The colder, dryer months of the year can leave us itchy and dry at times, and even bring out a skin issue that was already present. There are so many different causes of rashes, and some of these causes may be the least expected.
Soap is a frequent cause of irritating skin on the hands. The distribution of a rash will give us clues as to its culprit. When suspecting soap as the cause of hand irritation, we will check the backs of the hands and web spaces of the fingers for involvement. If just one’s palms are affected, we will look for different answers than soap as the cause.
Other questions we often ask patients when they have rashes on their hands include considering their work environment. Such questions might be asked as: do you wear gloves at work? Are you washing your hands before you put the pair of gloves on? How frequently are you changing the glove? Working with odd chemicals at work can leave us further suspicious that the work environment is playing a role in the rash.
A trick that we like to share with our patients is considering using an alcohol-free hand sanitizer. If one already has irritant hand dermatitis, applying an alcohol-based hand sanitizer is comparable to putting salt on a wound. For cracked, dry hands, Gold Bond Hand Sanitizer is a great alcohol-free option. When avoiding soap to heal irritated hands, replace hand washing with hand sanitizer when possible.
Using a hand sanitizer five times for every one hand wash should definitely show improvement in dry, inflamed hands. We recommend EO Hand Sanitizer found at health food stores to our patients for a great everyday option.
Go for soaps that are gentler when washing hands. Choose Cetaphil bar, Aveeno, Neutrogena bar, among others. In the end, decreasing frequency of hand washing along with avoiding dish soap for hand washing will be helpful. Dish soap is designed to clean chemicals and is therefore too harsh for routine hand washing. Further treatments of irritated hands include soaking them for twenty minutes, applying ointments, and wearing cotton gloves overnight. Wal-Mart, Lowes and Home Depot sell brown jersey gloves that can be used for this purpose. We carry Vanicream at our office as a healing moisturizer for especially dry skin. A great hand cream is CeraVe Therapeutic Hand Cream. If these measures do not do the trick, there is further medical management we can offer.
What if just the fingertips of the hands are affected? Frequently, this distribution of hand irritation is found on the dominant hand and affects the middle finger, index finger and thumb. Such dermatitis can be related to writing. This rash would not itch. In those that handle packages every day, this may be the cause of such a rash. Golf gloves are another common cause of this type of hand irritation.
If one has frequently sweaty hands, this can be another factor to consider with hand irritation. This cause may present as blisters that come and go with itching. If blisters on the hands are always present, it might be time to check for allergies including nickel allergy. Other times, we may see bacteria or fungus contributing to rashes on the hands.
Moving on to the eyelids, there are innumerable causes of eyelid irritation. Some causes include an allergic reaction, a product irritating the skin specifically, psoriasis, dandruff, and eczema, among others. If a rash spreads outside of the eyelids, we may check your shampoos and face soap as causes of an allergic response. If the rash is only on one eyelid, we may check if there is something on your hands that is coming in contact with your eyelids that is causing the irritation. Since nail products can often cause skin issues, consider Revlon Nail Enamels as a safe alternative to irritating nail polish.
Otherwise, mascara is one of the most likely causes of eyelid rashes. Mascara, along with other volatile solvents can be problematic in this area. We offer several therapeutic measures when seeing patients with eyelid dermatitis. Important measures to be done at home include stopping the irritants and washing your face with a gentle cleanser (such as Cetaphil or CeraVe) after shampooing. Sarna Sensitive is a calming lotion sold over the counter. CeraVe or EpiCeram cream are other calming options to apply to irritated skin on the eyelids. Remember to wash eyelids very well after washing the face when suffering from irritation.
Another common location for irritated skin can be under a ring on a finger. Women’s rings have concavities that can allow water and soap to get trapped beneath. Furthermore if wearing two rings together, this provides more space for trapped irritants. Jewelers can adjust rings to close off the concavities beneath them and offer soldering to bring multiple rings together as one.
Rashes on the face have their own patterns to pay attention to for clues of causes. If a rash of the face is in the central face only, we may worry about what moisturizers and makeup a patient is using. Even jewelry can play a role in rashes on the face. Titanium dioxide, found in mineral-based sunscreens, can release gold in jewelry, a common allergen that can be underestimated.
However, if the rash is located on the sides of the face, think about your rinse off pattern when washing. Perhaps soap or shampoo is the cause in this scenario. A good shampoo to try when needing to stop irritation is California Baby Supersensitive Shampoo and Body Wash. Free and Clear is another brand we often have patients switch to with allergic prone skin.
In regards to a rash on the neck, consider perfume as a possible culprit. Sometimes discontinuing use of all perfumes until a rash on the neck clears is a good first step. Rashes on the sides on the neck can once again point back to the rinse off pattern of shampoo.
A toothpaste allergy is a potential cause when irritation shows up on the lower lip or chin. Tom’s Toothpaste at whole foods stores is a good allergen-free alternative.
When considering any rash, remember that there are a lot of chemicals in modern day life. Even if it is a product that you have used for years, it can still be the cause of your current rash. Unfortunately cumulative exposure can lead to cumulative toxicity at times. There is always patch testing for allergies if other treatments of a rash are not working.
Amy Murphy, PA-C
Reference: The SDPA Conference in San Diego, CA 2014 with Matthew Zirwas, MD