Dear Dr. K: I have red, itchy, peeling eyelids and my dermatologist said it’s most likely due to using hand sanitizers. But I don’t use the sanitizers on my face, so how can that be true?

Your dermatologist is probably right. The hand/face connection is an interesting dichotomy. The skin on our hands is some of the thickest and toughest on our bodies; while the skin on our faces – especially on the eyelids – is among the thinnest and most sensitive.

Hence, using the “miners’ canary” analogy, the face will show an irritant or allergy much sooner than the hands. Thus, you don’t get the clue that your hands are the source of your facial rash via secondary contact.

Thirty years ago a social biologist studied how frequently human beings touch their faces. It’s an amazing number of times during the day, yet if you ask people how often they do it, they grossly underestimate the frequency.

Hand sanitizers have leapt ahead of other causes for dermatitis in the past few years. From their use on entry into grocery stores, to purse-sized sanitizers to baby wipes and personal hygiene products.

The American Board of Dermatologists recently found that more than 50% of nurses in the United States have experienced dermatitis due to hand sanitizers. The ethyl-alcohol that is a common component of many products is very drying. This produces microscopic fissures in the skin which then destroy the protective barrier, allowing other chemicals in the sanitizer to penetrate and cause irritation and/or allergy.

Other common causes for eyelid dermatitis via the hand include artificial nails, nail polish, nail hardeners, hand lotions and metal jewelry (rings). Gardeners often experience similar eyelid rash from handling certain flowers. The most common culprits: tulip, lily, chrysanthemum, daisy, marigold and sunflower.

Bakers can also get eyelid dermatitis from touching flour and yeast.