Definition
What is Hand eczema?
Hand eczema is an inflammatory skin condition of the hands marked by dryness, redness, scaling, cracks, itching and sometimes small fluid-filled blisters. It's one of the most common skin problems in adults and tops the list of occupational skin diseases. The skin on your hands is a shield that constantly faces water, cleaning products, chemicals and friction; when this shield wears down, eczema begins.
There are two main mechanisms. Irritant contact dermatitis is the most common type: water, soap, detergents, solvents, oil, metal dust and friction directly wear down the barrier. What scientific literature calls 'wet work', meaning hands in water for more than 2 hours a day, wearing waterproof gloves for the same amount of time or washing your hands more than 20 times per shift, is the main cause of this condition. Allergic contact dermatitis, on the other hand, is when the immune system develops an allergy to a specific substance: chromium in cement in construction, epoxy resins, rubber glove additives, nickel and cobalt in metalwork, and dyes and preservatives for barbers and hairdressers are common culprits. Men with a history of atopic dermatitis have a higher risk of hand eczema.
Although hand eczema is slightly more common in women in the general population, many male-dominated jobs carry serious risk: construction workers and tile setters, painters, concrete workers, auto mechanics, machine operators, cooks and kitchen staff, cleaning staff, healthcare workers and barbers. A study of occupational skin disease in the construction industry in Germany found notably high rates among tile and mosaic workers, with chromium in cement standing out as the most important allergen. Hand eczema isn't just a skin problem; it can affect your ability to work, workplace safety and even whether you can stay in your trade. When it's caught early and properly protected against, it can often be kept from becoming permanent.
Check yourself
How do you spot it?
- ✓Dryness, tightness and scaling on the backs of the fingers, the knuckles and the backs of the hands
- ✓Deep, painful, bleeding cracks on the fingertips and palms
- ✓Redness, burning and itching that gets worse especially in the evening
- ✓Small, itchy, fluid-filled blisters on the sides of the fingers and the palms
- ✓Thickened, hardened skin when it lasts a long time
- ✓A rash concentrated under rings, watch straps or along glove edges
- ✓Improvement on weekends and vacations, then worsening when you return to work
- ✓Swelling around the nails and ridges in the nails
- ✓Oozing, yellow-crusted or painful areas (possible signs of infection)
Why it happens
Main causes
01
Wet work and frequent handwashing
In jobs like kitchen work, cleaning, healthcare and barbering, hands are washed dozens of times a day or stay in water for hours. Water alone strains the barrier; together with detergent and soap, the effect multiplies.
02
Cement, mortar and construction materials
Wet cement is alkaline and wears down the skin, and the chromium it contains is one of the most common allergens. A study in the construction industry found that chromium was responsible for about half of occupational allergies, followed by epoxy resin and cobalt.
03
Oils, solvents and metalworking fluids
Auto mechanics and machine operators come into contact with motor oil, grease, paint thinner and cutting fluids. These substances dissolve the skin's oils, and the abrasive hand cleaners used afterward wear the barrier down even further.
04
Gloves and sweat inside gloves
Gloves are protective, but when worn for a long time, sweat that builds up inside softens the skin. Some additives in rubber gloves can also cause allergies.
05
Atopic tendency
Men who had eczema as children have a significantly higher risk of hand eczema. They need to be especially careful about protecting their hands when choosing a job and while working.
06
Cold weather and dry environments
Working outdoors in winter, cold and wind dry out the barrier and cracks get deeper. Indoor spaces with central heating can also dry out your hands overnight.
In daily life
Triggers that cause flare-ups
Medical approach
Treatment options
01
Protection and reducing exposure
In guidelines, the first step in managing hand eczema is reducing contact with irritants and allergens. Protective gloves suited to the job, limiting time spent on wet work and skin protection training at work are essential parts of treatment.
02
Regular moisturizing
Fragrance-free, rich, barrier-repairing hand creams should be used regularly during the day and especially after your shift. In a one-year study of healthcare workers, a program encouraging cream use led to a measurable reduction in the severity of hand dermatitis.
03
Topical corticosteroids and anti-inflammatory creams
During flares, your dermatologist may prescribe corticosteroid creams or non-steroidal anti-inflammatory creams to calm the inflammation. Because the palms are thick, creams of different strengths may be needed; your doctor will set how long to use them.
04
Patch testing
If your hand eczema is stubborn or seems linked to a specific job, your dermatologist may do a patch test to find out whether there's an allergic cause. If an allergy to cement, rubber, metal or a preservative is found, avoiding that substance becomes the most important part of treatment.
05
Advanced treatments for chronic and severe hand eczema
For chronic hand eczema that doesn't respond to creams, your doctor may consider light therapy, oral retinoid-type medications, immune-modulating treatments or newer targeted medications.
06
Occupational evaluation
If your hand eczema seems work-related, it's important for your dermatologist to evaluate it together with your occupational health physician. Protective measures, changing materials or, if needed, adjusting your duties can help you stay in your job.
Did you know? · Hand eczema
14.5% · A meta-analysis of the general population found a lifetime prevalence of hand eczema of 14.5% and a one-year prevalence of 9.1%.
Step by step
Care routine for Hand eczema
4 steps
- 01
Pre-work barrier cream
Before starting work, apply a fast-absorbing, fragrance-free protective cream to your hands; don't forget between your fingers and around your nails.
- 02
The right gloves
Choose gloves suited to your job: nitrile for cement and chemicals, lined gloves for heavy work. If you'll be wearing them for a long time, put a thin cotton liner glove underneath.
- 03
Gloves on dry hands
Always put gloves on completely dry, clean hands. Change gloves that get wet or sweaty inside.
- 04
Take off accessories
Take off rings and your watch for wet work; moisture and detergent trapped underneath trigger eczema.
Caution
What to avoid, and when to see a doctor?
Avoid these
- ✕Touching wet cement and mortar with bare hands
- ✕Cleaning your hands with paint thinner, gasoline or solvents
- ✕Putting wet or sweaty gloves back on
- ✕Putting alcohol-based sanitizer on cracked hands and then skipping cream
- ✕Doing wet work while wearing rings and a watch
- ✕Thinking hand cream after work is 'unnecessary'
- ✕Using a prescription steroid cream for months without asking your doctor
- ✕Continuing to work with painful cracks without treatment
See a dermatologist
- →If eczema on your hands doesn't improve within two to three weeks
- →If cracks are bleeding and making it hard to do your job
- →If there are signs of infection like oozing, yellow crusts, pain and swelling
- →If it seems linked to a specific job or material (for patch testing)
- →If it improves on weekends and vacations and gets worse when you return to work
- →If your nails have started to change shape and there's swelling around them
- →If the eczema is spreading to your arms, face or other parts of your body
Common misconceptions
Myth or fact?
✕Common belief
If I wear gloves, my hands are always protected.
✓Fact
Gloves are very important, but used incorrectly they can make the problem worse. Sweat that builds up inside closed gloves worn for long periods softens and wears down the barrier, and rubber additives can cause allergies. You need the right gloves, dry hands, a cotton liner if needed and regular changes.
✕Common belief
A man who does hard work is supposed to have cracked hands; that's normal.
✓Fact
Hands that crack, bleed and itch aren't 'normal'; they're a sign of a treatable skin disease. If you don't take steps early, eczema can become chronic and seriously affect your ability to work.
✕Common belief
If I wash more often with a stronger cleanser, my hands will stay clean and the eczema will go away.
✓Fact
Frequent, harsh cleaning is one of the most important causes of hand eczema. Choosing the gentlest cleanser that still removes the dirt and moisturizing afterward protects the barrier.
Popular searches
Most asked about Hand eczema
Your questions
Frequently asked questions
01Why does cement cause sores on your hands?+
Wet cement is a strongly alkaline substance and can wear away the skin's protective layer, causing irritation and even burn-like sores. The chromium it contains is also a common allergen. For construction workers, bare-hand contact with cement is one of the main causes of hand eczema; proper nitrile gloves and after-work care significantly reduce this risk.
02I have to wash my hands often. How do I protect them?+
Use lukewarm water and a soap-free, low-pH cleanser; avoid hot water and harsh soaps. Pat your hands thoroughly dry and apply a small amount of hand cream at every chance you get during the day. Use a richer cream at the end of your shift and before bed. On intact skin, alcohol-based hand sanitizers are sometimes less irritating than washing with soap, but they can sting on cracked skin.
03My hands itch when I wear gloves. Is it an allergy?+
There are two possibilities: sweat building up inside the glove softening and irritating your skin, or an allergy to rubber additives in the glove. If a cotton liner glove doesn't help and the itching matches the glove's outline, your dermatologist can check for an allergy with a patch test. If an allergy is found, switching to gloves made of a different material is often enough.
04Is hand eczema contagious?+
No. Hand eczema is not an infection; it doesn't spread through touch or by sharing items. However, bacteria can get into cracked and open areas, so you should see a doctor about areas that ooze, form yellow crusts or hurt.
05What should I look for in a hand cream?+
Fragrance-free, dye-free creams with barrier ingredients like ceramides and glycerin are a good foundation; formulas with prebiotic ingredients may help support microbiome balance. A practical solution is using a fast-absorbing, non-sticky cream during work and a richer cream in the evening and at night.
06Will I have to quit my job because of hand eczema?+
Usually not. With early diagnosis, the right gloves, changes in materials, regular care and the treatment your dermatologist recommends, many people can keep working. If it's severe or stubborn, it's important for your dermatologist and occupational health physician to evaluate it together and, if needed, adjust your duties.
Scientific basis
Sources
- 01Prevalence, incidence, and severity of hand eczema in the general population - A systematic review and meta-analysis.
Quaade AS, Simonsen AB, Halling AS, Thyssen JP, Johansen JD · Contact Dermatitis · 2021 · doi:10.1111/cod.13804
In the general population, the lifetime prevalence of hand eczema was 14.5%, the one-year prevalence 9.1% and the point prevalence 4.0%.
- 02Guidelines for diagnosis, prevention, and treatment of hand eczema.
Thyssen JP, Schuttelaar MLA, Alfonso JH, Andersen KE, Angelova-Fischer I, et al. · Contact Dermatitis · 2022 · doi:10.1111/cod.14035
The European guideline recommended reducing exposure, protective measures, moisturizing, patch testing and stepwise treatment for hand eczema.
- 03Hand eczema: epidemiology, prognosis and prevention.
Agner T, Elsner P · J Eur Acad Dermatol Venereol · 2020 · doi:10.1111/jdv.16061
A review evaluating the prevalence of hand eczema, its tendency to become chronic, occupational risk factors and prevention strategies.
- 04Occupational skin disease in the construction industry.
Bock M, Schmidt A, Bruckner T, Diepgen TL · Br J Dermatol · 2003 · doi:10.1111/j.1365-2133.2003.05748.x
In the construction industry, the highest rate of occupational skin disease was seen in tile and mosaic workers; chromium in cement was responsible for about half of occupational allergies.
- 05Wet-work Exposure: A Main Risk Factor for Occupational Hand Dermatitis.
Behroozy A, Keegel TG · Saf Health Work · 2014 · doi:10.1016/j.shaw.2014.08.001
Defined wet work as contact with water for more than 2 hours a day, wearing waterproof gloves for the same amount of time or washing hands more than 20 times per shift, and assessed it as the main risk factor for occupational hand dermatitis.
- 06Staphylococcus aureus and hand eczema severity.
Haslund P, Bangsgaard N, Jarløv JO, Skov L, Skov R, Agner T · Br J Dermatol · 2009 · doi:10.1111/j.1365-2133.2009.09353.x
A harmful, inflammation-linked bacterium was found on the hands of almost half of hand eczema patients, and its presence was significantly associated with eczema severity.
- 07Effectiveness of a skin care programme for the prevention of contact dermatitis in healthcare workers (the Healthy Hands Project): A single-centre, cluster randomized controlled trial.
Soltanipoor M, Kezic S, Sluiter JK, de Wit F, Bosma AL, et al. · Contact Dermatitis · 2019 · doi:10.1111/cod.13214
In healthcare workers, a one-year program encouraging cream use led to a relatively greater reduction in the severity of hand dermatitis; the effect was more noticeable in mild cases.
- 08The human skin microbiome.
Byrd AL, Belkaid Y, Segre JA · Nat Rev Microbiol · 2018 · doi:10.1038/nrmicro.2017.157
A key review summarizing how the skin microbiome interacts with the barrier and the immune system and its role in inflammatory skin diseases.
- 09pH in nature, humans and skin.
Proksch E · J Dermatol · 2018 · doi:10.1111/1346-8138.14489
A review explaining the importance of the skin's acidic pH for barrier repair and the microbiome, and how alkaline cleansers can disrupt this balance.
