Show of Hands

Skin eruptions on the hands are responsible for much misery, and for a big share of a dermatologist's practice nowadays. In the A.M.A.'s Archives of Dermatology and Syphilology, two doctors identify the typical patient: "A young matron, who must keep house, cook, wash dishes, do the laundry, raise her children, and hold her husband [and] whose occupation is inherently one of the most hazardous with which the dermatologist commonly has to deal."

There are ample reasons for all the hand trouble, report Drs. Richard L. Sutton Jr. and Samuel Ayres Jr. The hands are more exposed to heat, cold, light, moisture, irritant chemicals, sensitizing chemicals and germs than any other part of the body. Moreover, an infection or poisoning of the whole body may affect the hands with especial severity. Finally, because they are the most used organs of touch, they are subject to psychosomatic disturbances. ("The hands are busy if the mind is busy . . . agitated if the mind is agitated.")

An eczemalike eruption of the hands is often caused by the defatting and drying effects of soap and detergents used in dishwashing, especially during cold weather, the doctors report. And it may be aggravated by many common household irritants, such as bleaches, waxes, polishes, or even hand lotions and cold creams. These create a breeding ground for germs. "A common history," they find, "is that of an eruption beginning on the left fourth finger under rings and later spreading to other portions of the hands [caused] by the retention of dishwashing soaps or detergents beneath the rings as a result of inadequate rinsing."

Drs. Sutton and Ayres offer no cure-all for dishpan hands, but advise their fellow dermatologists: 1) eliminate physical irritants, along with nervousness ("practice amateur psychiatry"), and cut down coffee, tea and cola drinks; 2) eliminate chemical irritants and use only the mildest ointments or dressings. Many a case of dishpan hands, the doctors warn, is made worse by overzealous treatment.

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