Eczema From Hand Washing: Why Clean Hands Get Dry and Itchy (and a Gentler Routine)

This article is general skincare information, not medical advice. Eczema (atopic dermatitis) and hand eczema are medical conditions. If your or your child's hands are cracked, bleeding, blistered or not getting better, talk with your pediatrician or a board-certified dermatologist.

Every fall, our kids' hands told us the school year had started. More hand washing at school, more hand washing at home, cold air outside and dry heat inside. Within a few weeks their knuckles looked chapped and their fingers felt rough and tight. We weren't going to stop washing hands, so we had to learn how to wash in a way their skin could handle.

If your family's hands get dry, red or itchy every time hand washing picks up, here's what we learned from dermatology groups and from our own sink.

Can hand washing cause eczema on the hands?

Frequent hand washing is one of the most common reasons hands get irritated. The American Academy of Dermatology (AAD) explains that anything that irritates your skin can cause hand eczema, and that even water can irritate the skin if your hands are often wet. The AAD notes that many people who have wet hands throughout the day, such as nurses, hair stylists and plumbers, get hand eczema.

The National Eczema Association (NEA) describes irritant contact dermatitis as hand eczema caused by repeated exposure to things like soaps, detergents or chemicals. When it's work-related, it's called occupational hand eczema.

Hand eczema is common. According to the NEA, about 14.5% of people worldwide experience hand eczema, including roughly 10% of teens aged 16 to 19 and 1 to 4% of school-aged children.

Who is more likely to get eczema from hand washing?

• People who had eczema as kids. The AAD says you have a higher risk of hand eczema if you had atopic dermatitis as a child.
• People whose hands are wet a lot. Healthcare workers, stylists, food service workers, cleaners and parents doing dishes, baths and diaper changes all day.
• People who wear rubber or latex gloves. The AAD notes some health care workers get hand eczema from latex gloves, and the NEA lists rubber gloves among possible allergens.

Is it hand eczema or just dry skin?

It can be hard to tell. The AAD says hand eczema often looks like dry skin and is easily mistaken for it. Signs it lists include:

• Dry, chapped skin (often the first sign)
• Patches of red (or dark brown) irritated skin
• Scaly, inflamed skin that may itch
• A burning feeling or itchy blisters
• Deep, painful cracks, or bleeding or weeping skin

The AAD also points out that, unlike plain dry skin, hand eczema needs more than a good moisturizer, because finding the cause matters. That's why a dermatologist visit is worth it if the rash keeps coming back.

A gentler hand washing routine for eczema-prone hands

Clean hands still matter, especially during cold and flu season. These steps come from NEA and AAD guidance and are what we taught our kids at our own sink:

1. Use lukewarm water, not hot. The NEA recommends lukewarm water with a mild, fragrance-free cleanser.
2. Pick a gentle soap. Skip harsh, heavily scented soaps. The AAD's dry-skin tips list fragrance, including deodorant soaps, as something to avoid. We keep a gentle foaming hand soap at every sink so nobody grabs the harsh stuff. Here's how we pick the best hand soap for eczema-prone skin. More tips on choosing one are in our cleansing guide.
3. Pat, don't rub. The NEA says to pat hands dry instead of rubbing.
4. Moisturize right away. The NEA says to apply moisturizer immediately after drying, and the AAD recommends applying moisturizer after washing your hands while the skin is still damp.
5. Repeat through the day. The NEA suggests emollient-rich creams or ointments multiple times a day, especially after handwashing. The AAD suggests carrying a non-greasy hand cream and using it after each hand washing.

The habit that made the biggest difference for us was step 4. A small tube of our oatmeal hand cream lives in each backpack, and our kids rub it in after washing up for lunch. At bedtime, we use a thicker layer of our honey and oatmeal eczema cream on their knuckles and the backs of their hands.

What to look for in a hand cream for eczema-prone skin

• Creams or ointments over thin lotions. The AAD suggests a cream or ointment for dry skin.
• Fragrance-free when possible. Both the AAD and NEA point to fragrance-free products for sensitive skin.
• Barrier-friendly ingredients. The NEA mentions fragrance-free creams or ointments with ceramides or colloidal oatmeal, and lists colloidal oatmeal and shea butter among soothing ingredients.
• Something your family will actually use. A cream that sits in a drawer doesn't help. Keep one at each sink, in the car and in school bags.

Want to compare options? Our side-by-side comparison shows how Eczema Honey stacks up against other popular creams.

Protect hands during dishes, cleaning and wet work

Hand washing isn't the only time hands get wet. The NEA calls protective gloves one of the most effective steps for hand eczema and suggests cotton or vinyl gloves (not latex) for wet work or cleaning. If gloves make your hands sweat, it suggests lightweight cotton liners underneath. The AAD also recommends wearing gloves when you wash dishes, garden or have your hands in water a lot.

What about hand sanitizer?

The AAD's list of skin care ingredients to stop using on dry skin includes alcohol, with hand sanitizer as the exception. Follow your school's or workplace's hand hygiene rules, and moisturize once the sanitizer dries. If sanitizer stings on broken or cracked skin, mention it to your doctor.

When to call the doctor

Call your pediatrician or a dermatologist if hands are cracked and bleeding, blistered, weeping, crusted, painful, or showing signs of infection such as pus, or if the rash isn't getting better with gentle care. The AAD notes that dermatologists can help find what's causing hand eczema and help people keep working while avoiding it.

Our takeaway

We never asked our kids to wash their hands less. We changed how they wash: lukewarm water, a gentle soap, pat dry and cream right away. It's a 20-second habit after a 20-second wash, and our kids' hands are more comfortable for it.

Wearing cotton gloves over a rich cream at night is an easy add. Here's our guide to cotton gloves for eczema-prone hands.

Frequently asked questions

Can washing your hands too much cause eczema?

Frequent hand washing can irritate the skin and is a common trigger for irritant hand eczema. The AAD notes that even water can irritate skin when hands are often wet.

Should I stop washing my hands if I have hand eczema?

No. Hand washing is still important. Use lukewarm water and a mild, fragrance-free cleanser, pat dry and moisturize right after, as the NEA recommends.

How soon after hand washing should I moisturize?

Right away. The NEA says to pat dry and immediately apply moisturizer, and the AAD suggests applying it while skin is still damp.

What kind of soap is best for eczema-prone hands?

Look for a mild, fragrance-free cleanser, as the NEA recommends, and avoid harsh or deodorant soaps with added fragrance.

Is a cream or a lotion better for hand eczema?

The AAD suggests creams or ointments for dry skin. They tend to be thicker than lotions, which many families find work better on hands.

When should I see a dermatologist for hand eczema?

See a dermatologist if your hands crack, bleed, blister or weep, or if the rash keeps returning. The AAD notes hand eczema is easy to mistake for dry skin, and a dermatologist can help find the cause.

Sources: American Academy of Dermatology: Hand eczema; American Academy of Dermatology: Dermatologists' tips for dry skin; National Eczema Association: Hand eczema.

Related reading: Hand eczema: causes and daily care tips and supporting your skin barrier in winter.