Eczema: Why Are My Hands Still Dry and Itchy?

Questions regarding eczema?

Hello, I am a patient who has undergone surgery for hyperhidrosis.
The surgery was successful many years ago, and my hands are currently in good condition and no longer sweaty.
However, I am unsure if this is related, but last year, due to work, I started learning how to bake bread.
During this time, my hands were frequently in contact with oils, yeast, and cleaning agents.
Since then, I have experienced peeling and itching on the sides of my fingers.
After consulting a dermatologist, I was diagnosed with eczema, and the doctor advised me to keep my hands dry.
I find it puzzling because I had surgery for hyperhidrosis, and my hands are usually dry.
Additionally, I have not baked bread for a long time and am currently working in mail delivery, where I am outside in the sun daily and not in prolonged contact with water.
Why do my hands still frequently crack (on the sides), causing inconvenience in my work? I hope my description is clear, and I would appreciate your help.
Thank you.

Qiu, 20~29 year old female. Ask Date: 2004/11/02

Dr. Jiang Zheen reply Dermatology

It could be contact dermatitis, as some individuals may develop allergic reactions due to certain substances in flour.
In such cases, a patch test is necessary for diagnosis.
Generally, dermatology departments in major hospitals have the facilities for this.
Wishing you well.

Reply Date: 2004/11/02

More Info

Hello! Thank you for your question regarding the persistent dryness and itchiness of your hands, especially after having undergone surgery for hyperhidrosis. It sounds like you have been experiencing some discomfort related to your skin condition, and I’d like to provide some insights into why this might be happening and what you can do about it.

Firstly, it's important to understand that eczema, or dermatitis, can manifest in various forms, including contact dermatitis, which is often triggered by exposure to irritants or allergens. In your case, working with ingredients like oils, flour, and cleaning agents while baking could have led to an irritant contact dermatitis. Even if you are no longer baking, the skin can remain sensitive and reactive to previous irritants, especially if it has been compromised in any way.

After your surgery for hyperhidrosis, your hands may have become drier due to reduced moisture retention. The surgery can alter the normal functioning of sweat glands, which play a role in maintaining skin hydration. While you mentioned that your hands are generally dry and not sweaty, this can lead to a lack of natural oils that keep the skin barrier intact. When the skin barrier is compromised, it can lead to dryness, cracking, and itchiness.

Moreover, exposure to environmental factors, such as sun exposure, can exacerbate skin dryness. Even if you are not in contact with water frequently, UV rays can damage the skin and lead to further dehydration. The fact that you are now working outdoors may also contribute to this issue, as sun exposure can dry out the skin.

Here are some recommendations to help manage your symptoms:
1. Moisturization: Regularly apply a thick, emollient moisturizer to your hands, especially after washing them. Look for products that contain ingredients like ceramides, glycerin, or hyaluronic acid, which help to restore the skin barrier and retain moisture.

2. Gentle Cleansing: Use mild, fragrance-free soaps and avoid harsh detergents that can strip the skin of its natural oils. After washing your hands, pat them dry gently instead of rubbing them.

3. Protective Measures: When working with any substances that may irritate your skin, consider wearing gloves. This can help protect your hands from further irritation and allow the skin to heal.

4. Hydration: Ensure you are drinking enough water throughout the day to keep your skin hydrated from the inside out.

5. Consultation with a Dermatologist: Since you have already seen a dermatologist, it may be beneficial to follow up with them if your symptoms persist. They might suggest topical corticosteroids or other treatments to reduce inflammation and itchiness.

6. Avoiding Triggers: Identify and avoid any specific triggers that worsen your condition. This could include certain soaps, cleaning products, or even specific foods.

In conclusion, while your surgery for hyperhidrosis has successfully reduced sweating, it may have inadvertently contributed to the dryness and itchiness of your hands. The combination of previous irritant exposure, environmental factors, and changes in skin barrier function could be the underlying causes of your current symptoms. By implementing a consistent skincare routine and protective measures, you should be able to manage your symptoms more effectively. If the situation does not improve, further evaluation by a dermatologist may be necessary to explore other underlying conditions or treatment options.

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