Allergy to soap?

[theantichick]

I'm just wondering if anyone out there has had an allergy to the soap their facility uses, and if so how did you prove it was the soap?

I've been at my job almost 3 months, and anytime I work by the time I get home I have spots of flaky, scaly skin on the back of my hand at the wrist and my hands and the lower part of my wrists (where I wash) are swollen and red. The affected area extends past where the gloves sit - and we don't have latex gloves, they're vinyl. So I'm pretty sure it's the soap. On days I don't have a c diff patient and use the gel more, the symptoms are markedly less.

I couldn't find the entire ingredients list, but the active ingredient is triclosan. I had read some sketchy things about triclosan years ago and so I don't use any triclosan based soaps in my home. But, research says that contact dermatitis from triclosan is actually pretty rare.

Anyway, I spoke with the employee health nurse and she said that it was more likely it was the gloves as the affected area doesn't have to match the contact exactly. But she also was talking about latex allergy, and as I said we don't have latex gloves. She said I'm going to have to see my private physician and get some sort of test to bring back to show what it is I'm allergic to before she can authorize alternative products for me. I'm not exactly sure how my doctor can test the hundreds of thousands of possible ingredients to see what I'm allergic to. I would assume I would at least have to bring a sample of the soap and gloves in, wouldn't I?

Any experiences with this sort of thing would be really appreciated. I can usually get my skin back in decent condition by the 3rd or 4th day off, but I don't think I should have to deal with it or have my skin integrity constantly compromised on the job.

[TheCommuter, BSN, RN]

I have no anecdotal tales of soap allergies, but wanted to mention that one of my coworkers has an allergy to those sanitary antimicrobial wipes we use to clean equipment and surfaces.

[dishes, BSN, RN]

Usually the first step is a consult with a dermatologist where you will be told whether or not you need to bring a sample of the soap and gloves for the patch test.

[CodeteamB]

I have very similar symptoms to yours, but not due to allergies. My hands dry out from the soap we use. If I am vigilant about hand cream (and it took me awhile to find one that works) my hands are fine, if I'm not i get a flat blotchy red rash and I get tiny cracks that look like paper cuts all over the backs of my hands, and after awhile my hands swell.

I agree, see a dermatologist, but it might not be an actual allergy.

[theantichick]

Excellent, thanks for the feedback. I also happened to look at my Bath and Body Works soap container, and they slipped Triclosan in on me at some point, so that's not the offending ingredient. I didn't know how the testing would/could be done, but I'll follow up with my doc - she's been trying to get me into a dermatologist for years and years now (very pale with too many blistering sunburns as a teen to count puts me at high skin cancer risk apparently) so this may be her chance!

[Morainey, BSN, RN]

I have very similar symptoms to yours, but not due to allergies. My hands dry out from the soap we use. If I am vigilant about hand cream (and it took me awhile to find one that works) my hands are fine, if I'm not i get a flat blotchy red rash and I get tiny cracks that look like paper cuts all over the backs of my hands, and after awhile my hands swell.

This sounds exactly like what happens to my hands when I wash with soap w/ chlorhexidine in it. I get plaque-y looking things that take a long time to go away.

[kmarie724]

I have very similar symptoms to yours, but not due to allergies. My hands dry out from the soap we use. If I am vigilant about hand cream (and it took me awhile to find one that works) my hands are fine, if I'm not i get a flat blotchy red rash and I get tiny cracks that look like paper cuts all over the backs of my hands, and after awhile my hands swell.

I agree, see a dermatologist, but it might not be an actual allergy.

Yep, I have the same problem if I don't use hand cream throughout the day during the winter.

[dishes, BSN, RN]

The next time you experience a reaction, I suggest you take a picture of the front and back of your hands to take with you to your dermatology appointment, that way if your hands are not reacting on the day of your appointment, the picture will give the dermatologist a better idea of the reaction. Usually a patchtest is ordered to determine if a skin reaction is allergic contact dermatitis or irritant contact dermatitis. If you want to know more about the test, look up Thin-layer Rapid Use Epicutaneous test (TRUE test).

[blondy2061h, MSN, RN]

Be careful about using non-approved lotions at work. Some have ingredients that can alter the integrity of gloves.

[dishes, BSN, RN]

antichick, When you said you couldn't find the entire ingredients list for the soap, did you check the MSDS sheet for the soap? Suggest you bring the sheet with you to your dermatology consult, as it can help point the dematologist in the right direction.

Also reccomend you make two separate appointments to discuss the work related skin reaction and the high risk from past sunburns issue. If you do have a sensitivity to a workplace product and your employer needs to make accommodations with alternative products, they have the right to see the medically relevant report and recommendations, but they do not have a right to non-work related skin issue, so it is best for your privacy to keep these issues as separate appointments.

Be prepared for multiple appointments at the dermatology clinic, consult, application of the strips, removal of strips and follow up reading of the strips are done on separate days.

[theantichick]

Thanks again for the feedback, and the info about the dermatologist visit. I've had a medical situation with my kiddo which necessitated her being hospitalized for 4 days and now we're doing rounds of specialists visits with her, so once that's calmed down I'll pursue it.

On the advice of one of my co-workers I tried using nitrile gloves for a shift, and I didn't have the reaction, so it could in fact be the gloves. I still have to go see the dermatologist and get all the documentation if that's the case of course. I'll pull the MSDS next time I work.

Thanks again!

[applewhitern, BSN, RN]

We once had a doctor who had problems with the skin on his hands. He would wear two (2) pair of gloves~take one off, wash hands with one pair of gloves still on. I know that really doesn't solve the problem; I just wanted to mention this because this way you might could wash less and use the gel more, like he did. Personally, I find the gels very drying.