Hand eczema

Hand eczema is widely prevalent and, as it is a very visible condition associated with severe itching or pain, has serious consequences for the affected person including a high psychological impact.

Normally, skin inflammation connected with hand eczema is accompanied by blister formation and pronounced itching, but solid calluses and painful tearing may also occur.

The quality of life of the affected person is seriously diminished, especially in the case of chronic forms of the illness, and psychological impact is often very high.

There are a number of different causes of skin inflammation of the hands,[2] the interplay of which is also significant: environmental factors such as excessive water, contact with allergens or irritants, smoking and genetic disposition.

Disturbance of the skin's protective barrier also facilitates penetration by allergenic substances and promotes the development of contact dermatitis.

Severe and chronic patterns of hand eczema are often resilient to treatment, making the condition extremely stressful for those affected.

Discussion concerning frequency of contact with water, irritants, and allergens in private and professional environments will also help evaluate individual stresses on the patient's skin.

[7][8][9][10][11] Of primary importance is the strict removal and avoidance of catalysts for the development of chronic hand eczema, such as skin-irritating damage, excessive contact with water, or proven allergenic substances.

Treatment of every type of hand eczema and degree of severity must include sustainable replenishment of the natural oils and moisture contained in the skin with creams and salves free of fragrances and preservatives; this is an essential basic step.

In addition, protection procedures developed especially for the individual's skin stresses must be applied, e.g. use of cotton or hypoallergenic plastic gloves.

In the case of blister forming, drying treatments such as hand baths containing synthetic tannins or oily-moist preparations may hinder itching.

If callus development exhibiting tear formation is present, the focus should be on softening the skin with preparations containing urea or salicylic acid.

[citation needed] Topical corticosteroids are a standard treatment for hand eczema, but their efficacy in comparison to UV phototherapy is not clear.

[12] Severe and chronic cases seldom respond sufficiently and require long periods of treatment which can increase the risk of side effects occurring.

For acute, severe episodes exhibiting blister formation, internal cortisone preparations, sometimes in combination with certain antibiotics, may be helpful in the short term.

[14][15] The trial results showed that two thirds of patients did not have a recurrence 6 months after application of the medication, and that re-treatment is effective if hand eczema reoccurs.

Side effects mainly include temporary headaches during the initial days of treatment, as well as a possible increase in blood fat and cholesterol values.

hyperkeratotic fissured hand eczema
fingertip eczema