How Hand Eczema Is Treated

Hand eczema can interfere with many aspects of life and become debilitating. It's important to treat hand eczema promptly to prevent it from getting worse or becoming chronic.

Some hand eczema can be treated with moisturizing, a good skin care routine, and protecting hands from exposure to triggers. Eczema that is more serious or persistent may need topical or systemic medication. Less commonly, light therapy may be used.

This article discusses how you can manage hand eczema (or hand dermatitis), including home remedies, over-the-counter (OTC) treatments, prescriptions, and procedures.

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The most important parts of treating and preventing hand eczema involve lifestyle practices.

Hand eczema is often triggered by environmental factors. It is more common in people who work in certain occupations, such as healthcare workers, hairdressers, cooks, cleaners, manufacturing workers, and people in other jobs involving repeated contact with water or other irritants.

Avoiding contact with anything that irritates your skin is key to healing and preventing hand eczema. Anything can be a hand eczema trigger, but common ones include:

How you wash your hands makes a difference.

When you clean your hands:

A good skin care routine with proper moisturizing are often overlooked, but it is key to treating hand eczema, even if other measures are needed. Adhering to this routine, even when your hand eczema is not noticeable, can help prevent flare-ups (periods when the eczema is worse).

While soap substitutes such as cream cleansers are better for eczema, it's important to note that they do not destroy bacteria, viruses (such as the one that causes COVID-19), and other pathogens.

You need to use soap and water or sanitizer if sanitizing is needed, not just dirt removal.

If you can't avoid your triggers altogether, there are measures you can take to help protect your hands, such as wearing gloves.

Other hand-protecting tips include:

If you have a history of hand eczema, you will need to make some considerations when it comes to working:

OTC topical (applied to the skin) treatments are the first-line of treatment for hand eczema. A good moisturizer (also called an emollient) helps to hydrate the skin, prevent itching, and repair the skin barrier.

When choosing a moisturizer:

Some products to look for include:

Even when your hands look free of eczema, it can take months for your skin to heal fully. Continue using your skin care routine to help your skin finish healing and prevent future flare-ups. If you are using prescription ointments or medication, follow the advice of your healthcare provider on how long to use it.

In some cases, hand eczema doesn't respond well enough to a skin care routine alone, and medication may be needed.

Topical medications are typically the first choice of medicinal treatment for hand eczema.

Steroids

Topical steroids reduce inflammation, which helps with redness, soreness, and cracked skin. They are effective in the short term and generally are used for about two weeks. Long-term use (over six weeks) should be avoided because they can thin the skin.

Topical Immuneomodulators

The topical calcineurin inhibitors Elidel (pimecrolimus) and Protopic (tacrolimus) are approved for treating atopic dermatitis, another form of eczema. They can be used off-label for hand eczema for people who can't use topical steroids. They don't thin the skin, so they can also be used for longer than steroids.

Ultraviolet (UV) light protection, such as sunscreen and protective clothing, should be used if you are using calcineurin inhibitors.

Antimicrobials

Eczema makes skin more prone to infection. If you have an infection on your hand, you may be prescribed a topical treatment (go o the skin) or systemic medication (work throughout the body).

If symptoms are severe and other treatments have not been effective, oral corticosteroids, such as prednisolone, may be prescribed.

Long-term (over three weeks) or frequent use of these medications is advised against as they have significant side effects and increase the risk for conditions such as osteoporosis (progressive bone loss), glaucoma (high pressure in the eye damages the optic nerve), and cataracts (clouding of the lens of the eye).

There is currently no Food and Drug Administration (FDA) approved systemic treatment for chronic hand eczema in the United States, but several drugs are being explored.

Dyshidrotic eczema, also known as pompholyx eczema, is a specific type of eczema that affects the hands and feet. It is characterized by itchy, watery blisters on the palms, the sides of the fingers, and/or the sides of the toes.

Phototherapy is an option for hand eczema that hasn't responded to topical steroids. It involves the application of UV light or a combination of UV light and the medication psoralen (this combined treatment is called PUVA).

Psoralen increases the sensitivity to UV. It can be taken orally, but that can cause side effects like nausea and necessitates full-body UV protection. A topical cream is also available, which avoids these issues.

Treatments are typically two to three times a week for a few months. Long-term treatment can increase the risk of skin cancer. One study showed that using an excimer laser (a device that produces ultraviolet light in a tight beam) to administer the UV was effective and reduced the cumulative exposure to UV radiation as it targets specific sites.

Phototherapy should be done under the supervision of a healthcare professional. Don't try to do it yourself using sun exposure or tanning beds. This increases your risk of skin cancer.

Avoiding irritants and having a moisturizing skin care routine are the best ways to treat hand eczema. In some cases, medicated ointment, systemic medication, or phototherapy may be necessary.

You use your hands to do nearly everything, which makes hand eczema tough to deal with. If your hand eczema symptoms become concerning, make an appointment with a dermatologist or your primary care provider. They can help you find the best treatment for you.

While some types of eczema are typically more common in children, hand eczema happens primarily in adults. This is because it tends to be triggered by irritants in the workplace, and doing other activities mainly for adults, like using certain chemicals or cleaning products.

Hand eczema is not contagious. You can't pass it along to others, so there is no need to avoid touching.

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By Heather JonesHeather M. Jones is a freelance writer with a strong focus on health, parenting, disability,and feminism.