The study was conducted in Denmark, where about 40% of hairdressers develop occupational hand eczema (OHE), according to researchers. Hairdressers globally are exposed to wet work and myriad skin irritants and allergens, including dyes, permanent-wave solutions, persulfates, preservatives, and fragrances. The study, which was funded by the Danish hairdressers and beauticians union, was published in Contact Dermatitis.
Lead author Martin Havmose, BSc, of the National Allergy Research Center, department of dermatology and allergy, University of Copenhagen, Hellerup, Denmark, and colleagues wrote that prevention is critical, inasmuch as eczema can cut careers short and have lasting health effects.
Up to 70% of hairdressers experience some sort of work-related skin damage in their careers, as reported by this news organization.
Hand eczema also is common among hairdressers in the United States, Mark Denis Davis, MD, chair of dermatology at the Mayo Clinic in Rochester, Minn., told this news organization. It can be quite debilitating, itchy, and painful, he said.
“Often it is associated with painful fissuring, cracks in the skin, particularly involving the fingers. It may also be unsightly,” he said.
Dr. Davis said he hears anecdotally in his practice that many hairdressers are reluctant to wear gloves because of the touch and dexterity needed in their work.
The researchers evaluated the risk of OHE and compliance with skin protection measures among hairdressers who were trained before Denmark rolled out a nationwide skin protection program in hairdressing vocational schools in 2011.
Questionnaires were sent in May 2009 to all hairdressers (96.4% women; average age, 26) who had graduated from 1985 to 2007; in May 2020, questionnaires were sent to all hairdressers who had graduated from 2008 to 2018.
The average time worked in the trade was 8 years, and 28.8% no longer worked as hairdressers, data show.
The response rate was 66.6% (305/460) for the 2009 survey and 29.9% (363/1215) for the 2020 survey.
Prevalence of OHE dropped after program
The prevalence of OHE during career time dropped from 42.8% to 29% (adjusted odds ratio, 0.55; 95% confidence interval [CI], 0.40-0.77) between the two surveys.
In addition, the incidence rate of OHE decreased from 57.5 (95% CI, 48.4-68.4) to 42.0 (95% CI, 34.6-50.9) per 1,000 person-years (incidence rate ratio, 0.73; 95% CI, 0.560.95) in that period.
There was an increase in the use of gloves between the two surveys. There was more glove use when the hairdressers engaged in wet work and handled dyes, products with bleach, and permanent-wave solutions (P < .05).
The nationwide program educates hairdressing apprentices on contact allergy/urticaria, how to prevent occupational skin disease, and skin biology. Teaching materials focus on 11 recommendations, 7 of which are related to glove use.
“The lack of primary prevention of OHE in hairdressing vocational schools may be a missed opportunity in the prevention of the disease,” the authors concluded.
Dr. Davis said hairdressers with hand eczema should know that in the short term, topical corticosteroids can be used to decrease the inflammation of the skin.
He highlighted the following advice from the authors:
- Gloves should be used when washing, dyeing, bleaching, and creating perms.
- Disposable gloves should never be reused.
- Gloves should be used only as long as necessary.
- Rings should not be worn at work.
- Cotton gloves should be worn underneath protective gloves.
- For clients who are having their hair both cut and dyed, the hair should be cut before it is dyed.
- Nitrile gloves should be used without rubber accelerators.
“In the longer term,” said Dr. Davis, “the most important thing is to avoid exposure to the precipitating factors, such as wet work – working with water, which irritates the skin – and avoiding any allergens that are contributing to the eczema.”
The study was funded by an unrestricted grant from the Danish hairdressers and beauticians union. Two coauthors have links to industry, as listed in the original article. Dr. Davis reports no relevant financial relationships.
A version of this article first appeared on Medscape.com.