Dry, red, cracked, and itchy hands—many bakers suffer from eczema and may even consider it an inevitable part of the job. However, recognizing and addressing the condition early can make a significant difference. Prof. Dr. Thomas Rustemeyer shares his knowledge.
Prof. Rustemeyer, occupational dermatologist and allergologist at Amsterdam UMC and member of the AI&I immunology program, regularly treats bakers with these symptoms. ‘It is essential to differentiate between irritant and allergic contact eczema. They develop differently but are interconnected. Both types pose a serious risk for bakers, so recognizing symptoms early is crucial to staying in the profession.'
Irritant Contact Eczema
Baker’s eczema often starts as irritant contact eczema, caused by frequent exposure to irritants such as flour, dough, and constant handwashing. Over time, these factors weaken the skin’s natural barrier, leading to irritation, dryness, and cracking.
Prof. Rustemeyer: ‘Each time you wash your hands, the protective layer of your skin wears down, especially when using degreasing soaps. Frequent washing does not allow enough recovery time, causing the skin to dry out and develop cracks, which leads to itching.’ Although most cases affect the hands, wrists, and forearms, eczema can also appear on the face or other exposed areas. Contact eczema is not contagious.
Allergic Contact Eczema
Allergic contact eczema develops when prolonged exposure to certain substances leads to hypersensitivity. Bakers may develop allergies to flour dust, additives, or spices. Once sensitized, even minimal exposure can trigger a severe reaction.
Prof. Rustemeyer explains: ‘Damaged skin from irritant eczema makes it easier for allergens to penetrate, increasing the risk of allergic reactions.’ Unlike irritant eczema, allergic contact eczema is a lifelong condition. In severe cases, it may make continuing in the bakery profession impossible.
Prevention Strategies
To minimize exposure to irritants, bakers should adopt protective measures:
- Limit unnecessary handwashing. When washing is necessary, opt for rinsing with water rather than soap when possible.
- Use gentle, fragrance-free soaps. If soap is required, choose one without abrasive particles or strong detergents.
- Wear gloves. While impractical for dough handling, gloves are essential during cleaning tasks to protect against moisture and harsh chemicals.
- Apply moisturizing cream regularly. Keeping skin hydrated strengthens its natural barrier.
Breaking the Itch-Scratch Cycle
Eczema is notorious for its persistent itching, leading to a vicious cycle:
- Itching begins.
- Scratching provides temporary relief but worsens the condition.
- The skin becomes inflamed, cracks, and forms wounds.
- As wounds heal, itching intensifies, leading back to step 1.
Dr. Rustemeyer emphasizes: “To break this cycle, frequent moisturizing is essential. A simple, neutral, fragrance-free cream works best. For bakers, the rule is: the more, the better. Recommended application times: in the morning, during lunch break, and after work.’
A Baker’s Experience
A 27-year-old artisan baker shares his struggle with allergic contact eczema:
‘It started eight years ago with itchy hands, but I only realized the severity during New Year's Eve while making apple fritters. My hands became red and irritated. A dermatologist confirmed allergies to wheat, rye, and corn—key ingredients in baking.
Initially, I used ointments and medication, but later, I joined the ‘Blij met Stofvrij’ (Happy with Dust-Free) health study, which also revealed lung issues. Now, I wear gloves, which help significantly. We also switched to low-dust flour to reduce airborne exposure.”
My advice: take symptoms seriously. I ignored mine at first, thinking they would go away. Addressing them early can help prevent severe consequences.’
Recognizing Symptoms Early
Prof. Rustemeyer warns: ‘Eczema develops gradually, making it easy to dismiss. However, ignoring symptoms increases the risk of allergic reactions and worsening skin conditions. Seek medical advice early.’
Watch for warning signs such as:
- Dry, chapped hands
- Redness or swelling
- Blisters or cracks
- Persistent itching
A general practitioner or occupational physician can recommend preventive measures and prescribe treatments. If necessary, a referral to a dermatologist can provide further diagnosis and specialized care.
Treatment Options
Prof. Rustemeyer outlines the treatment approach:
- Anti-inflammatory creams to reduce irritation and speed up recovery.
- Allergy testing to identify and avoid specific triggers.
- Workplace adjustments to minimize exposure, such as using protective equipment or alternative ingredients.
If eczema is caused by an allergy to essential baking ingredients like wheat, changing professions may be necessary. However, for less common allergens like fruits or spices, minor work adjustments can often allow bakers to continue their careers.
This article is a revised version of a Dutch article published on www.bakkerswereld.nl written by Eveline Janse.
Read more about Prof. Thomas Rustemeyer and his extensive allergy knowledge here: