Suggested instruction sheet for patients with hand dermatitis

1 Hand washing: Use lukewarm water and a soap substitute (e.g. Wash E45, Aqueous cream, Emulsifying ointment). If your hands are dirty use a non-perfumed soap without tar or sulphur. The soap should be used sparingly and the hands thoroughly rinsed. Dry carefully with a clean towel, especially between the fingers. If soap is used this should be followed with the application of a non-perfumed moisturizer.

2 If your skin is dry use a non-perfumed moisturizer (e.g. E45 cream, Diprobase cream Neutrogena Norwegian Formula hand cream, Aqueous cream, Oily cream BP, Emulsifying ointment, Liquid Paraffin⁄White Soft Paraffin) as frequently as possible to restore a feeling of suppleness. As your skin improves the frequency can be reduced. You can use different ones at different times of the day with less greasy preparations used when undertaking paperwork.

3 Avoid contact with detergents and other strong cleansing agents.

4 Avoid contact with shampoo. Use plastic gloves or let someone else shampoo your hair or your children’s hair.

5 Avoid contact with polish: metal, wax, shoe, floor, car, furniture and window polishes.

6 Avoid contact with solvents: white spirits, petrol, paraffin, turps, thinners and trichlorethylene (tric).

7 Do not peel or squeeze citrus fruits with bare hands: oranges, lemons, limes, satsumas.

8 Do not apply hair lotion, hair cream or hair dye with bare hands.

9 Wear warm gloves in cold weather.

10 Rings should not be worn for work or housework until the skin has been clear for 3 months. Never wash your hands with soap while wearing a ring. Keep the inside of rings clean (brush under running water).

11 For washing up use running water if possible keeping the temperature of the water low. Use long handled brushes rather than cloths. Always wear gloves when in contact with washing up liquid or detergents.

12 When gloves are worn, use PVC rather than rubber – preferably with cotton gloves inside to reduce sweating and friction. They should not be worn for more than 20 minutes at a time. If water happens to enter a glove, it should be immediately removed. Gloves should be turned inside out and rinsed under warm water several times a week. The outside gloves should be replaced every few weeks for home use and more frequently for industrial use.

13 Washing machines and dishwashers are an ideal way of preventing further attacks. Use a measure when handling detergent powder. Remember that the resistance of the skin is lowered for at least 4 or 5 months after the dermatitis has apparently healed. Therefore continue to follow these instructions.