Irritant contact dermatitis is far more common than allergic contact eczema, and is a common cause of occupational-related health problems. Prolonged direct contact of the skin with an irritant, as long as the irritant has a high enough concentration, will invariably cause irritant contact dermatitis in everyone.

Unlike allergic contact dermatitis, it is not an immune system disorder. It is merely due to the damage of the skin surface. Prolonged contact with water swells the surface cells of the skin and disrupts the normally tight joins between them, exposing the more vulnerable deeper layers.

Almost all occupation in which skin is made wet repeatedly, are associated with irritant contact dermatitis. Hairdressers, cleaners, catering workers, food processors and fish handlers are particularly at high risk. People suffering from atopic eczema are also particularly prone to develop this type of eczema, and should choose carefully the nature of their work.

Household work involving cleaning materials, or cooking ingredients can lead to irritant contact dermatitis as well and sometimes it is called the maids’ hands.

Signs

Irritant contact eczema is dependent for diagnosis on a good history of work exposure and knowledge of likely problem agents. Also, a negative patch test result can be useful to exclude an allergic contact dermatitis.

It can affect any part of the body. Dripping saliva in babies, repeated licking of the fingers or area around the mouth in young children, and household workers doing cleaning and cooking duties are commonly seen situations.

The skin with the thinnest layer of stratum corneum has the least natural protection against irritation, therefore the finger webs, back of the hands and forearms, are frequent places where irritant contact dermatitis occurs.

In mild cases there is only some dryness and redness. When severe, there is cracked skin, weeping and crusting. When it becomes chronic because of unavoidable contact with irritants, the skin is dry, cracked, thickened, scaly, and is very tender and itchy.

Severe Maid’s Hand

Management & Treatments

The most important of all is to avoid the offending substances, but it is often impractical. In this case, the aims of treatment can only be to reduce symptoms. Unfortunately, some irritants cause skin reaction even with very little exposure.

Where contact is inevitable, protective gloves are essential. Since the latex or rubber in gloves can cause or worsen eczema some people find it helpful to use cotton-lined gloves or separate cotton inner gloves to reduce the degree of direct skin contact.

Simply avoiding the substances and putting on frequent moisturisers is enough to improve the mild cases. Using soap substitutes and barrier cream can offer extra protection. In more severe cases, steroid cream is the mainstay of treatment. If there is infection on top, then it is needed to add in some antibiotics.

If there is possibility of an allergic component on top of the irritant contact dermatitis, then a patch can be carried out. Simple avoidance of a few allergic substances can make a huge difference.