Washing Hands When Medically Prohibited

Question

I have a question regarding my daughter, who is under the age of Bas Mitzvah and is currently suffering from a medical skin condition (such as eczema). Her doctor has strictly forbidden her from getting her hands wet for several days. How should she conduct herself with respect to Netilat Yadayim in the morning and washing hands for bread ? Are there any precautions we should take during this time?

Answer

Since the child is medically prohibited from wetting her hands, she is exempt from washing Netilat Yadayim—both in the morning and for bread—for the duration of the medical restriction. Instead, the following should be done:

Morning washing: In place of washing hands in  the morning, she should rub her hands on a towel or similar item, without reciting a blessing. She is to wipe both the front and back of the hand up until the wrist three times. After doing so, she may recite the morning blessings [aside for Al Netilas Yadayim] and learn Torah as usual.

Eating bread: If she wishes to eat bread during these days, she may do so without washing, provided that she: Eats the bread while wearing gloves (Best), or (if not possible) Holds the bread using a plastic bag or other barrier, so that her hands do not directly touch the bread. She recites the regular blessing of Hamotzi, but not Al Netilas Yadayim.

General conduct: During this time, she should preferably avoid touching foods that others will eat, in order to prevent any concern of spiritual impurity being transferred. If possible, using gloves when handling even her own food is ideal. She should also avoid directly touching her orifices with her bare fingers whenever possible.

Explanation

This case is halachically comparable to situations discussed in Poskim where a person is unable to wash hands due to medical reasons, or where no water is available.

Regarding Netilat Yadayim in the morning: Halacha rules that when one cannot wash, he should rub his hands on an item (such as a towel or garment) without a blessing, and may nevertheless recite blessings of the morning, Daven, and blessings over food and learn Torah. However, during that time, one should ideally avoid directly touching food or bodily orifices with ones bare fingers due to the Tuma.

• Regarding a child under Bas Mitzvah: The matter is less severe for a minor, as the full spiritual impurity associated with unwashed hands does not fully apply until after Bar or Bas Mitzvah, when the nefesh Elokit fully enters the body. Therefore, there is greater room for leniency in the case of a child, especially when medical necessity is involved.
• Adults: If an adult is medically restricted from washing, they should be more careful to avoid touching food or bodily openings and should preferably use gloves whenever possible. Nonetheless, medical instruction takes precedence, and the same halachic allowances apply.

Regarding washing for bread: The halacha is explicit that if one does not have water available, or cannot wash due to circumstances beyond their control, one may eat bread by using a barrier, such as gloves or a bag, to avoid direct hand contact with the bread. This solution applies here as well. However, according to many Poskim, and so rules Admur in his Seder, the allowance is only to eat the bread while wearing gloves or while both hands are both wrapped in a cloth, and not while they are simply inside of a bag, and therefore the best option is to use gloves and not a bag.

Medical Background: Why Hands May Be Prohibited From Getting Wet

From a medical standpoint, it is common for patients—especially children—with hand eczema, contact dermatitis, or other inflammatory skin conditions to be instructed to avoid getting their hands wet, particularly during an active flare. In such conditions, the skin barrier is damaged, meaning the outer layer of the skin no longer protects properly against irritation and infection. Repeated exposure to water, soaps, or even prolonged moisture can further strip natural oils, worsen inflammation, cause cracking or bleeding, and significantly delay healing. This is especially relevant when the patient is being treated with a topical steroid cream, as excessive moisture can lead to maceration of the skin, increased absorption of the medication beyond what is intended, and a higher risk of irritation or secondary infection. For this reason, dermatologists often instruct patients to strictly limit water exposure for a defined period, to allow the skin to heal and for the medication to work effectively. During such times, protective measures such as avoiding hand washing, using gloves, and keeping the hands dry are considered medically necessary and take precedence.

Sources:

See Piskeiy Teshuvos 162:16

See regarding washing hands in the morning: Admur Basra 1:7; Kama 4:3; 47:9; Siddur Hilchos Netilas Yadayim: “If there is not enough water available to wash three times properly, he nevertheless may not delay learning Torah or saying Hashem’s name in blessings because of it. Rather he is to clean his hands with the little water he has, or with anything which cleans, and is to learn Torah relying on the Talmudic ruling.”

See regarding touching the orifices and food: Siddur Hilchos Netilas Yadayim, Ketzos Hashulchan 1 footnote 10; Not mentioned in Basra.

See regarding how to wipe the hands on an item instead of washing: P”M 4 M”Z 15; Shiyurei Kneses Hagedola 7 in name of Birchas Avraham, Elya Raba 4:12; Yafeh Laleiv 1:33; Olas Tamid 4:13; Kisei Eliyahu 4:9; Mamar Mordechai 4:12;  Kaf Hachaim 4:101; Kaf Hachaim 4:103

See regarding eating bread through gloves if there is no water available: Yeish Makilin in Admur Seder Netilas Yadayim Halacha 22; Only opinion in Admur 163:1; Michaber and Rama 163:1 [permits even with fork]; Aruch Erech Gevel; Rabbeinu Chananel Pesachim 46a;

See regarding eating in bag, versus fork, versus glove: Admur Seder Netilas Yadayim Halacha 22 [permits only with cloth on both hands, such as gloves]; Admur 163:1 [permits even with fork]; Michaber 163:1 [permits with cloth on both hands] and Rama 163:1 [permits even with fork]; M”B 163:7 and 10 and Piskeiy Teshuvos 163:3-4 [Must initially wrap hands, eating in bag does not suffice]; Kaf Hachaim 163:8 [may eat with fork although best with cloth]; Tzitz Eliezer 8:7 and Avnei Yashpei 2:11 negates eating in bag