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.

Home Remedies and Lifestyle

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

Avoiding Triggers

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:

• Having wet hands
• Using some soaps or hand cleansers, such as ones that are antibacterial as they often contain solvents and alcohol
• Working with solvents, detergents, cement, or other irritating materials
• Wearing metal rings, particularly ones containing nickel

Skin Care

How you wash your hands makes a difference.

When you clean your hands:

• Take off your rings first.
• Use lukewarm water, not hot.
• Use a fragrance-free soap substitute.
• If sanitizing isn't necessary, use cleanser without water and blot off excess cleanser when you're done.
• Pat hands dry on a soft towel, taking care to dry between the fingers.
• Apply a good moisturizing cream or ointment.

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).

Protecting Your Hands

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

• Cotton gloves: Use for dry activities, like folding laundry, dusting, and other chores around the house.
• Waterproof gloves: Use when you will be in contact with wet substances, such as washing the dishes or cleaning with liquid cleaners. Choose latex-free gloves, like plastic or nonallergenic rubber. Wear cotton gloves underneath.

Other hand-protecting tips include:

• Make sure your hands are clean and dry before putting on gloves.
• Keep water out of your gloves by using rubber bands on your forearms (not too tight).
• If water gets in your glove, take it off right away, blot your hand dry, and replace with a dry glove.
• Try not to wear plastic or rubber gloves for longer than 20 minutes at a time (air them out in between to prevent a sweat build-up).
• Wear gloves when preparing foods like chopping potatoes, onions, peppers, meat, or acidic foods like citrus or tomatoes.
• Wear gloves to shampoo your hair, or have someone else wash it.
• Use a dishwasher instead of handwashing dishes, if possible.
• When handwashing dishes, use running water and a long-handled scrubber.
• Don't reuse disposable gloves.
• Regularly wash your gloves in fragrance-free and dye-free detergent if they aren't disposable.
  
• If eczema doesn't affect your fingertips, you can cut the tips off your cotton gloves.
• Remove your rings before doing housework or getting your hands wet, and clean your rings often.
• Promptly treat any wounds on your hands, including minor ones, and bandage them.

Over-the-Counter (OTC) Therapies

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:

• Go with fragrance-free products.
• Look for one that is greasy and contains as little water as possible (creams and ointments have less water than lotions).
• If your ointment makes your hands too greasy, use it at night (under cotton gloves) and a less greasy cream during the day.
• Reapply often throughout the day, especially after washing your hands.

Some products to look for include:

• Petroleum jelly (like Vaseline)
• Dove
• Aveeno
• CeraVe
• Cetaphil
• Eucerin
• Aquaphor

Prescriptions

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

Topical

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).

Systemic

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.

Specialist-Driven Procedures

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.

Summary

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.

A Word From Verywell 

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.