What Triggers Eczema on Hands?

Symptoms of eczema on the hands and fingers include: 

• Intense skin itching 
  • Itching may worsen at night
  • Scratching may aggravate itching and inflammation
  • Oozing, bleeding, or crusting may occur if the skin is scratched open
  • Pustules, blisters, and red, hot skin may occur if a secondary infection occurs
  • Thickened, darkened, and scarred skin may result from repeated scratching 
• Dry skin
• Scaly, rough patches of skin
• Patches of inflamed skin
• Sensitive skin
• Pain
• Skin flaking and peeling
• Cracks in the skin
• Clogged hair follicles that cause small bumps and usually appears on the face, upper arms, and thighs
• Skin discoloration (especially red or pink)
• Increased skin creasing on the palms 

Hand eczema can be managed with home care and medications. 

Home remedies to relieve or reduce symptoms of hand eczema may include: 

• Identifying and avoiding triggers
• Keeping the skin hydrated
  • Emollients
    • Use thick creams or ointments 
    • Moisturizers with higher oil content are most effective 
    • Apply an emollient immediately after washing hands while the skin is still damp
  • Washing hands
    • Use lukewarm water (not hot) 
    • Use unscented mild soap or non-soap cleansers sparingly
    • Carry your own hand cleanser, moisturizer, and medication with you
    • Avoid waterless, antibacterial cleansers, which often contain alcohol and solvents that are harsh on the hands, especially during flare-ups
• Wet dressings to help soothe and hydrate skin, reduce itching, loosen crusty patches, and prevent injury caused by scratching
• Gloves
  • Use cotton gloves to protect the hands while doing chores
  • Wash gloves with fragrance-free, dye-free detergent
  • Use a combination of vinyl gloves with cotton liners for tasks that involve getting the hands wet
  • Use disposable gloves when preparing foods such as potatoes, onions, peppers, meat, or acidic fruits
• Do not wash dishes or clothes by hand; use a dishwasher and washing machine
• When eczema clears, use petroleum jelly on the hands overnight with gloves

Medications used to treat hand eczema include:

• Over-the-counter (OTC) or prescription topical steroid creams or ointments 
• Over-the-counter (OTC) or prescription oral antihistamines for itching 
• Diphenhydramine (Benadryl), hydroxyzine (Vistaril, Atarax), and cyproheptadine cause drowsiness; these may be helpful for patients whose itching keeps them up at night
• Cetirizine (Zyrtec) and loratadine (Alavert, Claritin) cause less drowsiness
• Oral steroids (e.g., prednisone) may be used for a short duration to treat severe flares
• Tacrolimus ointment (Protopic) and pimecrolimus cream (Elidel)
• Injectable biologics such as dupilumab (Dupixent) for adults with moderate to severe eczema that has not responded to other treatments
• Immunosuppressive drugs for patients with severe eczema who do not improve with other treatments

Although ultraviolet light therapy (phototherapy) may help control hand eczema, it should only be used for patients with severe eczema that has not responded to other treatments.