Dry cracked skin macro closeup of index finger of female young woman's hand showing eczema medical condition called dyshidrotic pompholyx or vesicular dyshidrosis

Hands are a necessary role in performing our daily activities. When the palms are scaling and fissuring, it causes pain, humiliation, and psychosocial distress. Cracked/chapped hand, called hand dermatitis or hand eczema, is a common skin condition affecting ~ 10% of the overall population, mostly girls. It’s also the most popular occupational skin disease, i.e., occupational dermatitis/eczema or occupational irritant hand dermatitis/eczema. Particular jobs related to higher rates of hand eczema include hairdressers, printers, cement workers, painters, mechanics, animal handlers, food processors, florists, chefs, constructers, pharmaceutical factory employees, and laundry employees. The common features shared by these jobs are an excessive exposure to water, solvents, or micro trauma.

Symptoms Of Hand Dermatitis/Eczema

      • Redness (erythema)
      • Dryness, scaling, and flaking
      • Cracking or fissuring
      • Thickening of the skin (hyperkeratosis)
      • Blistering and swelling
      • Pain, irritation, burning, or itching

The condition may last couple of days, weeks, even months or years. It can come and go over the course of several years.

Reasons For Hand Dermatitis/Eczema

Hand eczema is a condition that has many possible causes. It begins by irritants or allergens coming into contact with the skin that causes chain of events, i.e., cellular damage, inflammatory reactions, and disruption and dysfunction of skin barrier.

Irritants And Allergens

Irritants are agents which may cause toxic effects to skin cells after single or repeated contact. Common skin irritants contain additives, greases, solvents, rubber, and food items. Weak irritants may require repeated exposure to cause the problem whereas highly irritating materials may trigger hand eczema with the initial vulnerability.

Allergens are small components, which may penetrate impermeable skin barrier and get the living layers of skin. Allergens may cause an allergy or skin sensitization. Metals, soaps, detergents, topical medications, balsams, nickel, phenol, rubber, formaldehyde, and resin are the most common allergens.

Disruption Of Stratum Corneum

Irritants or allergens can lead to disturbance of stratum corneum, the superficial layer of skin made from dead, flat skin cells which drop about every 2 weeks. The cells of the stratum corneum are embedded in a lipid coating of ceramides, fatty acids, and cholesterol with 25% water content. The stratum corneum functions as a significant barrier by keeping molecules out of moving into and out of the skin, thus protecting the surface of the skin against the outside environment and preventing water loss.

Irritants or allergens provoke disturbance of stratum corneum by direct cell toxicity, lipid barrier removal, cell membrane damage, and destruction of keratins (the key structural material which makes up the outer layer of the human skin). All sorts of hand dermatitis include a disturbance in the stratum corneum.

Besides irritants and allergens, some host factors may weaken the skin functioning and reduce the repair capacity of the skin, and therefore lead to the development of hand dermatitis. These conditions include predisposition to allergies and other skin ailments for example atopic dermatitis, psoriasis, etc..

Cellular Damage Sets Off Inflammation

Despite varying irritants or allergens, the final common path of hand eczema is implemented with the release of inflammatory mediators from keratinocytes, the major cell type in the epidermis (the top layer of skin).

Keratinocytes are crucial in the producing and releasing inflammatory cytokines upon entering irritants throughout the stratum corneum. These inflammatory cytokines augment immune and allergic reactions and propagate eczema.

Persistent Inflammation Impairs Skin Barrier Function

Hand dermatitis is often a recurrent illness owing to sustained inflammatory reactions. Studies have shown that regular contact of irritants or allergens promotes continued inflammation that exposes the immune system to immunogenic peptides and cause persistent recruitment of inflammatory cells and continued generation of inflammatory mediators. Some inflammatory mediators (i.e., TNF-a) are controlled in a self-stimulating fashion and so involved in the continuation of inflammatory reaction.

Sustained inflammation may initiate the damage to deeper layers of skin and weaken the skin barrier. When the skin barrier function is diminished, the permeation of irritants and allergens in addition to the subsequent answers are amplified. This, in turn, cascades into a vicious cycle of lifelong illness, experiencing dryness, fissuring and cracking.

Hand Dermatitis/Eczema Treatment

The objective of treating hand dermatitis is to prevent irritant contact, prevent allergen, and alleviate skin irritation-caused itchy blisters and sore cracks. It’s well-known the flip side dermatitis is present, the harder it is to deal with.

Treatment Failure And Allergic Infection

Undoubtedly, it’s very tricky to take care of hand eczema successfully. There are numerous possibilities: First, identifying one material is ineffective at best, and frequently impossible. Second, it’s impractical to prevent the vulnerability of irritants or allergens. Third, inadequate and unsustainable control of stubborn inflammatory/immune responses.

Recent studies suggest that some additives in lotions and creams, commonly utilised to help the skin maintain moisture and reduce cracking, may prolong or aggravate inflammation.

Natural Anti-inflammatory Remedies For Control Of Sustained Inflammation

Because of fear of side-effects of steroids and dissatisfaction with traditional therapy, dermatitis sufferers are searching for alternative solutions. Most commonly recommended methods are organic anti inflammatory remedies. In actuality, many anti inflammatory plant extracts, such as Astragalus, Scute, Coptis, Γλυκόριζα, και Αλόη βέρα, have shown beneficial effects in treating inflammatory skin disorders including hand dermatitis.

Since inflammation initiates, propagates, and aggravates hand eczema, control of inflammation is vital to cure hand eczema and prevent skin barrier dysfunction. Studies indicate that elimination of inflammatory chemicals help prevent disruption of stratum corneum and protect skin barrier function.