and Treating Rich Hand Syndrome: Causes and Solutions

How is Dupuytren's contracture treated?

What is the condition known as "wealthy hand," and how can it be treated? Initially, I only had one finger affected, but now multiple fingers are involved.
What could be the reason for this? I've also observed that the areas with "wealthy hand" are continuously spreading.
To make matters worse, I no longer have fingerprints on my hands, which is quite distressing.
I've tried many different ointments, and while they seemed effective at first, it feels like I've developed immunity to them over time.
My hands have become severely damaged.
Currently, I am using a cream called "Fudi," and it has improved a bit after application.
Is this a good approach? When I previously consulted a doctor, he mentioned that this is eczema, but I'm unsure what that really means.
My mother referred to it as "wealthy hand."

Tian Tian, 10~19 year old female. Ask Date: 2006/03/17

Dr. Huang Ruiyun reply Dermatology

"Rich Hands" is a type of hand eczema caused by "congenital insufficiency and acquired imbalance." Some individuals are born with more sensitive skin on their hands, which cannot withstand irritation or excessive washing.
Unfortunately, they may not have a privileged life, and engaging in activities (especially household chores involving water) gradually triggers the condition.
Therefore, treating "Rich Hands" cannot completely eradicate the issue; the fundamental approach is to live a life of ease, hence the name "Rich Hands." Individuals with this condition should never wash dishes or do laundry without wearing gloves, nor should they wring out cloths or mops vigorously.
For any water-related tasks, except for washing the face, bathing, or handwashing after using the restroom, gloves should be worn to create a barrier or the tasks should be avoided altogether.
Organic solvents and surfactants should also be avoided.
While topical ointments can relieve itching and redness, they may become less effective with continued use, leading to thinner skin.
Therefore, it is advisable to apply them only twice a day.
It is important to keep a good hand cream readily available; apply it whenever the skin feels dry, even if it means applying it ten to twenty times a day.

Reply Date: 2006/03/17

More Info

Rich Hand Syndrome, often referred to in layman's terms as "富貴手" (literally "rich hand"), is a colloquial term that typically describes a condition related to hand eczema or dermatitis. This condition can manifest as dry, cracked skin, itching, and inflammation, often exacerbated by environmental factors or irritants. The term itself suggests a predisposition to skin issues due to genetic or environmental factors, leading to a cycle of irritation and worsening symptoms.

Causes of Rich Hand Syndrome
The development of Rich Hand Syndrome can be attributed to several factors:
1. Genetic Predisposition: Individuals may have inherently sensitive skin that is more prone to irritation and allergic reactions. This sensitivity can be exacerbated by environmental factors.

2. Environmental Irritants: Frequent exposure to water, soaps, detergents, and other cleaning agents can strip the skin of its natural oils, leading to dryness and irritation. This is particularly relevant for individuals who engage in activities that require frequent handwashing or exposure to chemicals.

3. Allergic Reactions: Some individuals may develop contact dermatitis due to allergies to certain substances, such as latex, fragrances, or preservatives found in skincare products.

4. Underlying Conditions: Conditions such as diabetes or thyroid disorders can also contribute to skin issues, making the skin more susceptible to infections and irritations.

Treatment Options
Treating Rich Hand Syndrome involves a multifaceted approach:
1. Moisturization: Regular application of emollients and moisturizers is crucial. Products like petroleum jelly or thick creams can help lock in moisture and protect the skin barrier. It is advisable to apply these after washing hands and throughout the day to prevent dryness.

2. Avoiding Irritants: Identifying and avoiding triggers is essential. This may include wearing gloves while washing dishes or using cleaning products, and avoiding harsh soaps or alcohol-based hand sanitizers.

3. Topical Treatments: Over-the-counter hydrocortisone creams can help reduce inflammation and itching. However, prolonged use should be monitored by a healthcare professional to avoid skin thinning.

4. Prescription Medications: In more severe cases, dermatologists may prescribe stronger topical steroids or immunomodulators to manage inflammation.

5. Lifestyle Modifications: Reducing stress, which can exacerbate skin conditions, and maintaining a balanced diet rich in vitamins and minerals can also support skin health.

Observations and Concerns
You mentioned that your condition has spread from one finger to multiple fingers and that you have noticed a loss of fingerprints. This progression can indicate that the skin barrier is severely compromised, leading to widespread dermatitis. The absence of fingerprints may be due to the thickening or damage of the skin, which can occur in chronic cases of eczema.

It is also concerning that you have tried various ointments with initial success but then experienced a decrease in effectiveness. This phenomenon can occur when the skin becomes tolerant to certain ingredients, or when the underlying condition is not adequately addressed.

Seeking Professional Help
Given the severity of your symptoms and the fact that your condition has worsened, it is crucial to consult a dermatologist. They can provide a definitive diagnosis and tailor a treatment plan specific to your needs. It is essential to communicate all your symptoms, including the progression of the condition and the treatments you have tried.

In summary, Rich Hand Syndrome is a manageable condition with the right approach. By understanding the underlying causes and implementing effective treatment strategies, you can significantly improve your skin health and quality of life.

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