Eczema on the Hands: Why Is It So Difficult to Treat?
Hand eczema is common, painful and frustrating. It can make everyday tasks – washing up, typing, cooking, childcare – uncomfortable, and for some people it threatens their job. It is also one of the most stubborn forms of eczema to treat.
Why hands are so hard to heal
Constant exposure. Hands are washed, wet and dried many times a day, and come into contact with soap, detergents, food, cleaning products and chemicals. Every exposure damages the barrier again.
Treatment is washed off. Creams applied to the hands rarely stay on long enough to work fully.
Thick skin on the palms. Palm skin is thick, so weaker creams penetrate poorly and stronger treatment is often needed there.
Cracks and fissures. Cracked skin around the fingers and knuckles is painful and slow to heal, and lets bacteria in.
Several causes can overlap. Hand eczema may be atopic eczema, irritant contact dermatitis, allergic contact dermatitis, or a mixture. Rubber gloves, fragrance, preservatives, hair dye and metals are common culprits.
Types of hand eczema
Irritant hand eczema – from repeated wet work, soap and detergents; very common in healthcare workers, hairdressers, cleaners, caterers and parents of young children
Allergic contact dermatitis – an allergy to something the hands touch
Pompholyx (dyshidrotic eczema) – small, intensely itchy blisters on the palms and sides of the fingers
Hyperkeratotic hand eczema – thick, scaly, cracked skin on the palms
What helps
Protect the hands. Wear cotton-lined gloves for wet work and household tasks. Remove rings when washing.
Wash less harshly. Use lukewarm water and a soap substitute; pat dry gently.
Moisturise after every wash. Keep moisturiser by every sink, in your bag and at work.
Treat at night. Applying treatment at bedtime and wearing cotton gloves overnight allows it to stay on the skin for longer.
Use the right strength. Hands, especially palms, usually need stronger treatment than the face.
Treat cracks and infection. Weeping, crusting or sudden worsening can signal bacterial involvement.
Consider patch testing if you suspect an allergy.
When to get help
See a doctor if hand eczema has lasted more than a few weeks, is cracking and bleeding, affects your work, or keeps returning. The earlier it is controlled, the easier it tends to be to keep it under control.
At eczema-doc, we tailor treatment strength to the hands specifically, address bacteria and the skin barrier together, and give practical advice to fit around your work and home life.
Book a video consultation for hand eczema.
This article is for general information and does not replace individual medical advice.