Inspired by Patient Encounters

By: Jenna Trubschenck, M.S. PA-C

Rough hands

The other day I had a patient come into the office stating that he thought he had herpes on his hand. He had no history of cold sores or genital lesions. He has no known exposure to the herpes virus. He also said he washes his hands “more than he probably should” throughout the day.

Herpes infection can occur on the hands (although this is rare) and needs to be identified when it happens. But I was able to assure this particular patient that what he was dealing with was no more than a case of severe hand eczema.

Hand eczema is very common and can be a recurrent problem. It can have many different causes. The most common is irritant hand eczema induced by:
– Chemical exposure: solvents, detergents, alkalis and acids
– Friction
– Weather: cold air and low humidity
– Allergens, which can include anything, but commonly can be attributed to latex, rubber additives, preservatives, fragrances, acrylics on nails, or nickel
– Sweaty palms

Some people, even if they are compliant with all the appropriate treatment and care measures, are more prone to hand eczema because they are susceptible to atopic dermatitis due to allergies or heredity.

Hand eczema can vary in presentation. You may find:
– Scaling skin
– Cracked skin
– Rash
– Itching
– Blisters
– Tenderness

The best way to deal with hand eczema if it is secondary to irritant hand eczema is to remove the exposure or irritant. If the culprit is hand washing frequency, please continue to wash your hands for hygiene purposes, but not excessively. Use moisturizing soaps (not antibacterial — any soap will get rid of all the bacteria if you wash for 20 seconds) and make sure to moisturize after using soaps. Doing too many dishes? Use dish gloves to protect your hands.

If you can’t get control over your hand eczema with the appropriate care, it is probably time to visit us at SBC for an evaluation (to confirm it is hand eczema) and treatment plan.

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