Fortunately, shaking hands is not hip because of Corona. Otherwise it would be quite uncomfortable to shake hands with the customer: The skin is flaking on the back of the hand and fingers, it is red and torn and even a little bit wet. Is that contagious? Not that, but the disease can reduce the quality of life enormously and is difficult to treat. The woman has hand eczema, which is a red, inflammatory, non-infectious rash. Every year around 10 out of 100 people get hand eczema. Those who have to expose their hands to heavy loads on a daily basis are particularly affected. That is why hand eczema is a classic occupational disease.

In 2020, 15,797 of 52,956 confirmed occupational diseases were skin diseases - that's more than a third. Much of this involved hand eczema. But of the 37,181 recognized occupational diseases, only 381 - a good one percent - were skin diseases. “That was due to the legislation,” says Christoph Skudlik, chief physician at the Institute for Interdisciplinary Dermatological Prevention and Rehabilitation at the University of Osnabrück. “I hope that a lot more will be recognized in the future.” In January 2021 there was a change in the law on occupational diseases. There is no longer any need to cease and desist. Previously, those affected had to give up their work in order to have an occupational disease recognized. Only then did the trade association have to pay a supply.Now the employees can stay in their job and still receive the therapy. “This is a fundamental change in patient care,” says Skudlik.

When harmful foreign substances enter the skin

Normally, horny cells and fats form a stable bond in the skin - like bricks and mortar in a wall. This wall prevents foreign substances such as bacteria, pollutants or allergenic substances from penetrating the skin. If the wall becomes porous due to constant stress, foreign matter can penetrate more easily and moisture is lost. Dry air, heat build-up in gloves or constant contact with water can disrupt the skin's barrier in such a way that pollutants can penetrate more easily. Usually there is not just one cause, but several factors come together that reinforce each other, says Peter Elsner, Director of the University Dermatology Clinic in Jena. "If the skin is exposed to harmful influences every day for weeks,at some point it can no longer recover and reacts with inflammation and a rash. "

Hand eczema has different causes.

If someone gets dry, flaky, red spots, especially on the backs of their hands and fingers, it could be irritating hand eczema.

This is caused by substances that can damage the skin, such as solvents, hair care products, cleaning agents or cement.

Allergic hand eczema - for example due to rubber additives in gloves - itches and burns at the beginning, later the skin thickens.

"Irritant hand eczema is often misunderstood," says Hanspeter Rast, occupational physician and specialist in hand eczema at the Swiss accident insurance company Suva.

Mixed forms often occur.

Prompt treatment protects against chronic illness

If you notice a rash on your hands, you should see a dermatologist as early as possible, advises Rast. “The sooner the eczema is treated, the lower the risk of it becoming chronic.” If the suspicion is confirmed, the most important measure is to avoid the pollutant causing it. Then comes the basic therapy: apply cream to the skin regularly, in the acute stage with light lotions or creams, later with greasier ointments. Depending on the type and severity of the eczema, doctors will gradually prescribe additional treatments, such as cortisone or UV light.

As soon as Skudlik suspects a work-related hand eczema, he suggests the so-called dermatologist procedure. “The person concerned only benefits from this.” The dermatologist reports the case to the professional association or the accident insurance company. With the new law, they are obliged to pay for therapies that are not covered by statutory health insurance, such as UV treatments or creams for basic therapy. In addition, patients are entitled to the full program of advice and care offers created for occupational skin diseases - seminars, inpatient treatment for severe cases and, if necessary, professional retraining. Employers must take precautions to minimize hand damage. Every employee then has to additionally protect their hands if necessary:with gloves or protective cream at work and gentle cleaning and care cream afterwards.

According to a survey by the Professional Association of German Dermatologists from May 2020, more than 80 percent of 512 respondents said that they have been seeing patients with hand eczema more and more often since the start of the corona measures. One thing is clear: hand hygiene is one of the most important measures to get the pandemic under control. He keeps hearing, says Skudlik, that disinfectants are much worse than washing with soap. “But that's a myth,” he says. There is now sufficient evidence that disinfectants are less irritating to the skin than soap and water. Nevertheless, constant disinfection increases the risk of hand eczema. The only thing that helps as a preventive measure is: cream, cream and cream again.

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