Maybe You Shouldn’t Put a Ring On It

Photo courtesy of nbcnews.com

Do you ever get a rash like this – an excessively dry or peeling, pink or red, and either itchy or tender, condition – just under your ring?

Many people suffer from what’s known as hand dermatitis or hand eczema, especially those with a history of sensitive skin, eczema, allergies, or atopic dermatitis. And, often, the rash is confined to the ring region, particularly in those who rarely, if ever, remove their ring. Ring dermatitis is most common in married women, but anyone who wears any ring for prolonged periods may suffer.

The rash may occur suddenly or after many years of wearing the same ring without any problems. Usually, over the course of days to weeks, a small pink or red patch of skin and excess flakiness occur under the ring. While the rash may come and go spontaneously at first, it eventually progresses and becomes chronic.

Ring dermatitis is a form of irritant dermatitis, and the primary culprit is soap that gets trapped under the band and occludes the skin. Soap residue absorbs the skin’s natural oils, and these oils serve an important protective purpose. When that strong outer barrier is lacking, soap reaches and inflames the delicate skin layers, particularly under the tight occlusion of a ring.

The other culprit may be an actual allergy to a nickel component of the ring. Nickel allergy is very common worldwide – it has previously previously named allergen of the year. But most people do not know they have it because it is mild and signs and symptoms do not manifest until occlusion occurs, like when the metal from a ring touches the skin for extended periods of time. Most 14-18K gold jewelry has a small component of nickel that hardens the naturally soft gold.

Prevention

1. When you wash your hands, use an easy-to-rinse cleanser that is also gentle on your skin. Consider a hypoallergenic cleanser, such as Free & Clear.
2. Rinse ALL soap (dish soap, bath soap, shampoo) from your hands, especially the ring region. Taking your ring off before using soap and wearing gloves whenever possible may be necessary in severe cases.
3. Clean your ring regularly. With a cleaning solution, brush under and between stones where soap residue accumulates. Dry the ring well before slipping it back on your finger.
4. For mild nickel allergies, apply a thin coat of clear nail polish onto the ring to decrease direct skin contact with metal.
5. When a rash is active, wear the ring on an alternate finger while healing.
6. Rotate the ring between the right and left hand periodically to give the skin “breathing” time (my husband wears his wedding band on his left ring finger during the day and on his right ring finger (or off completely) overnight and in Las Vegas (j/k).
7. Use a mild topical cortisone cream for active rash.

Do You Have Really Sensitive Skin?

If you have a more severe, extensive, or refractory ring (or a broader hand) dermatitis, following these tips will not be enough. Here are some extra steps that may be helpful for your ring/hand dermatitis:

1. Adopt the habit of applying a non-greasy hand and hypoallergenic cream or ointment immediately after immersing your hands in water, and particularly after contact with soap. An example that is popular in my household is Neutrogena Norwegian Formula Hand Cream.
2. Add a daily therapeutic hand treatment at night. I like the regimen of Bag Balm and cotton gloves (both available at any pharmacy). This treatment works well on feet, too.
3. Before washing your hands, showering, or cleaning dishes, take your ring off (and safely stow it). This prevents the risk of soap build-up under/around a ring.
4. When using soap to clean (e.g., kitchen, bathroom) wear two sets of gloves: tight-fitting nitrile or vinyl gloves under longer, forearm-length rubber gloves. This will help to limit exposure to soap and water.
5. In moderate to severe nickel allergy cases, consider changing to a platinum or titanium ring band.
6. If signs and symptoms do not improve after 5-7 days after removing your ring and using an OTC cortisone cream, consider seeking professional medical care. Severe rashes may require higher potency topical steroids, or it might be something other than ring rash that requires different treatment.