Everything You Need to Know About Hand Eczema

Dryness is one possible sign of hand eczema. However, the symptoms of eczema go beyond dry skin. One way to tell that you’re dealing with more than dry skin is that you can’t find relief from using hand moisturizer alone.

According to the American Academy of Dermatology (AAD), symptoms of hand eczema may include:

• patches or rashes that may be red, violet-brown, or dark brown, depending on the tone of your skin
• mild to severe itchiness
• scaly, chapped skin
• small blisters that may itch or burn
• deep cracks in your skin that may eventually bleed
• cuts in your hands that may ooze or become crusty
• dry, painful cracks

The severity of these symptoms can vary in each case.

Before trying to treat hand eczema, it’s important to find the underlying cause(s) of your symptoms. Below, we discuss the three types of eczema that may affect your hands.

Atopic dermatitis

For some people, hand eczema can be related to more widespread allergic eczema. When this is the case, it may be a symptom of atopic dermatitis (AD), which can run in families.

The American Academy of Allergy, Asthma, and Immunology (AAAAI) suggests that if you have skin rashes along with allergies or asthma, you may have AD.

AD is the most common type of eczema. The AAD estimates that 1 in every 10 Americans has this condition. It usually develops before the age of 5, but eczema rashes may come and go over a lifetime.

Itchiness is the most common symptom of AD. Scratching at the itch can cause your skin to become cracked and discolored. Over time, the skin on your hands may also thicken. In some cases, symptoms may be severe enough to interfere with your daily activities, sometimes even causing insomnia.

AD is thought to be caused by a leaky skin barrier. This can be genetic or environmental. It can leave your skin vulnerable to dryness and irritation as water leaks out and irritating substances settle in.

Contact (irritant) dermatitis

Contact (irritant) dermatitis is a type of eczema that occurs when your skin reacts negatively to contact with a foreign substance. The reaction can happen almost immediately.

Substances that can cause contact dermatitis include fragrances, chemicals, metals, cleaning solutions, and more. It’s also possible for eczema to develop from wearing latex gloves, or if you’re sensitive to certain food substances, such as citrus.

According to the AAD, people in certain occupations may be at increased risk of developing hand eczema. These include but are not limited to:

• hairdressers
• healthcare workers
• chefs
• construction workers
• plumbers
• custodians
• machinists

As a rule of thumb, any job that exposes your hands to chemicals or to frequent water immersion (such as frequent handwashing) can increase your risk of hand eczema.

Dyshidrotic eczema (pompholyx)

Also called pompholyx, dyshidrotic eczema is a type of rash that only affects your hands and feet.

Pompholyx primarily causes blisters on the palms of your hands, on your fingers, or on the soles of your feet. It may also cause cracked, bleeding skin.

Per the AAD, blisters from this type of eczema may last 3 to 4 weeks at a time. The National Health Service (NHS) has found that even before these blisters develop, you may feel burning or prickling sensations in your skin.

Some people may experience occasional dyshidrotic eczema flare-ups for life. For others, this type of hand eczema can be a one-time occurrence.

According to the the NHS, there is no clear cause of pompholyx. However, it’s thought that this hand eczema may share some triggers with contact dermatitis. These include:

• allergies or sensitivities
• frequent handwashing or immersion in water
• exposure to metals, fragrances, and chemicals

According to the AAD, one of the first steps in treating hand eczema is to avoid the cause(s), if possible. You can also frequently apply a fragrance-free, preservative-free moisturizing hand cream to help your skin heal. Your doctor might be able to recommend one that will be effective.

If your symptoms are severe, consider meeting with a dermatologist to discuss treatment options. The AAAAI outlines some of the treatments you could receive for different issues hand eczema can cause.

For example, if your hands are extremely dry or cracked from eczema, your dermatologist may prescribe a topical steroid cream — a treatment that’s applied directly to the skin — to help decrease any underlying inflammation that could be causing your symptoms.

Topical steroids are typically only used for short-term treatments, however, as they may make the skin thinner.

If your dermatologist thinks allergies or AD may be triggering eczema on your hands, they may recommend oral antihistamines — allergy medication taken by mouth — to help prevent inflammation associated with allergic reactions. Some antihistamines may cause drowsiness, so your doctor may recommend taking them at night.

Sometimes, severely dry, cracked hands or blisters may lead to an infection. In such cases, your doctor may prescribe antibiotics in addition to other eczema therapies.

Depending on the underlying cause, you may also talk with your doctor about certain injections that may help treat eczema.

Possibilities include allergy shots and powerful medications called biologics. Immunomodulators — medications that modify or change the function of your immune system — may also be considered, according to this research from 2019.

In addition to prescribed treatments, you can help manage hand eczema with the following tips:

• Apply an unscented moisturizing hand cream within a few minutes of washing your hands, suggests the AAD.
• Wash your hands in cool or lukewarm water with unscented soap only.
• Pat hands dry instead of rubbing them with a towel. Rubbing them dry can further irritate eczema rashes, according to the AAAAI.
• Apply a moisturizer to your hands before bed and wear cotton gloves for better absorption into your skin.
• Keep your fingernails short. The AAAAI says this will help prevent any accidental cuts and wounds caused by scratching at your eczema rashes.

Also, for occupation-related hand eczema that’s more severe, the AAD recommends taking a few days off work during treatment, if possible. This may help give your hands a better chance at recovering more effectively.

While certain treatments and skin care changes can help with eczema on your hands, the symptoms are likely to come back if you don’t take preventive steps.

Here’s what you can do to help prevent hand eczema:

• Avoid directly exposing your hands to irritating substances, such as fragrances, detergents, and chemicals.
• Wear gloves if your hands are to be submerged in water for long periods of time, such as when washing your hair or dishes.
• Use only fragrance-free soaps, detergents, and lotions.
• When using a hand sanitizer, the AAD recommends choosing one that has a moisturizer.
• Avoid irritating fabrics, such as wool gloves.
• If you have allergies, avoid your triggers whenever possible. These may include dust mites, pollen, and animal dander.
• Minimize stress, which the AAAAI warns can cause worsening itching and irritation in eczema rashes.

At first, hand eczema can be a challenging condition to manage. But once you’ve identified the underlying causes, you can better treat and prevent this type of eczema.

According to the AAD, it’s also possible to recover from hand eczema by carefully adhering to your treatment and prevention plan.

If you continue to experience severe hand eczema symptoms, such as significant dryness, inflammation, and pain, it may be time to see a dermatologist for help. In addition to maintaining home strategies for healthy skin, they may prescribe treatments to help you manage your eczema.