When To See A Dermatologist
If you have extremely dry, painful hands and using moisturizer throughout the day fails to bring relief, you may have hand eczema. Without treatment and preventive measures, hand eczema tends to worsen.
Seeing a dermatologist can relieve hand eczema before it worsens.
* This patients story appeared in the Journal of the American Academy of Dermatology. For this article, the patient was given a fictitious name.
ImagesImage 1: Image used with permission of the American Academy of Dermatologys National Library of Dermatologic Teaching Slides.
Image 2: Image used with permission of the Journal of the American Academy of Dermatology.
Stay Away From Skin Irritants
Sometimes the problem is that you need to identify and remove an irritant in order for the inflammatory rash to go away. Here are some examples:
- Medicated skin creams or oral retinoid medication
- Metals like nickel that are commonly found in jewelry
- Soaps, detergents, and fabric softeners
- Foods that have a lot of acid, such as tomatoes, pineapples, or citrus fruits
What Are The Symptoms Of Hand Eczema
Dryness is one possible sign of hand eczema. However, the symptoms of eczema go beyond dry skin. One way to tell that youre dealing with more than dry skin is that you cant find relief from using hand moisturizer alone.
According to the American Academy of Dermatology , 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
Before trying to treat hand eczema, its important to find the underlying cause of your symptoms. Below, we discuss the three types of eczema that may affect your hands.
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How Is Dyshidrotic Eczema Diagnosed
Diagnosing the condition usually involves examining the patient, noting the symptoms and taking the patients history, says Lio.
If we suspect that a contact allergen is driving it, we may perform patch testing. Rarely, fungal infection can cause a very similar picture to occur clinically, so we can perform a scraping and a KOH examination to look for fungal forms, he adds. According to U.S. National Library of Medicines MedlinePlus guide, a KOH examination involves scraping the problem area of your skin with a needle or scalpel blade and examining the tissue under a microscope on a slide to which KOH has been added.
How Is Eczema Diagnosed
There is no specific test used to diagnose eczema. The doctor will look at the rash and ask about symptoms, the child’s past health, and the family’s health. If family members have any atopic conditions, that’s an important clue.
The doctor will rule out other conditions that can cause skin inflammation, and might recommend that your child see a dermatologist or an allergist.
The doctor may ask you to ban some foods from your child’s diet, switch detergents or soaps, or make other changes for a time to see if your child is reacting to something.
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Clinical Patterns Of Hand Eczema
There are different patterns of hand eczema which differ only clinically, not histologically. Several clinical variants of hand dermatitis have been described, including hyperkeratotic , frictional, nummular, atopic, pompholyx , and chronic vesicular hand dermatitis. Hybrids of these patterns exist and some experts do not agree on classifications.
Many published classifications involve a combination of etiological factors and morphological features . However, no single classification of hand eczema is satisfactory.
Eczema Coping Tips Good Hygiene
Skin affected by eczema is more vulnerable to a range of infections, including impetigo, cold sores and warts. The bacterium Staphylococcus aureus may cause a secondary infection of impetigo, and possibly contribute to the symptoms of eczema.Suggestions for washing include:
- Take lukewarm baths or showers, and avoid really hot showers.
- Dont use ordinary soap, as the ingredients may aggravate your eczema. Wash your body with warm water alone. For armpits and groin, use soap-free products, such as sorbolene cream.
- Bath oils can help to moisturise your skin while bathing.
- When towelling dry, pat rather than rub your skin.
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How To Use Emollients
Use your emollient all the time, even if you are not experiencing symptoms as they can help limit the return of your condition. Many people find it helpful to keep separate supplies of emollients at work or school.
To apply the emollient:
- use a large amount
- don’t rub it in, smooth it into the skin in the same direction that the hair grows instead
- for very dry skin, apply the emollient every two to three hours
- after a bath or shower, gently dry the skin and then immediately apply the emollient while the skin is still moist
If you are exposed to irritants at work, make sure you apply emollients regularly during and after work.
Don’t share emollients with other people.
What Are Symptoms Of Eczema On Hands
Symptoms of eczema on the hands and fingers include:
- Intense skin itching
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Signs And Symptoms Of Dyshidrotic Eczema
Common symptoms, according to the AAD, include:
- Small blisters and rashy skin
- Blisters filled with clear fluid
- Blisters that appear in clusters between fingers and toes or on the edges of fingers, toes, palms, or soles of the feet
- Rashy, scaly, red and cracked skin around the blisters
- Blisters that are very itchy and sometimes painful
- Blisters that dry and peel in about three weeks
Alamy
Food Allergy And Eczema Flare
- Food allergies are a factor in 30% of young children with severe eczema. This factor is mainly seen in babies.
- The main allergic foods are cow’s milk and eggs.
- The main symptoms are increased skin redness and itching. Some parents report these symptoms start during or soon after the feeding.
- The eczema becomes easier to control if you avoid the allergic food.
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Related Conditions And Causes Of Dyshidrotic Eczema
As mentioned, atopic dermatitis or contact dermatitis, especially when related to a nickel allergy, can increase your risk of having dyshidrotic eczema, according to the AAD.
Differentiating between the conditions can be a challenge, and sometimes they are related anyway, says Kindred. Atopic dermatitis prefers skin folds, such as the insides of the elbows and the knees. Contact dermatitis is usually within the location that the skin was in contact with the trigger. The confusing part is that both atopic dermatitis and contact dermatitis may be associated with dyshidrotic eczema, confusing the picture.
Learn more about these conditions from the NEA:
- Atopic dermatitis Also simply known as eczema, atopic dermatitis is chronic and is the most common type of eczema.
- Contact dermatitis This happens when physical contact with an irritating substance or allergen triggers an irritation or inflammation reaction of the skin.
Mental Health And Dyshidrotic Eczema
In addition to physical anguish, flare-ups of dyshidrotic eczema can lead to mental anguish. For those whose hands are affected, it is in a highly visible area that can’t be covered with clothing, so many patients feel ashamed or embarrassed about their skin, notes Lio. Also, severe cases can interfere with a person’s ability to work or carry out routine daily tasks involving hands or feet stressful situations brought on by a condition that itself is aggravated by stress.
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Eczema Coping Tips Diet
In most cases, eczema isnt caused or made worse by diet. If you notice that your eczema seems to get worse after eating a particular food, you may be an exception to this. See your doctor or dietitian for proper allergy testing and dietary advice.Never self-diagnose or you risk depriving yourself of enjoyable and nutritious foods for no good reason. Unnecessarily avoiding certain foods can lead to nutritional deficiencies.
Who Does Dyshidrotic Eczema Affect
Dyshidrotic eczema can affect anyone. However, it most commonly affects people:
- Between the ages of 20 and 40.
- Assigned female at birth.
- With a personal or family history of eczema.
- With a personal or family history of contact dermatitis.
- Who develop allergic reactions when they touch an antigen, which is a foreign substance that causes an allergic reaction.
- Who receive immunoglobulin infusions. Intravenous immunoglobulin is an injection of antibodies for people with an immune deficiency.
About 50% of dyshidrotic eczema cases occur in people who have allergic reactions when they touch an antigen. Researchers think that people assigned female at birth may be more likely to develop dyshidrotic eczema because they more frequently interact with certain antigens, like nickel and cobalt in jewelry.
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Stay Away From Triggers
Find out what your common triggers are and stay away from them as much as possible. There are many substances in your environment that may make your symptoms worse. Some are known triggers. You may also have triggers youâve never even thought about. Hereâs a partial list of some of the most common ones, indoors or outside:
Favorite Organizations For Essential Dyshidrotic Eczema Information
The NEA is a great first stop, being the most prominent U.S.-based nonprofit devoted to education, research, patient support, and advocacy relating to the various forms of skin disease that fall under the eczema umbrella, including dyshidrotic eczema. Check out their dyshidrotic eczema page before you peruse their fact sheets, glossary of skin-care terms, and webinars. We also recommend Lios video on hand hygiene for people with hand eczema in the COVID-19 era.
This well-regarded library of information all about the skin is affiliated with the New Zealand Dermatological Society. The jargon is aimed at professionals, but theres plenty of information for laypeople to use as well. Take a look at their page on vesicular hand dermatitis , or try out their DermDiag tool for narrowing down possible causes for your symptoms .
One of the foremost networks of medical institutions in the United States has an extensive library of information on health conditions, including this page about a common trigger for dyshidrotic eczema: nickel sensitivity.
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When To Seek Medical Advice
You should see your GP or pharmacist if you think you may have discoid eczema, as the condition can take a long time to improve without treatment and it may keep recurring.
You should also seek medical advice if you think your skin may be infected, as you may need to use antibiotic cream or, in very severe cases, take antibiotics tablets.
- oral corticosteroids for severe flare-ups
- antibiotics for infected eczema
- antihistamines for severe itching
There are many different preparations for each type of medication and it is worth taking time with your pharmacist to find the best one for you.
A range of emollient products, soap substitutes and some topical corticosteroids can be bought from pharmacies without a prescription. Some of them are cheaper to buy this way than with a prescription.
Ask your pharmacist for advice on the different products and how to use them. See your GP if your eczema does not improve after using an over-the-counter preparation.
Common Types Of Eczema On Hands
A few types of eczema can affect your hands, depending on the cause:
- Irritant contact dermatitis happens when you come into contact with something that irritates your skin, like dust or chemicals. You might even get it after washing your hands a lot. These things can cause problems with the protective barrier of your skin, leading to eczema.
- Allergic contact dermatitis is caused by an allergic reaction to something around you. Common causes include nickel, fragrances, rubber, and certain plants.
- Dyshidrotic dermatitis causes itchy, watery blisters, usually on your palms and the sides of your fingers. You can have this along with a different kind of eczema in another spot on your body. It may come in cycles and is most common before age 40. Doctors arenât sure what causes it. But things like metals, allergies, stress, heat, and sweating can make it worse.
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Treatment For Hand Eczema
Severe hand eczema on the palms of an adult male
The best treatment for hand eczema is avoiding what caused it.
Knowing which substances trigger your hand eczema and protecting your hands at home and at work, can help guard your skin against further irritation. The most important thing to remember is to be consistent a dailyskin care routine is the best defense.
If you believe that a substance at home or at work is causing your hand eczema, your doctor can do a patch test to see which allergens or irritants may be the problem. Your doctor can also help pinpoint behaviors or practices that may be contributing to your hand eczema and help you find ways to modify or avoid them. In some cases, antihistamines, biologics, topical corticosteroids or other prescribed or over-the-counter medications might be necessary. However, discuss treatment options with a healthcare provider with experience in dermatology before deciding on a treatment plan.
Takeaways For Eczema Sufferers: Why Does My Eczema Not Go Away
When people ask why does my eczema not go away? Link them here. Because behind going away, there needs to be specific considerations of how you can make your eczema recovery work, the factors driving your recovery, and common obstacles stopping you on a plateau.
Did you like this post? Any thoughts? Leave a comment below and let me know if you have suggestions for the next post!
If you would like to get more hands-on information like this article, I invite you to join this slowly rising community of parents and adults on Facebook called Reverse Eczema Together. Its free, and hey, its technology
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Does Hand Eczema Go Away
With the right treatment and lifestyle changes, mild eczema, characterized by occasional itching and symptoms that dont interfere with your daily life, usually gets better within a few weeks, Dr. Silverberg says. But it could take longer if you have really frequent, ongoing itching that takes a toll on your everyday life. I tell patients that if it took two years to get this way, its going to take some time to clear up. Its not getting better overnight, Dr. Silverberg says.
Living With Eczema And Atopic Dermatitis
Eczema can flare up when you are under stress. Learn how to recognize and cope with stress. Stress reduction techniques can help. Changing your activities to reduce daily stress can also be helpful.
The area where you had the eczema may easily get irritated again, so it needs special care. Continue to follow the tips provided here even after your skin has healed.
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Treatment Includes Avoiding The Cause
As you can see from Marks story, finding the cause often takes time, detective work, and expertise.
But finding the cause is essential to get relief. Once you know whats causing the hand eczema, treatment can bring relief. Treatment includes avoid whats causing the hand eczema. To help your hands heal, your dermatologist may also include a moisturizer, barrier repair cream, or cortisone cream in your treatment plan.
A dermatologist can also tell you how to avoid whats causing your hand eczema.
Even if it seems unlikely that youll be able to avoid certain tasks like immersing your hands in water throughout the day or putting on a pair of latex gloves, a dermatologist can help. Dermatologists have developed strategies to help their patients continue to work while avoiding whats causing their hand eczema.
Sometimes, a few days off of work can be helpful. If you have severe hand eczema, more time off of work may be necessary.
With preventive measures and treatment, however, most people with hand dermatitis recover completely.
Relief Requires Finding The Cause
Effective treatment begins with finding the cause. Anything that irritates your skin can cause hand eczema. Even something as harmless as water can irritate your skin if you often have wet hands. Many people who frequently have wet hands throughout the day, such as nurses, hair stylists, and plumbers get hand eczema.
Working with chemicals like solvents, detergents, or cement also increases the risk. Hand eczema is common among construction workers and machinists.
Chef with hand eczema
Anything that irritates your skin can cause hand eczema. For example, whenever this chef handles garlic, hand eczema develops.
Hand eczema can also be caused by an allergic reaction. Some health care workers get hand eczema from wearing latex gloves.
You also have a higher risk of developing hand eczema if you had atopic dermatitis as a child.
Because so many things can cause hand eczema, finding the cause can be tricky. Until you find the cause and avoid it, hand eczema can worsen.
Thats why it can help to see a dermatologist. These doctors have the expertise needed to track down the cause, as Marks* story illustrates.
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Obstacles To Following Your Treatment Plan
Eczema treatments can effectively get this skin disease under control — if you follow them as your doctor prescribes. But that can be challenging.
Did you take your medications as you were supposed to? Have you been able to avoid your triggers? Donât worry if your answer is âno.â Just be honest about what you found challenging at your next appointment. These are just some of the reasons people may not be able to follow their doctorâs recommendations:
- Frustration with how well or fast the medication works
- Confusion about how to use the medications
- Not understanding how the medications work
- Not understanding what might happen if you donât treat the rash
It may feel awkward to tell your doctor you havenât followed up on your treatment plan. But itâs an important conversation to have so that you can work together on ways to overcome the barriers, even if theyâre financial. Also, your doctor will not want to prescribe stronger medications when the current medication hasnât had a fair chance to work.