International Academy of Cosmetic Dermatology
LATEX GLOVE ALLERGY
Gloves are great for protecting the hands from irritants, chemicals, and germs. Unfortunately, sometimes gloves can hurt rather than help. (Figure 1) When people develop dermatitis on their hands after wearing gloves, they frequently say “I am allergic to latex,” but latex may not be the reason for the redness. Three types of dermatitis are associated with wearing gloves:
• Irritant contact dermatitis
• Allergic contact dermatitis
• Hives (urticaria).
Such hand dermatitis will have different causes and may require different treatments. Irritant contact dermatitis is the most common problem in people who use latex and other elastic gloves. (See also Contact Dermatitis and Contact Dermatitis under Cosmetic Dermatology 101)
Stretchy, strong, and durable, latex gloves are made from natural rubber – latex – the sap of a tree that grows in Malaysia and Africa, called Hevea Brasiliensis. Latex gloves became popular in the medical field and the food industry in the 1990s, when “universal precautions” were instituted to protect patients and workers from blood borne pathogens, such as the HIV virus. Unfortunately, it soon turned out that some people were allergic to the natural rubber latex. Luckily, many synthetic alternatives are now available for use.
People with a true allergy to natural rubber latex may get hives within minutes of putting on the gloves. The hives may be just on the hands or may spread to other areas. These people may also develop a runny nose, itchy eyes, and, rarely, even such severe reactions as asthma or even anaphylaxis. The only way to treat this problem is to eliminate any exposure to latex and use only latex free gloves. A blood test can help determine if someone has a true allergy to natural rubber latex.
Nitrile, vinyl, polyisoprene, neoprene, and other synthetic rubber material are used to make latex free gloves. A person with latex allergy should look for a “latex free” label on the box. Interestingly, “latex” paint does not usually contain any natural rubber latex in it and is safe to use.
The situation may be more complicated as latex allergy is not the most common cause for hand dermatitis from wearing stretchy gloves. Dry, crusty, red, cracked skin called irritant contact dermatitis is more frequent. Gloves are great for keeping things out, but they can also keep things in. Powder in the gloves, along with detergents and soaps not washed off before putting on the gloves, can all result in dermatitis, as the gloves will keep these irritants on the skin for some time. In addition, anything that leaks into the glove can irritate the skin, as well. Frequent hand washing also goes hand in hand with wearing gloves.
Detective work will help to clarify if the soap, rather than the glove, is the villain. Making sure that any irritating agents are washed off, applying barriers such as zinc, Vaseline, or one of the prescription barrier creams, or wearing cotton liners under the gloves can minimize irritation and provide relief. Patch testing (See Patch Testing under Cosmetic Dermatology 101) may confirm that the culprit was another contactant: carbamate, thiourea, benzothiazole, or thiuram.
Yelena Frankel, MD
Baltimore, MD, USA