Chronic Hand Eczema: Treatment and Prevention

Living with Eczema

We use our hands every day but for people living with Chronic Hand Eczema (CHE), even simple tasks like washing, dressing, or preparing food can be painful.

What is Chronic Hand Eczema (CHE)?

CHE is a long-term inflammatory skin condition that affects the hands and wrists. It is considered chronic when it lasts longer than three months or recurs multiple times a year. Symptoms often include dryness, itching, skin cracking and persistent discomfort.

This guide offers practical advice on treatment options and prevention strategies to help manage flare-ups and protect your skin daily.

What triggers CHE?

CHE is often aggravated by repeated exposure to irritants, which can damage the skin barrier over time.

Common irritants include:

  • Detergents and household cleaners
  • Chemicals
  • Household activities such as dusting, cleaning, food preparation and laundry
  • Frequent hand washing
  • Changes in temperature
  • Emotional distress

Protecting and restoring your hands

Taking action to protect and restore the skin barrier is a vital part of treatment for hand eczema.

Restoring:

  • Skin barrier repair involves regular and liberal use of non-perfumed emollients, including leave-on creams, even when the skin appears clear. Maintaining skin hydration is essential to reducing flare-ups and improving skin resilience.
  • For many people, treatment also includes applying prescribed topical anti-inflammatory medications, which may include topical corticosteroids or calcineurin inhibitors. These should always be used as directed by a healthcare professional.

Protecting:

  • Avoiding soaps and harsh detergents is equally important. Traditional soaps and strong cleansers can strip the skin’s natural oils and worsen sensitivity. Soap substitutes or emollient-based cleansers should be used when washing hands, especially for those with sensitive skin.
  • Identifying personal aggravating triggers, such as allergens or irritants, and implementing avoidance or reduction measures can be key in preventing flare ups. Your healthcare professional may refer you for patch testing in some situations, especially if your skin continues to worsen or flare despite treatment. Patch testing can identify contact allergies or specific ingredients that may be contributing to eczema flares, and can offer clarity for more targeted avoidance.

Long-term management of CHE

Long-term management of CHE is often supported by making simple but meaningful changes in daily habits. This can be done by:

  • Switching to mild, non-perfumed emollient and cosmetic products, and using soap substitutes for hand washing, especially for those with sensitive skin. Strong cleansers can strip the skin’s natural oils and worsen sensitivity.
  • When washing your hands, showering and bathing, use lukewarm water instead of hot water, and use an emollient-based soap substitute to clean the skin gently without drying it out.
  • Try to avoid skin contact with detergents and household cleaning products, these can be very irritant to the skin.
  • When carrying out household or occupational tasks, wear non-latex gloves with cotton liners to provide an added layer of protection for your hands.
  • Try to avoid your hands getting wet too often and apply a non-perfumed emollient liberally, as often as required, throughout the day.
  • Try not to scratch or rub the skin as will cause damage to the skin barrier and can introduce infection, keep your nails short, try applying your emollient, a cold compress, cognitive behavioural therapy can also be useful to reduce habitual scratching.
  • Stress is a known trigger for many skin conditions, and stress management can play a role in preventing eczema flare-ups. Practices such as mindfulness or relaxation exercises can be helpful for some people.

For those who continue to experience flare-ups despite taking precautions, seek advice from a healthcare professional as further support and investigations may be required to help manage your condition.

Daily care summary

StepActions
MoisturiseDaily, all over the affected area, carry an emollient.
Treat flaresUse prescribed treatments.
Protect handsWear non-latex gloves with cotton liners and emollient.
Avoid irritantsUse non-perfumed, mild cleansers
Prevent scratchingCool compresses, gloves, and keep nails short.
Identify and manage triggersPatch tests, limit stress and avoid allergens.

When to seek help

You should seek help if your symptoms are getting worse, not improving, or if the condition is affecting your mental health or overall wellbeing. If you’re experiencing persistent sadness, loss of interest in activities, sleep problems or social withdrawal, it’s important to speak to a healthcare professional.

Key messages to remember

Moisturising your hands both morning, day and night, even when no eczema is visible, helps maintain a strong skin barrier. Using gloves with cotton liners while cleaning or doing manual tasks can significantly reduce flare-ups. Avoid hot water, soap and fragranced skincare products and cosmetics. Use gentle, non-perfumed alternatives designed for sensitive, eczema prone skin.

If your skin shows signs of infection, isn’t improving, or is beginning to affect your mental wellbeing, it’s important to seek advice from a healthcare provider.

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