Eczema can have a major impact on your work life—especially if you have a job where you work with your hands. Take this story about an employee at an Agropur dairy processing plant in Michigan. In 2018 the employee, who had severe dyshidrotic eczema on her hands, discovered she was allergic to plastic and rubber, and that the gloves she was required to wear at work made her skin worse.
She asked her employers for an accommodation: to wear a different type of gloves. But Agropur didn’t accommodate her, and instead required her to leave work when the eczema on her hands flared. So she missed a lot of shifts and racked up attendance points—and then Agropur fired her. The EEOC sued Agropur for violating the Americans with Disabilities Act and failing to provide reasonable accommodation. Agropur recently agreed to settle the lawsuit.
The Agropur story shows how profoundly hand eczema can impact our ability to earn a living. Work can irritate the skin on our hands, which in turn makes working with our hands harder. People whose hands get wet regularly, or who are exposed to chemicals on the job, are at particular risk of developing occupational dermatitis: eczema that occurs in response to your work.
That means if you work in professions like food prep, metalwork, or manufacturing, if you’re a hairdresser, custodian, or healthcare worker, if you paint or do construction or farm or fish, you’re more likely to develop eczema on your hands. Research shows that 70% of hairdressers report work-related skin damage over the course of their careers. During the pandemic, hand eczema among healthcare workers skyrocketed due to increased hand washing and disinfection.
Addressing occupational hand eczema isn’t as simple as throwing on gloves and avoiding exposure. Coming into contact with irritating substances may be unavoidable in some jobs. Wearing gloves can help, but it’s complicated: gloves can both protect your hands and irritate your skin. Certain jobs require certain types of gloves, and gloves may not be an option for some jobs that require fine motor skills.
Occupational hand eczema comes at a serious economic cost to both workers and their employers. A recent review of hand eczema studies from the last two decades shows that up to 57% of people with chronic hand eczema took sick leave and up to 25% lost or changed their jobs because of their skin. But missing work and changing jobs isn’t an option for everyone. Scientists estimate that presenteeism—working while sick—is widespread among people with chronic hand eczema.
Even though occupational hand eczema doesn’t have easy solutions, there are steps you can take to manage it. Here’s what you need to know about the different types of eczema that can occur on your hands—and what you can do if it’s caused by or impacting your work.
Understanding Occupational Dermatitis
There are two types of types of occupational dermatitis that can occur on your hands: irritant contact dermatitis or allergic contact dermatitis.
Irritant contact dermatitis accounts for the majority of occupational dermatitis cases and is the most common cause of hand eczema. It occurs when exposure to an irritant damages the skin barrier and triggers an inflammatory response. Substances that can cause irritant contact dermatitis include detergents, soaps, solvents, acids, alkalis, fertilizer, cement, pesticide, and gasoline. If you have eczema-prone skin, you’re more likely to develop irritant contact dermatitis.
Allergic contact dermatitis occurs when the skin comes into contact with substances that trigger an allergic reaction. These allergies develop over time after repeated exposure. Patch testing, sharing your occupational history with your doctor, and reviewing Material Safety Data Sheets for the substances used in your workplace can help you determine what you’re allergic to. Occupational allergens that can cause allergic contact dermatitis include platinum, nickel, cobalt, epoxy, formaldehyde, parabens, and fragrances.
Other types of eczema, including atopic dermatitis, dyshidrotic eczema, and neurodermatitis, can also occur on the hands. These can be exacerbated by exposure to workplace irritants and allergens and can impact your ability to work with your hands.
What to Do About Hand Eczema at Work
If the skin on your hands is inflamed and you suspect it’s caused by something at work, here are three steps you can take.
Step 1: Work With Your Doctor to Determine What's Triggering You
Schedule a visit with your primary care provider, allergist, or dermatologist and let them know what’s going on with the skin on your hands. They can provide an accurate diagnosis, help you determine which irritants or allergens are contributing to your flares, suggest treatment options, and provide advice on how to protect your skin at work.
Step 2: Wear the Right Gloves
The Agropur story illustrates just how complicated gloves can be: on the one hand (pun intended), they’re important for preventing contact with irritating substances. But they can also cause irritation. Your hands can get sweaty and itchy when they’re encased in gloves, or they can react to materials gloves are made out of, like rubber or latex. Try switching to gloves that don’t irritate your skin, such as accelerator free nitrile gloves. You can also consider wearing cotton glove liners inside your gloves to keep your skin comfortable. Moisturize before you put your gloves on, and take regular breaks from your gloves to let the skin on your hands breathe. After removing your gloves, rinse your hands off and moisturize immediately.
Step 3: Request Accommodation
Don’t let the Agropur story deter you. The Americans with Disabilities Act protects people who have disabilities, which it defines as people who have “a physical or mental impairment that substantially limits one or more major life activities, a person who has a history or record of such an impairment, or a person who is perceived by others as having such an impairment.” If your hand eczema meets that definition, you have the right to reasonable accommodation under the ADA. There are many ways to accommodate limitations that can stem from eczema and other skin conditions.
Step 4: Switch to Gentle Skincare Products
Occupational dermatitis damages the skin barrier on your hands. That means your skin needs extra moisture to stay protected. Switch to gentle soaps and cleansers that won’t further irritate your skin and opt for products like Gladskin Eczema Cream, which both moisturizes and balances the skin microbiome in order to restore skin health.