Hand Rashes Due to Handwashing: 5 Possible Causes

Some people experience a hand rash after washing their hands, and there are several reasons why handwashing might cause this. Simply overwashing the hands can compromise the barrier function of the skin, causing irritation. Scrubbing and water temperature can also contribute as can any allergy you might have to the cleansers you use.

A rash from handwashing usually occurs on the back of the hands as well as the spaces between the fingers. The skin on the palms is much thicker and more resistant to irritants and allergic rashes.

This article explains some of the more common causes of hand rashes caused by handwashing. It also lists the signs and symptoms of hand rashes and what you can do to prevent and treat them.

Causes of Hand Rashes From Handwashing

The skin is the largest organ in the human body. Its primary role is to protect the body from infection and environmental irritants. Part of this protection is afforded by natural oils on the skin.

Tiny organs situated beneath the outermost layer of skin, called sebaceous glands, secrete an oily substance known as sebum that serves several important functions:

• It lubricates the skin to protect against friction.
• It makes the skin more impervious to moisture that might otherwise draw water out of the skin and make it drier.
• It transports antioxidants to the surface that help slow skin damage and aging.
• It offers some protection against ultraviolet (UV) radiation from the sun.
• It has some natural antibacterial and anti-inflammatory properties.

The skin itself has specific barrier functions. Atop the outermost layer of skin (epidermis) is a layer called the stratum corneum made of dead skin cells. The stratum corneum is important because it blocks bacteria and other microorganisms from entering underlying tissues. It also serves as the scaffolding onto which sebum clings.

Compromising these functions can cause skin problems including rash. There are several ways that handwashing contributes to this:

Contact Dermatitis

Most isolated hand rashes are caused by a condition called contact dermatitis caused by contact with substances found in the environment. This includes allergic contact dermatitis (caused by contact with an allergen) or irritant contact dermatitis (caused by contact with skin irritants).

The two cause similar symptoms like:

• An itchy rash
• Generalized swelling and redness
• Dry, cracked, scaly skin
• Leathery patches
• Possible blistering

Contact dermatitis is most commonly caused by irritants such as soaps and detergents, solvents, or regular contact with water. Fragrances found in soaps, cleansers, and moisturizers are also common triggers.

Changing skincare products may help you avoid future outbreaks. In their place, use a mild, fragrance-free soap without dyes.

Overwashing

Sebum is composed of fatty acids and wax-like compounds that mix with sweat and delay the evaporation of sweat from the skin. Sebum also coats the skin so that moisture is repelled.

Under normal circumstances, handwashing won't strip away sebum entirely, giving sebaceous glands plenty of time to supplement the supply. Washing your hands frequently, however, can strip sebum away entirely, making the skin vulnerable to moisture loss, irritants, and infection.

When this occurs, you might experience:

• Skin redness and dryness
• Itchiness
• Skin cracking, especially between the fingers
• Rash-like bumps from inflamed pores
• Leathery or scaly patches
• Possible bacterial skin rash

People who work in healthcare must wash their hands frequently to prevent the spread of infection. The downside to this is that up to 30% of healthcare workers develop hand rashes due to overwashing.

Rather than overwashing, give your skin a break by occasionally using an alcohol-based hand cleanser. According to the Centers for Disease Control and Prevention (CDC), hand cleansers cause far less irritation to the skin than repetitive handwashing with soap.

Hot Water Temperature

Hot water temperature also plays a role by overheating the skin. The high temperature is not only better able to "melt" the fats and waxes in sebum, but it also accelerates the evaporation of moisture from the skin before sebum levels are restored.

These effects alone can increase the risk of skin irritation, dryness, itching, and rash even if you don't overwash.

On top of this, hot water exposes the skin to undue inflammation and intensifies skin sensitivity. This is potentially troublesome if you have a condition called cholinergic urticaria in which the irritation of nerve fibers in sweat glands can cause the spontaneous outbreak of rashes.

Symptoms of cholinergic urticaria include:

• Numerous tiny bumps the same color as your skin
  
• Larger raised wheals (hives)
• Itching, burning, or tingling sensations
• Generalized swelling of the hands (angioedema)

The outbreak may last a few minutes or up to an hour as the skin eventually cools down.

It is always best to wash your hands with lukewarm or cool water. Hot water is more damaging to the skin and is not any more effective at eliminating germs than cool water.

Scrubbing

Scrubbing the skin vigorously eliminates the stratum corneum. This not only strips away one level of skin protection but also removes the scaffolding that sebum naturally clings to. It also exposes underlying pores, called hair follicles, to invasion by bacteria and other microorganisms.

Because it can take the stratum corneum anywhere from 12 to 24 hours to rebuild itself, common skin bacteria like Staphylococcus aureus can early infiltrate pores and cause a condition called folliculitis in which hair follicles become inflamed.

Symptoms of folliculitis include:

• Clusters of small bumps or pimples around hair follicles
• Red inflamed skin
• Itching or burning
• Pus-filled blisters that can break open and crust over

According to the Centers for Disease Control (CDC), you should lather your hands vigorously for around 20 seconds in order to prevent transmission of infection. Scrubbing doesn't remove any more bacteria or viruses than lathering.

Soaking

The skin is porous, and the prolonged immersion of the skin in water oversaturates tissues and can lead to skin breakdown. This is because the top layers of skin—the epidermis and underlying dermis—are in a constant state of moisture exchange in order to maintain homeostasis (equilibrium).

Oversaturation of the epidermis causes blood vessels in the dermis to constrict (narrow) to compensate for the imbalance of fluids. This, in part, is why your hands and fingers wrinkle whenever you're in the bath or a pool for too long.

The constriction of blood vessels also robs the skin of oxygen and nutrients that it needs to thrive. Habitually soaking the hands effectively "ages" them, increasing the risk of skin dryness, cracking, and flaking.

This can worsen existing skin conditions like atopic dermatitis (eczema). It can also make the skin vulnerable to a condition called irritant contact dermatitis in which contact with irritants like soap, perfumes, and detergents can cause an outbreak of rashes.

Symptoms of irritant contact dermatitis include:

• An itchy, bumpy rash
• Leathery patches that are darker than the surrounding skin
• Dry, cracked, and scaly skin
• Swelling, burning, or tenderness.
• Bumps and blisters, sometimes oozing
  

Bathing or soaking your hands for too long can cause more harm than good. Limit baths, showers, and hand-soaking to 10 to 15 minutes, and moisturize immediately afterward.

Treatment

If you get a hand rash, you can often treat it with over-the-counter medicines. These medications can help with any itchiness and discomfort until your rash goes away. Make sure you follow the directions on the medication label.

Common over-the-counter treatments for hand rash include:

• Calamine lotion
• Hydrocortisone cream
• Oral antihistamines
• Zinc oxide ointment

If the cause is allergic, an over-the-counter oral antihistamine like Claritin (loratadine) or Zyrtec (cetirizine) may help temper the allergic response.

A cold compress can help reduce generalized swelling and itching, but you should ice the skin for no longer than 15 or 20 minutes to avoid frostbite.

An unscented moisturizing cream can help with skin dryness and prevent cracking and itching.

Prevention

One of the main ways to prevent hand rashes is to reduce the irritating effects of handwashing.

In addition to washing with lukewarm or cool water, not scrubbing or soaking hands for too long, and avoiding harsh cleansers, it's important to moisturize your skin right after washing it or anytime it feels too dry. It's best to use creams and ointments instead of lotions, as they are richer.

Petroleum jelly (Vaseline is one brand) is a good choice, as it does not contain skin-irritating ingredients such as lanolin and preservatives. Other effective moisturizing ingredients include shea butter and coconut oil.

You can also reduce the risk of hand rashes simply by wearing gloves while doing the dishes or any chore that requires your hands to be in water.

Other Possible Causes of Hand Rash

There are many other causes of hand rashes, including certain diseases and infections. In these situations, there are typically other symptoms besides a rash. Possible causes of hand rashes include:

• Bites and stings: Sometimes insect bites and stings on or near the hands can cause a rash. Additional symptoms may include redness, swelling, and itching. In some cases, anaphylaxis, a life-threatening reaction, can occur, requiring immediate medical attention.
• Fifth disease: Fifth disease is common in children, but adults can get it too. In addition to a skin rash, symptoms include a runny nose, fever, and headache.
• Impetigo: Some skin rashes are caused by a skin infection called impetigo. It's caused by the bacteria group A Streptococcus and Staphylococcus aureus. When this kind of bacteria infects your skin, it causes sores that leak pus or a clear liquid before forming scabs.
  
• Eczema: Eczema is a common skin condition also known as atopic dermatitis. It affects around 15 million Americans and causes scaly or bumpy patches of skin, as well as itching, dryness, and redness.
• Fungal infection: Symptoms of fungal infection on the skin include red, itchy, flaky skin, as well as swelling. If you get a fungal infection on your skin, your doctor will prescribe an anti-fungal medication.
• Hand, foot, and mouth disease: Hand, foot, and mouth disease is a highly contagious illness that is common among children under age 5. Symptoms include a rash (usually on the palms or soles of the feet), sores in the mouth, and fever.
• Kawasaki disease: Kawasaki disease, also known as Kawasaki syndrome, usually affects kids 5 years old and younger. It affects mostly boys. Symptoms of Kawasaki disease include fever, swollen hands and feet, irritation and inflammation around the mouth, lips, and throat, and redness in the whites of the eyes.
  

When to See a Healthcare Provider

Most rashes go away on their own. But sometimes you may need to see a healthcare provider for a hand rash. If you are an adult, see a doctor about your rash if:

• The rash is located all over your body.
• The rash appears suddenly and spreads quickly.
• You have a fever as well as a rash.
• The rash is full of blisters.
• The rash hurts.
• The rash is infected.
  

If a child has a skin rash, consult a healthcare provider if:

• The skin turns lighter (blanches) when you press on the rash.
• Your child has hives.
• The rash is infected.
• The rash has fluid-filled bubbles.

Summary

It's important to wash your hands regularly to stop the spread of infection. However, washing too frequently or incorrectly can strip off the natural oils on the top layer of the skin.

This can result in a hand rash, with symptoms such as dryness, itchiness, redness, and cracked skin. To prevent a hand rash, avoid washing with hot water or harsh soaps. Refrain from soaking or scrubbing the hands too vigorously, and apply a thick moisturizer after washing.