Hand Eczema Dos and Don'ts for Cleansing

When living with eczema, keeping your hands clean is an important part of staying healthy and preventing infection at all times — but that’s especially true given the current pandemic. The Centers for Disease Control and Prevention (CDC) recommends that you wash or sanitize your hands frequently to help protect yourself and others from being infected with the novel coronavirus that causes COVID-19 illness.

Yet for people with the chronic, inflammatory skin condition known as eczema — frequent hand cleaning can dry out and irritate skin. That can lead to flare-ups of itchy, rashy, scaly skin, as the National Eczema Association (NEA) explains. About 10 percent of the U.S. population has hand dermatitis, or hand eczema. Symptoms include dry, flaking, peeling, cracked, blistered, and itchy hands. It can be triggered by allergens and irritating chemicals.

Seemal Desai, MD, a dermatologist in Plano, Texas, is familiar with this conundrum both as a healthcare provider and a person with eczema on his hands. He must keep his hands clean in the course of treating patients, as well as putting on fresh gloves with each one. “I am cleansing and washing constantly,” says Dr. Desai, who is a past president of the Skin of Color Society (SOCS). “You can’t put moisturizer on because you’re going to have to wash your hands in the next few minutes. So it makes things more difficult.”

Still, there are things you can do to balance the need to avoid infection and disease with the need to manage flare-ups. Some dos and don’ts of keeping your hands clean and healthy have been outlined by Desai and Nada Elbuluk, MD, a dermatologist and assistant professor at the USC Keck School of Medicine in Los Angeles, who is also a SOCS board member.

1. Do Wash Your Hands as Directed by CDC Guidelines

The agency recommends that you cleanse them with soap and water for at least 20 seconds to ensure that they are clean, especially after you have been in a public place or after coughing, sneezing, or blowing your nose.

3. Do Moisturize Your Hands After You Clean Them

“The minute that someone’s done with washing their hands they should moisturize, and that’s a step that people skip a lot,” notes Elbuluk. It’s particularly important for people with eczema, since dry skin can create irritation, make skin more vulnerable to bacteria, and trigger flare-ups, notes the NEA. (So far, though, it is unclear whether broken skin, such as from eczema, makes someone more prone to novel coronavirus infection, Desai says.) Elbuluk explains: “I usually recommend that you keep a bottle of moisturizer right next to your sink, or if your job requires you to be out of the house then keep it in your bag or purse or whatever you take with you. Have a moisturizer with you at all times.”

She recommends thicker moisturizers, such as ointments that are petrolatum- or mineral oil–based, or creams. “Petroleum jelly, Aquaphor, products like that are really going to give you the most for locking in moisturize.” She also advises that you opt for fragrance- and dye-free moisturizers. Fragrance and dyes can irritate skin and trigger flare-ups.

5. Do Use Hand Sanitizer if Soap and Water Are Not Available

The CDC recommends that hand sanitizers contain at least 60 percent alcohol, but Desai says he opts for at least 70 percent alcohol content. He also cautions that hand sanitizer can be a trigger for eczema symptoms. “Hand sanitizer can lead to flare-ups, absolutely. I just put some on a moment ago, and my hands are burning and stinging,” Desai says. Moisturize immediately after the hand sanitizer dries, and look for hand sanitizers with emollients in them, he advises. According to the National Eczema Society, emollients are moisturizing agents that can help treat eczema. Creams, lotions, ointments, sprays, and gels are all examples of emollients.

6. Don’t Rinse or Wipe Off the Sanitizer Before It Dries

“If you don’t let it dry, it’s not going to work,” says Desai. Wiping or rinsing it off may cut down on its effectiveness, according to the CDC.

7. Do Stay Hydrated, Inside and Out

Stay indoors with a humidifier. Keep your ambient environment moist so that the moisture will help your skin,” advises Desai, adding, “Drink lots and lots of water.” Dehydration can lead to dry skin, which in turn can compromise your skin barrier, notes the NEA, making you more vulnerable to flare-ups if cracks and fissures form.

8. Don’t Hesitate to Reach Out to Your Dermatologist if You Are Having Troublesome Symptoms

Many healthcare professionals are using telemedicine to consult with patients during the COVID-19 pandemic, notes Elbuluk. This can involve video chat, text messaging, or inbox messaging with your doctor. It may also include uploading photos or videos of your affected areas of skin. Find out which portal or app your doctor uses and whether it is HIPAA-compliant, which will protect the privacy of your health information. (Most major insurers are covering the costs of these virtual visits in the same way they do in-person appointments.)

A Final Word on Keeping Your Skin Healthy During the COVID-19 Pandemic

While the previously mentioned list of protective measures may be especially difficult for people with eczema, remember: “The sanitation and the cleanliness of our hands and how we do that is the most important thing right now,” Desai says. “We try to manage this, and do the best we can, and that’s all we can do.”

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