Occupational Dermatitis: Skin Disease Caused by Work

What occupational dermatitis is

Work exposes the skin to water, detergents, solvents, metals, plants, rubber chemicals, oils, heat and sunlight, often many times a day. Dermatitis is labeled occupational when work causes it or substantially worsens a pre-existing condition such as eczema. People with a history of childhood eczema are much more likely to develop hand dermatitis at work.

Workers in health care, hairdressing, cleaning, food service, construction, manufacturing, metalworking, agriculture and printing are at the highest risk. The job-by-job triggers of rash-type dermatitis are listed on our occupational contact dermatitis page. This page covers the full range of work-related skin disease, how a work link is established and what employers and workers can do.

Types of occupational skin disease

Long-term outdoor work also raises the risk of skin cancers on sun-exposed skin.

Wet work: the biggest single cause

Hands are considered to be doing "wet work" if they are wet or in waterproof gloves for more than about 2 hours a day, or washed more than about 20 times a day. Water and soap strip the skin's protective lipids. Glove occlusion makes skin sweat and soften. Together they cause irritant dermatitis, which then makes it easier for allergens to penetrate.

Symptoms

• dry, rough, scaly skin, especially on the backs of the hands and between fingers
• redness, itching and burning
• painful cracks (fissures) on fingertips and knuckles
• small blisters on the sides of the fingers and palms
• weeping and crusting in acute flare-ups
• thickened, leathery skin with long-standing dermatitis
• hives or swelling within minutes of contact, in urticaria

How a work link is established

A dermatologist, ideally with an interest in contact or occupational dermatitis, will look for:

• Timing: the rash started after a job change, new product or process.
• Pattern at work vs away: improvement on weekends or vacation, worsening on return.
• Location: matching the areas exposed.
• Coworkers with similar problems.
• Safety data sheets for substances you handle; bring them to the appointment.

Tests include:

• Patch testing for allergic contact dermatitis: small amounts of allergens, including workplace substances, are taped to the back for 48 hours and read over several days.
• Skin prick tests or blood tests for immediate allergy such as latex allergy.
• Skin scrapings for fungal infection, and swabs if infection is suspected.

A clear diagnosis matters for treatment, workplace changes and workers' compensation claims. In the US, employers must record significant work-related skin disorders under OSHA rules.

Treatment

• Avoid or reduce the trigger wherever possible, which is the most effective treatment.
• Emollients and barrier creams: apply fragrance-free moisturizer often, including after every wash and at the end of the shift.
• Topical corticosteroids for flares, with stronger ones on the palms for short periods as directed by a clinician.
• Topical calcineurin inhibitors for sensitive areas or long-term use.
• Further options for severe chronic hand eczema: phototherapy, alitretinoin (in some countries), other oral or newer targeted medicines prescribed by a dermatologist.
• Treat infection if present.
• Antihistamines help contact urticaria but do little for the itch of contact dermatitis.

Prevention at work

Effective prevention follows the hierarchy of controls, starting with the most effective:

1. Eliminate or substitute: switch to a less irritating cleaner, powder-free non-latex gloves, or chromate-reduced cement.
2. Engineering controls: automated or closed processes, splash guards, tools with long handles.
3. Administrative controls: rotate wet tasks, limit exposure time, training on skin care.
4. Personal protective equipment: gloves chosen for the specific chemical (nitrile, neoprene or butyl, not one type for everything), cotton liners under gloves for long wear, and changing gloves when wet inside.
5. Skin care: use alcohol-based hand rub instead of soap and water when hands are not visibly dirty (it is gentler), dry hands well, moisturize regularly, and avoid wearing rings at work.

Regular skin checks for workers in high-risk jobs catch dermatitis early.

Outlook

Occupational hand dermatitis can become chronic, particularly when the cause is an allergen that cannot be fully avoided, or in people with atopic eczema. Prognosis is best with early diagnosis, specific allergen avoidance and good skin care. Some people need to change tasks or, less often, jobs. Changing jobs does not always clear it, because irritated skin can stay sensitive for months.

Frequently asked questions

What is occupational dermatitis?

It is any skin inflammation caused or worsened by work. Most cases are contact dermatitis of the hands from wet work, chemicals or allergens like rubber accelerators. Work can also trigger hives, oil acne, sun-related rashes and skin color loss.

How do I prove my dermatitis is caused by work?

Keep a diary of symptoms on workdays and days off, collect safety data sheets for products you handle, and see a dermatologist for patch testing. Improvement away from work, matching exposure areas and positive patch tests to workplace substances support a work-related diagnosis.

Which jobs are most at risk of occupational dermatitis?

Health care workers, hairdressers, cleaners, cooks and food handlers, construction workers handling cement, mechanics and machinists, printers, florists and farm workers have the highest rates, largely because of wet work and contact with allergens.

Can gloves cause dermatitis?

Yes. Latex proteins can cause hives and anaphylaxis, rubber accelerators in latex and nitrile gloves can cause allergic dermatitis, and wearing any glove for long periods traps sweat and irritates skin. Accelerator-free gloves and cotton liners help.

Will occupational dermatitis go away if I change jobs?

Often it improves, but not always. Irritant dermatitis may take months to settle as the skin barrier repairs, and allergic sensitization is lifelong, so the allergen must be avoided everywhere. Early treatment and workplace changes are usually more effective than leaving the job.