Massage therapists have high prevalence of hand dermatitis

August 16, 2004

CHICAGO - Massage therapists who frequently use essential oils involved in aromatherapy treatments, have higher rates of hand dermatitis than the general population, according to an article in the August issue of The Archives of Dermatology, one of the JAMA/Archives journals.

Hand dermatitis (also known as hand eczema) is a skin disorder that causes the hands to develop a rash and become dry and cracked. Hand dermatitis can interfere with social activities and can cause permanent disfigurement, the article states. Currently, there are between 260,000 and 290,000 practicing massage therapists and massage therapy students in the United States. Many massage therapists are exposed to multiple factors known to increase the risk of hand dermatitis, including frequent hand washing, contact with fragrances, dyes, detergents, latex and other irritants and allergens found in massage oils, creams and lotions. The essential oils used in aromatherapy can also cause hand dermatitis.

Glen H. Crawford, M.D., of the University of Pennsylvania Medical Center, Philadelphia, and colleagues investigated the prevalence of hand dermatitis over a 12-month period among 350 massage therapists practicing in Philadelphia. The researchers used a mailed survey that included questions about use of essential oils, lotions, and other products, history of diagnosis of hand dermatitis, and symptoms of hand dermatitis.

The researchers found that the 12-month prevalence of hand dermatitis among the survey respondents was 15 percent by self-reported criteria (respondent had been diagnosed with hand dermatitis) and 23 percent according to symptoms reported. Those who reported using aromatherapy products, massage oils, lotions, or creams, were more than three times as likely to have hand dermatitis, and respondents with a history of dermatitis were more than eight times as likely to have hand dermatitis.

"The prevalence of hand dermatitis in massage therapists is high," the authors write. "Significant independent risk factors include use of aromatherapy products in massage oils, creams, or lotions and history of atopic dermatitis."

"Massage therapists should be aware of the sensitizing potential of their oils and the possibility of personal and client adverse skin reactions. To lower this high prevalence of hand dermatitis in massage therapists, it may be useful to conduct an educational campaign regarding the potential hazards of aromatherapy products," write the researchers.
(Arch Dermatol. 2004;140:991-996. Available post-embargo at

For more information, contact JAMA/Archives Media Relations at 312/464-JAMA (5262) or e-mail

To contact Glen H. Crawford, M.D., call Susan Winston.

The JAMA Network Journals

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