Dealing With Eczema As A Healthcare Professional

“I have found that you have to use trial and error to find what’s best suited to your skin and your lifestyle.”

Amira talks us through her life-long struggle with Eczema and gives tips on how to deal with the condition as a Healthcare Professional.

Topics Covered In This Article

Introduction

Dealing With The Condition At Work

Eczema Triggers And Symptoms

Infections

Managing Eczema Effectively

Final Thoughts

Introduction

Atopic Eczema is one of the most common forms of Eczema, it causes dry itchy skin.

It’s a non-contagious inflammatory dry skin condition.

Often times the itching is unbearable and during flareups skin can be red, sore, cracked and raw.

Hand dermatitis is one of the most common forms of dermatological disorders seen in Nurses working in the healthcare sector.

The factors that increase the risk of developing hand dermatitis are as follows: frequent washing hands, using disinfectants, wet-work conditions, exposure to medical substances, detergents and wearing rubber gloves.

I had a mild form of Eczema as a child, but it was only ever in the insides of my elbows and the backs of my knees.

As I grew older, I eventually grew out of my Eczema but would occasionally get dry patches of skin during winter, which was normal.

During my student placements where I was constantly washing/sanitising my hands I would constantly moisturise them therefore I never really experience any dry skin on them.

However, I would constantly hear other healthcare staff member complain of dry skin or even Eczema on their hands but I would never really pay attention as it didn’t apply to me.

Dealing With The Condition At Work

When I started working in theatres I obviously had to “scrub up” for procedures.

Scrubbing refers to the way we wash our hands and arms before starting a procedure.

This includes: cleaning nails with a nail pick and brush, doing a pre scrub wash and doing a surgical scrub.

The types of hand wash we use are: chlorohexidine, povidone iodine and hibiscrub.

Often, these types of wash are non-irritating on normal skin however after a few months I found my hands to be incredibly dry and irritated.

I used to try to moisturise as much as possible but nothing would help as I was only able to moisturise after the procedure was over.

Eventually, my hands became so dry and cracked constantly. In addition to this, on one particular day, my flare up got so bad my finger swelled up to double it’s size and was covered in red, sore itchy blisters.

At this point, I had to tell my team leader as I couldn’t even physically scrub or even put on a pair of gloves.

After this I had to take a few days off due to the fact I couldn’t actually scrub.

Due to this I had an occupational health appointment.

During this appointment, we discussed what possibly could’ve caused it.

We went over possible triggers and reasons for the flare up.

We spoke about stress, possible latex allergy and how to deal with it.

Eczema Triggers And Symptoms

Possible triggers for Eczema flare ups in healthcare:

1) Hand washes/ solutions that are abrasive or drying

2) Constant use of alcohol gel as alcohol is very drying on the skin

3) Stress

4) Allergens

5) Humidity and heat can also affect the skin

Common persisting symptoms of Eczema:

1) Pruritus (itching) This is the most common symptom of Eczema. Scratching can disrupt your sleep, make your skin bleed, and cause secondary infections. It can also make itching worse, and a cycle of itching and regular scratching may develop.

This can lead to sleepless nights and difficulty concentrating at school or work.

2) Redness. Blood supply to the skin is prolific and normally only required in low volume.

Inflammatory skin diseases alter this balance by causing dilation of blood vessels feeding the skin, leading to generalised total body redness (erythroderma).

3) Areas of skin affected by Eczema may also turn temporarily darker or lighter after the condition has improved.

This is more noticeable in people with darker skin.

4) Inflamed skin can become red on lighter skin, and darker brown, purple or grey on darker skin.

This can also be more difficult to see on darker skin.

Infections

Primary or secondary infections can cause exacerbations of Eczema.

Infections resulting from bacteria such as Staphylococcus or Streptococcus are characterised by weeping, pustules, yellowish crusting and rapid deterioration or failure to respond to treatment.

Due to the itching and scratching infections can be common in Eczema flare ups.

Obviously, scratching with nails can cause infections so it is recommended that we tap the skin instead of scratching.

Saying that, it is always easier said than done.

Managing Eczema Effectively

There are so many ways to deal with your Eczema and everyone’s skin is so different so there’s no one size fits all for treatment.

The first thing I would recommend is look at possible triggers such as laundry detergents, the products you use on your skin and your surroundings.

This may be easily fixed by changing your cleaning products or even skincare products.

In addition to this, you should also look at possible food allergens that could cause your flareups.

To calm flare ups, you can take over the counter antihistamines which will provide short term relief whilst you’re figuring our what is causing your skin to react.

You also need to stay on top of moisturising your skin!

Emollients such as cetraben and aproderm can be used to help your skin retain moisture and heal.

The choice of emollient depends on the disorder:

• Dry, hyperkeratotic skin - use oily, occlusive ointments

• Flaky, rough, excoriated skin - use grease-based preparations

• Erythematous, inflamed skin - benefits from the cooling effect of water-soluble creams.

Apply the moisturiser with smooth downward strokes in the direction of the hair - this reduces friction/irritation on the skin surface and avoids an increase in skin temperature that triggers itching.

Rubbing in the moisturiser can block hair follicles, leading to localised infection (folliculitis).

Topical corticosteroids have also proved to be effective in dealing with Eczema.

These are often prescribed although you can get some low strength steroids OTC at pharmacies.

These are not a long-term treatment option and are often times supposed only be used thinly over the 7 days.

Final Thoughts

At the moment, I am still scrubbing theatres with my Eczema.

The way I deal with it at work is by using dermol wash when I scrub.

This is a gentle wash that is moisturising and doesn’t dry out my skin

After I have completed my procedure, I try to moisturise my skin as soon as possible.

I always carry around my hand creams and even have E45 on standby

In addition to this, I also have been prescribed stronger anti-histamines as recently my Eczema has become quite wide spread.

Along with this, I have found that my Eczema does worsen when I am stressed therefore, I also try to work out and have “self-care days” to help me destress.

I have found that you have to use trial and error to find what’s best suited to your skin and your lifestyle.