more effective at moisturising, and better in the winter or during the night.
Are All Hand Creams Effective? In short…No.
Lanolin, shea butter, cocoa butter are all examples of emollients that work but the problem we often encounter by buying high street moisturisers is that they are mixed with other products, which give fragrance to the product and can prove to be irritating. That’s why when looking for products to use for the treatment of eczema, look for those that have minimal ingredients added to it. Aveeno, E45, Cetaphil are all emollients that work well for most people.
When Should I Use Them?
As often as possible. Ideally 3-4 times a day and whenever the hands feel dry, such as after washing or bathing the skin which is when the skin needs most moisture. Emollients should be patted onto the skin in a thin layer and not rubbed in as commonly done with other moisturisers. They should be applied in the direction of the growth of the hair. Leave it on for ten minutes and allow for it to soak in.
Hand sanitisers are naturally drying as they all contain alcohol. Using them may irritate already present eczema but the use is important to help protect you from the virus. In this case, apply your usual emollients afterward to minimise the irritant effect.
World Health Organisation On Soap Substitutes
WHO recommends using soap and water to help break down the virus. Although Emollient Soap Substitutes exist, they are NOT considered to be effective in removing the virus and hence, should not be used primarily for washing. However, you can use these soap substitutes to rewash your hand after washing with soap and water to protect them. Soap substitutes do not foam up like normal soap. They are mixed with a little bit of water and then patted over the dry skin – do not rub them!
Prevent To Protect
In some cases, it may take 2-3months of treatment before clinical improvement is seen, which is why its so important to recognise and treat it early! Cotton-lined rubber or plastic gloves should be used as much as possible and removed frequently so as not to build up sweat which can in turn also aggravate existing dermatitis. Nitrile gloves are recommended if you have existing eczema.
Seeing A Doctor
If your symptoms do not seem to be getting better or are getting worse, consult your pharmacist or doctor. Your doctor may prescribe a steroid; the type depends upon the severity of your ICD. When using steroid creams, or any other treatments for your skin – wait at least 30 minutes after putting on your emollient to avoid dilution. By doing this, the treatment is absorbed to the areas that need treatment rather than spreading over healthy skin.
Health Risk Advice
- Paraffin-based emollients are flammable, so avoid open flames, cigarettes, birthday candles etc.
- People can still be allergic to emollients. If it is making your skin itchy, stop using it. Discuss it with your doctor and try another.
- Emollients can make surfaces slippery and so people should take extra care especially coming out of baths/showers.
- Aqueous creams are commonly thought to be effective at treating eczema but are no longer advised for treatment of contact dermatitis because of the high risk of developing other skin reactions. Always maintain appropriate hygiene by using clean applicators and not your fingers when using emollients from a pot or tub. This avoids contamination and reduces the risk of an infection.
- Like with all products, if you experience any burning, stinging, irritation, or rash, stop using it and consult a pharmacist or doctor. You may have to try a few different emollients to find the best one for your or your child’s skin.