Find out how to manage the itchiness and redness from hand eczema.

 

Mdm TS, a 72-year-old Chinese woman who wants to remain anonymous, noticed rashes on both of her hands worsening since the COVID pandemic began. She was at the time using alcohol-based hand sanitisers many times throughout the day like many of us, afraid we might contract the virus.

As a result, she started noticing painful cracks and splits in her skin particularly on her fingers, associated with redness and peeling. Her nails also looked rough and ridged after her cuticles were affected by the inflammation. She wanted to put a stop to this and went to see a dermatologist practising at Gleneagles Hospital, Dr Ker Khor Jia.

She diagnosed TS with hand eczema and advised her to stop the alcohol-based hand sanitisers and opt for more gentle soaps and use moisturisers containing ceramides frequently throughout the day, particularly after each hand wash. Dr Ker also prescribed anti-inflammatory creams and topical antibiotics, with oral anti-histamines to manage the eczema.

After two months, her condition improved and according to Dr Ker, she only uses moisturisers without medicated creams from the last review in October 2024.

 

What is hand eczema?

So what is hand eczema or what is also called hand dermatitis? “It is a chronic inflammatory condition localised to the hands, characterised by redness, itch, dryness or cracking,” explained Dr Ker. “Frequent handwashing, use of alcohol-based sanitisers and wet wipes can dry out and irritate the skin. Prolonged glove use and exposure to disinfectants and harsh cleaning agents can increase the risk of hand eczema, especially in jobs with frequent skin contact.”

Unlike general eczema, it is often triggered by repeated exposure to water, harsh soaps and chemicals, while general ezcema’s triggers can include a larger list of causes from stress and hormones, insect bites and stings, pollen, food, clothing, weather and moulds.

As a result, with hand eczema, it often affects workers in cleaning, catering, mechanical, and especially those with healthcare roles who have repeated exposure to water, chemicals and irritants. “In Singapore, this also impacts many seniors, who make up a substantial portion of occupations above, especially in healthcare,” added Dr Ker.

There is no specific detail on prevalence rates of hand eczema in Singapore but rather eczema in general with about one in five children and one in 10 adults suffering from it, and these rates are said to be among the highest in Asia. Majority of patients with eczema have an age of onset before the age of five, but it is a condition that spans across all age groups, with the areas of distribution being different at various ages, said Dr Ker.

“Since the COVID pandemic, more than 60 percent of healthcare workers surveyed noted development of hand eczema. A lot of them are seen in the dermatology practice as they seek help to manage the troubling symptoms of rash, fissures, dryness and itch,” she shared.

Besides those symptoms and the redness and blisters also reported, it can affect daily tasks and job performance. The visible symptoms can further impact self-esteem, leading to discomfort and reduced focus at work. “Hand eczema can cause dry skin, weakened immunity, flare-ups, and compromised skin barriers, making tasks like handwashing and glove use difficult. Repeated flare-ups weaken the skin’s ability to retain moisture and protect against irritants, worsening the condition and prolonging recovery,” noted Dr Ker.

 

How to avoid it and/or manage the symptoms?

It is important to know what triggers your hand eczema. Look at what you use including the harsh soaps, disinfectants and other irritants. Dr Ker shared these tips:

• Wash hands, dry them and moisturise frequently instead of using hand sanitisers if possible.
• Wash hands with lukewarm water, not hot, to prevent dryness.
• Avoid alcohol-based hand sanitisers.
• Use mild, fragrance-free hand wash as harsh soaps can strip the skin of its natural oils.
• Gently pat hands dry with a soft towel, instead of rubbing them, to avoid further irritation.
• Wear rubber/latex gloves when doing housework. If rubber gloves have to be worn for long periods of time, wear an inner pair of cotton gloves first, to minimise irritation from perspiration.
• Choose products on your skin that is formulated for sensitive skin to minimise irritation. Choose in particular fragrance-free, colorant-free, and preservative-free products to avoid irritants.

When all fails, you can consider what is called a patch test. This is only if you have an identifiable allergen or you are not responding to your available treatment.

 

What’s a good moisturiser for hand eczema?

Dr Ker recommended choosing products that repair the skin barrier such as products with a 3:1:1 ceramide-dominant ratio and those that maintain a healthy skin pH through multiple washes. “Chronic inflammation can persist despite avoiding triggers, making emollient choice crucial,” she shared.

Here are some products with ceramide to consider:

• Ceradan Advanced Hand Balm, which is designed for hand eczema. Developed by local pharmaceutical company Hyphens Pharma and A*STAR, the new hand balm uses patented pH technology to restore the skin barrier and main health pH levels for over 12 hours. The product comes in 50g and is available at islandwide hospitals including National Skin Centre, KK Women’s and Children’s Hospital, Singapore General Hospital, etc, and costs S$30.90.
• CeraVe Reparative Hand Cream. It is rich, non-greasy and fast-absorbing and suited for extremely dry, cracked hands. It is blended with three naturally occurring ceramides and uses the MVE delivery technology to deliver controlled, long-lasting hydration. It also has hyaluronic acid and anti-inflammatory niacinamide. The 50ml tube is available on Shopee for around S$13. There are other CeraVe products with ceramide that is for the face and body.
• Vytle Daily Ceramide Moisturiser by Suu Balm. Formulated by the National Skin Centre, Singapore, it is non-greasy and contains five types of skin-identical ceramides and 98 percent natural origin ingredients. Clinically tested for sensitive skin, this hypoallergenic formula is proven to improve skin’s moisture by 87 percent on first use, according to the company. It comes in 100ml (around S$23.90) or 450ml (around S$54.90). It is available in Guardian, Tan Tock Seng Hospital and Shopee.