How can I treat contact dermatitis?

March 14, 2008 4:56 PM

I get pretty severe contact dermatitis on my hands. Is there anything other than Triamcinolone cream which might help?

I work in the produce department of a Kroger store, and for years I have had what doctors tell me is contact dermatitis on my hands from handling fresh produce. I wear latex gloves, but through seepage or ripping, my hands still get raw and sore, until I mercifully have a couple days off for the healing to begin. When my hands are at their worst, they are red and blotchy, with slight clear oozing. Yuck! I keep myself clean when I get home from work, and try to moisturize and get my hands as clean as possible, which usually keeps them from getting worse.

Soaking my hands in VERY hot water gives an almost orgasmic feeling, but is probably not a healthy thing to do (often). Is there anything other than Triamcinolone cream which might help? Over the counter Cortisone creams don't seem to do much good.

I will be making an appointment with my doc for some more of the cream, but in the meantime, I thought I'd ask the real experts (mefites!) for any suggestions.

posted by newfers to health (22 comments total)

I get painful cracking at my fingertips, and general raw dryness which my doctors call dermatitis. I have been prescribed fluocinonide, a cortizone gel (consistency of stiff vaseline in a tube). I put it on at night and wear white cotton gloves when it gets bad... winter usually. It helps, but plain old vaseline seems to work just as well for me.
posted by jeff-o-matic at 5:03 PM on March 14

BTW, the gloves I mentioned are available at big drugstores for around $3 a pair. I use them around 5-7 times and wash them. They only hold up for a couple washings, but they're cheap.
posted by jeff-o-matic at 5:07 PM on March 14

Have you considered that you might have a latex allergy? My father does, and latex gloves produce almost the same symptoms you describe. Have you tried switching to nitrile gloves, or another synthetic plastic glove?
posted by pullayup at 5:09 PM on March 14

Also, when I worked in a produce department, I never found anything that worked better for my chapped hands than lanolin.
posted by pullayup at 5:10 PM on March 14

Here's more info about latex gloves.
posted by pullayup at 5:12 PM on March 14

I work with birds for a living and we feed our birds of prey a ground meat diet that causes contact dermatitis if I handle it too much. It isn't nearly as bad as you describe, but when it breaks out I have used a few over the counter products that pretty help.
Corn Huskers Lotion - very gooey and would probably work great with the gloves Jeff-o-matic mentioned.
A&D ointment is one of my favorites for minor irritations. I used it on all of my tattoos when they were new.
If you can't find it in the skin care section check the baby products as it is also used for Diaper Rash. Beware though it contains lanolin and some people are allergic to that.
posted by fogonlittlecatfeet at 5:16 PM on March 14

I developed the allergy years ago, before the necessity of my allergy required me to wear gloves. Of course, one doesn't preclude the other - maybe the latex gloves do not help. On a whim, I will go completely gloveless tomorrow (and eventually switch to non-latex gloves) and see what happens. I am off on Sunday, so I will have time to recover a little, if my experiment fails!

At the very least, I will seek out other gloves to wear.

But in the meantime, any suggestions to speed the healing process are welcomed. Lanolin sounds promising.
posted by newfers at 5:20 PM on March 14

Also... if it is an allergic thing which "contact" dermatitis is by definition.. would some sort of antihistimine help?? just a thought
posted by fogonlittlecatfeet at 5:29 PM on March 14

Many fruit allergies cross react with latex allergies so definitely try and swap to nitrile gloves. Examples are kiwifruit, papaya, pineapple and banana, if you're allergic to those you'll also likely react to latex (and if not now, then it will develop over time). I suggest nitrile because I find the gloves are thicker, harder, less stretchy, and much less likely to break. So they'll help eliminate your other problem.

As for how to get some, I suggest you try to get hold of somewhere that supplies laboratories etc. If you can't get them to sell you some direct then maybe contact your local university or research organisation and see if they'll on sell a box to you. As an example I can buy a box of 100 nitrile gloves from my stores department (I work for a Crown Research Institute in NZ) for NZ$13 and apparently they're happy to sell them to me for cash for personal use. This is way cheaper than buying gloves from a supermarket or pharmacy and they're better quality.

We've also been known to wear the thin cotton gloves under the nitrile or latex ones to give extra protection. This is mainly done when working with cold stuff but I'll sometimes do it when in gloves all day anyway because the perspiration that builds up in there is pretty gross. They need to be very thin cotton, the drugstore ones jeff-o-matic suggests are probably perfect, and you do lose some dexterity but I'm still able to do reasonably fine work and grip properly with this combination. The extra layer of padding makes the outer gloves a lot less likely to rip and gives you some protection if they do.

Alternatively you can double glove (i.e. put on two gloves, one over the other) so if the outside one rips the inside one still protects you. It's heaps easier to change the outer glove in this situation, I hate putting new gloves straight onto my already-sweaty glove-gross hands, so we double-glove routinely when doing something that necessitates constant changes. This adds very little extra thickness and shouldn't affect your grip at all.

I can't help with what to do once you have the dermatitis but hopefully this can help stop it developing in the first place.
posted by shelleycat at 5:37 PM on March 14 [1 favorite]

I completely understand about the hot water - I had eczema on 75% of my body, and I would stand under a scalding shower and scratch - and it felt SO good. But it's the single worst thing you can do for your problem. After 5 doctors failed me, I finally found one who cured me:

Betamethasone Dipropionate cream (also brand name Diprolene). But, how you use it is key - you have to soak in luke-warm water three times a day, PAT until your skin is just moist and not dry, apply a thin layer of cream, and follow with vaseline. Cotton cloves help.

My skin plagued me for almost a year, and within a week of starting this treatment, I was cured. I keep the stuff on hand (no pun intended) for occasional flare-ups, and it works like a charm.

Good luck!
posted by coollibrarian at 5:48 PM on March 14 [1 favorite]

what shelleycat said 100%. Also, your supermarket should stock both latex AND nitrile gloves, and bear the cost for both. Latex allergies are extremely common.
posted by lonefrontranger at 5:50 PM on March 14

Bag balm is great stuff. Our local Costco carries it behind the counter at the pharmacy. For really serious stuff my son and wife have both been prescribed clobetasol.
posted by ericales at 6:21 PM on March 14

Costco carries two boxes of 100 nitrile gloves for like, $14. It's a great deal.

(They also carry like 300 Claritin for $10, if you decide to go the antihistamine route...)
posted by Comrade_robot at 6:45 PM on March 14

Yikes, bag balm sent me to the doc the last time I tried it... honestly, it somehow seemed to do more harm than good, for some odd reason.

I will be talking to someone at work tomorrow about nitrile gloves!
posted by newfers at 6:52 PM on March 14

Nthing trying non-latex gloves and Vaseline. I get contact dermatitis on the back of my hands from most bathroom soap and I've found that Vaseline not only helps with the rash, but if I put it on in the morning it helps protect my hands a bit as I wash them throughout the day.
posted by Jacqueline at 7:20 PM on March 14

My wife, an RN, said that they always used Cetaphil hand cleanser, cream, and lotion on the job. I swear by these as well. Cetaphil is available at most drug stores. If you see a dermatologist, ask for samples. (She also developed a sever latex allergy.)

My doctors have uniformly recommended against using anti-bacterial soap.
posted by swarkentien at 7:32 PM on March 14

I used to get that, probably not to that extent though, and I developed a daily habit of plain old Curel. That's for regular life, follow the non-latex glove deal. Also seconding the advice to never, ever use anything with Triclosan in it. It messes me up. Worst experience of my fingers' lives was when I got some mineral spirits on them, and scrubbed clean with some soap chock-full of that stuff and I thought my hands were on fire. That hot water - orgasm thing was dead on!
posted by gjc at 8:39 PM on March 14

Aquaphor is amazing for OTC stuff. It's soothing and heals. I used to get cracked, bleeding, painful hands and this helped immensely, without burning.

I've been prescribed Elocon (generic: mometasone furoate 0.1%) cream for my more stubborn ezcema. It's a corticosteroid and a bit rough; I get the pleasure of using it on my eyelids (in extreme moderation, as it thins skin). I'm not sure if this would help dermatitis outright, but it works great for ezcema.
posted by disillusioned at 9:18 PM on March 14

Clobetasol propionate .05 from a doctor works well. http://en.wikipedia.org/wiki/Clobetasol_propionate

Clobetasol is used to treat the itching, redness, dryness, crusting, scaling, inflammation, and discomfort of various skin and scalp conditions.

This medication is sometimes prescribed for other uses; ask your doctor or pharmacist for more information.
posted by CFMartin at 10:02 PM on March 14

If you can't find the nitrile gloves for some reason, try wearing the white cotton gloves that jeff-o-matic mentioned UNDER the latex ones. I have very dry hands and my doctor recommended using the cotton + latex gloves when I wash dishes. Wearing the cotton gloves to bed helps too. I've also found urea cream (eg. Uremol 20) to be a good OTC solution when I don't want to use a prescribed cortisone cream so much (the steroid thins your skin).
posted by pised at 8:17 AM on March 15

Latex is definitely one of the more immunogenic compounds around and repeated exposure, especially to compromised skin, can sensitize you. Switch to any other kind of glove.

Aveeno makes an oatmeal-based lotion and hand wash that a lot of people get some relief from.
posted by ikkyu2 at 8:48 AM on March 15

Old-fashioned calamine lotion (yes, that ugly pink stuff) soothes my sensitive skin.
posted by Carol Anne at 1:08 PM on March 15