Hand rashes are a widespread problem because the hands come into contact with wind, dry air, soap, and many other irritating substances. Most hand rashes are not serious, but any sudden or severe rash warrants a call to the doctor.
In this article, we look at the possible causes of a rash on a person’s hands and when to seek medical help.
The National Eczema Association describe contact dermatitis as a condition that causes changes in skin color, itching, and irritation on a part of the body that comes into contact with an irritant.
Sometimes it is an allergic reaction. For example, a person might develop contact dermatitis after petting an animal or using a new lotion.
However, contact dermatitis can also appear when something irritates the skin, such as a tight ring on a finger. Contact dermatitis usually goes away once people remove the irritant.
Hives, sometimes called urticaria, is a rash that usually appears suddenly and then goes away. The bumps are itchy and may (blanch) become lighter when pressed. They signal an allergic reaction.
Hives are widespread, and about 20% of people will experience them at some time in their lives.
Sometimes hives can appear before a serious and life threatening allergic reaction called anaphylaxis.
Several substances can cause minor allergic reactions on the skin. These substances may affect the hands when a person is gardening, using a new lotion, or coming into contact with a chemical to which they are allergic.
Plants are a common trigger for these allergies. Poison ivy, oak, and sumac contain urushiol, an oil that triggers an allergic reaction in most people. According to the American Academy of Dermatology Association (AAD), the rash usually appears within 4–48 hours in people who have previously had a poison ivy, oak, or sumac rash.
If people have not had a previous rash from one of these plants, a rash can take 2–3 weeks to appear.
According to the American Academy of Allergy, Asthma, and Immunology (AAAI), anaphylaxis is a severe and potentially life threatening allergic reaction that causes the body’s immune system to react aggressively to a harmless substance. It sometimes begins with a slightly swollen rash similar to hives.
If the rash spreads quickly, it can lead to more severe symptoms, such as a swollen throat and trouble breathing.
A person who suddenly develops a rash following a sting, new medication, or exposure to another new substance should immediately call their doctor. If they develop other symptoms, they should call 911 or go to the emergency room.
Eczema, sometimes called atopic dermatitis, is a chronic skin condition. It causes scaly patches on the skin that may be darker or lighter than the rest of the skin. The patches may be all over the body or just on one place, such as the hands.
The rash often itches and may get worse when the skin is dry, or during cold or dry weather. The AAD indicate that eczema is more common in children than in adults. In children, eczema typically goes away by itself, but others have the condition in adulthood.
Dyshidrotic eczema is a more severe form of eczema that can cause small but very painful blisters. The National Eczema Association indicate that 50% of people who develop dyshidrotic eczema already have atopic dermatitis.
There is a variety of eczema types. Learn more here.
Psoriasis is an autoimmune disease that causes the body’s immune system to attack healthy tissue. It can affect any part of the body.
Psoriasis on the hands may make the nails look misshapen. A person may notice a red or dark scaly rash that may itch. People with psoriasis on their hands may eventually develop the rash elsewhere, such as on the scalp.
There is no cure for psoriasis, but some medications can help manage the condition.
Sometimes a person applies suncream to their entire body but forgets to cover their hands. This can cause sunburn on the tops of hands and wrists.
Sunburn may hurt at first, and then begin itching. The skin may look dry, blister, or peel.
Keratolysis exfoliativa causes the palms of the hands to peel, usually on a recurring basis. The peeling is not painful, and the skin is not usually discolored or swollen. Some people also notice peeling on their feet.
The peeling may get worse during the summer or after frequent hand washing or exposure to water.
Keratolysis exfoliativa is not dangerous, but it can be alarming. A person may worry about the cosmetic appearance of their hands. Few treatments are effective, so most doctors recommend tracking and avoiding triggers, such as harsh detergents.
Tinea manuum is a type of fungal infection of the hands, similar to athlete’s foot. It usually causes a ringworm-like rash with a raised border. The rash is often much larger and more irregularly shaped than ringworm, which is typically circular.
According to an older article, a person may get the infection from a person, animal, or soil with tinea manuum or from touching the feet of someone with athlete’s foot. The rash is usually very itchy and can cause the nails to discolor or look misshapen.
Lichen planus is a common inflammatory skin condition. It causes swelling, redness or darkening of the skin, and bumps. It can affect any part of the body, including the mouth and scalp, but some people first notice the rash on their wrists or hands.
According to the American Skin Association, some liver infections may cause lichen planus, but doctors cannot always find a specific cause. Some people notice that their symptoms get worse when stressed.
Cellulitis is a bacterial infection of the deep layers of skin. If bacteria enter the skin, it can cause cellulitis.
According to the AAD, a variety of diseases or injuries can allow bacteria to penetrate the skin. A person can get cellulitis even after minor injuries, such as a cut from a razor or a bee sting.
Cellulitis may resemble a rash because it looks swollen and red or darker in color, but it is a dangerous infection that can spread quickly.
While cellulitis can affect any area of the body, the hands are most vulnerable because a person can easily cut them when preparing food, gardening, or using tools.
The skin may look like an orange peel, and a person may notice streaks. When a person touches the skin, it may feel hard, and the skin may be so sensitive that moving the hands or touching anything becomes painful.
Treatment depends on the cause of the rash. It is usually safe to treat minor conditions, such as contact dermatitis and eczema, at home. The most common treatments include:
- Steroid creams can treat many skin conditions, including eczema, lichen planus, and allergic reactions.
- Calamine lotion and colloidal oatmeal may ease many itchy rashes, including from poison ivy, oak, and sumac, psoriasis, and eczema.
- Keep skin moisturized. Aloe vera can ease the pain of sunburns.
- Avoid the sun following sunburn. Stay indoors or wear loose-fitting clothes with long sleeves.
- Creams that encourage the shedding of skin cells may ease symptoms of psoriasis. Some people also get relief from sunlight.
- Antifungal creams may help with fungal infections.
It is not possible to prevent all rashes. However, some strategies that may help include:
- Use fragrance-free moisturizers to reduce the risk of irritation and allergic reactions.
- If a person has eczema, use a cream formulated for eczema, especially after washing hands.
- Wear gloves when working in the yard or using irritating chemicals.
- Avoid using medications, including medicated creams, unless absolutely necessary. This can reduce the risk of a medication-induced allergic reaction.
- Ask a doctor about carrying an epi-pen if people have a history of severe allergic reactions.
See a doctor for any rash that does not go away on its own with home treatment or that starts spreading.
A person should call a doctor immediately if:
- they have a fever, or the rash shows signs of infection such as pus or oozing
- the rash is painful, not itchy
- the skin is very swollen
- they have other symptoms, such as symptoms of a cold or the flu
Go to the emergency room or call 911 if:
- a rash appears all over the body, especially after an insect sting or taking medication
- a person has a rash and has trouble breathing
Most rashes are not serious and will go away on their own, even without treatment. If a rash hurts, appears suddenly, or does not go away, it may signal a more serious problem.
Prompt medical treatment can ease the pain and treat the rash.