Hand eczema in adults

Our hands come into contact with many different materials and substances every day, so unsurprisingly, they’re one of the most common areas of the body where eczema develops, especially in adults. With so many joints and moving parts, the skin on our hands is particular vulnerable to cracking, making hand eczema particularly uncomfortable. And because we use our hands so much, it’s also really visible – making it more difficult for both sufferers and bystanders to ignore. We look at the common causes of hand eczema and investigate its causes and treatment options.

Types of hand eczema

Contact dermatitis

Contact dermatitis occurs when the skin reacts to an irritant or allergen. If you come into contact with an irritant or allergen, it’s probably your hands that will be on the front line, bearing the brunt. There are many different triggers for contact dermatitis on the hands, including exposure to chemicals, allergens, extended periods in water and hard weather conditions. In most cases, hand eczema is down to the hands coming into prolonged contact with an irritant or allergen. The impact of irritants and allergens can be cumulative over time, so something that you previously had no problem with may gradually become problematic.

Contact dermatitis on the hands is characterised by cracked, peeling, scaly, or crusting skin. The skin is usually inflamed and is often so dry that it becomes flakey. Cracking is common across the knuckles and along the natural creases in the palm. Infections are common and associated with pain and weeping.

Pompholyx (dyshidrotic eczema)

Pompholyx (also called dyshidrotic eczema) is typified by extremely itchy, fluid filled blisters on your hands and sometimes feet. The name is derived from the Greek word for bubble. These blisters typically appear on the palms and the sides of your fingers. Scratching the blisters can cause them to burst and become sore and weepy.

Pompholyx is most common in younger adults, typically between the ages of 20 and 40. It is more commonly found in women thanPeople can have a single flare-up, but it’s more common for it to come and go over long periods of time. Pompholyx is often related to allergies – metals, particularly nickel, are a common trigger. It is often found in conjunction with seasonal allergies like hayfever. In these cases antihistamines can help.

Metals, particularly nickel (found in alloy jewelry and cement), are a common trigger. As is working in a role where your hands are wet for long periods, like hairdressing. Stress can also cause a flare. The condition is also linked to seasonal allergies like hay fever, and to hot, humid weather.

Treating hand eczema

What the doctors can do for you: emollients and topical steroids

If you think you’re suffering from hand eczema, it’s important to get an official diagnosis from your doctor or dermatologist. They will examine your physical symptoms and recommend suitable treatment options. The frontline treatment for eczema anywhere on the body is the use of emollients. These aim to replace the moisture that has been lost from the skin.

Your doctor will be able to advise you on the most suitable emollients for your skin. There are plenty to choose from and most brands will have a number of versions to varying greasiness to suit different situations, including lotions, creams, and ointments. Depending on the severity of your hand eczema, you may also be given a prescription for a short course of topical steroids to bring the skin back under control. It’s important to follow the instructions for steroid creams to avoid possible problems in the future.

Emollient treatment involves keeping your hands thoroughly moisturised at all times. Applying emollients during the day has obvious drawbacks as you won’t want to be leaving a trail of greasy fingerprints. Try using frequent applications of a lighter, less greasy emollient during the day. At night, dry wrapping can really help. Apply a thick layer of greasy emollient and cover this with gloves, ScratchSleeves or, if your hands get too hot, a pair of light cotton socks with the toes cut off. This dry covering not only keeps the emollient in contact with your skin (rather than being smeared over the bed clothes). The extra warmth helps your skin to absorb the moisture.

What you can do for yourself

The most important thing you can do to minimise hand eczema is to identify and avoid irritants. You can find out more about tracking down eczema triggers here. When eczema is localised to just the hands, it usually has some sort to contact related trigger.

• Industrial settings – hand eczema is commonly associated with the work environment – mechanics, hairdressers, cleaners, healthcare professionals and builders often come into contact with chemicals and other irritants. In these cases wearing protective gloves is usually the best solution. See more on this below.
• Food preparation – the acids in raw food like potatoes, tomatoes, onions and citrus fruits are common triggers. Using disposable gloves will help or you could use my mum’s approach of never peeling potatoes and only using tinned tomatoes.
• Toiletries – foaming hand washes are known to be especially bad for the skin, but all toiletries can cause problems. Consider taking your own handwash with you when you’re out and about. Shampoo can also be problematic, again protective gloves (with an elastic band around the wrist) can help. You can find our more about common irritants found in toiletries here.
• Prolonged exposure to water – if you don’t have a dishwasher, use protective gloves or a long handled dish-brush and running water to do the dishes. Be sure to dry your hands properly after washing, making sure that you dry under any rings
• Hand sanitisers – to be effective these need to contain high levels of alcohol which will dry our your hands. Soap and water are just as effective at killing bacteria, so stick to these whenever you have the choice.
• Weather, especially if your hand eczema flares up in the autumn or winter or spend a lot of time outside with damp hands. Protective gloves or a barrier cream, like Vaseline, will help with this.

Protect your hands

If avoiding irritants isn’t an option, protective gloves really are the best way to minimise aggravation of eczema on your hands. It can take time to get used to wearing gloves and it really is worth finding a brand that fits you well. The latex in some protective gloves can cause reactions in some people, as can the powder used on the inside to stop the gloves sticking to themselves. Look for powder-free, vinyl gloves.

Some people find that wearing waterproof gloves for prolonged periods can get sweaty, aggravating sore skin. In these cases wearing a soft glove under the protective glove can help. We love the Tepso range for this – expensive but so much better for sore skin than regular cotton gloves. You may need to size up the outer gloves to accommodate the soft gloves, especially if they have seams,

Manage your stress levels

Stress is believed to be one of the biggest triggers of eczema flare-ups in adults. If you can find no obvious trigger for the eczema on your hands, it’s worth considering whether stress is a possible trigger. You can find out more about how stress can influence eczema triggers here. Many people who suffer from stress-induced eczema find that it is a vicious cycle. Stress triggers their eczema, but then the symptoms of their eczema cause them more stress. 

Consider incorporating some of the following stress management techniques into your lifestyle to help you slow down and destress.

• Take time for yourself
• Take up yoga, meditation, or mindfulness
• Spend time outdoors
• Exercise regularly
• Get enough sleep
• Reduce screen-time
• Slow down
• Address mental health problems

Often, a holistic approach is required to banish stress-related hand eczema.  By understanding your triggers and taking steps to treat the condition, protect your skin, and reduce stress, you can improve both your skin’s health and your mental well-being.

If you find yourself scratching at itchy hands during the night whilst you sleep, then our range of adult eczema nightwear and scratch sleeves can be worn to help prevent scratching, protect your skin, and give it time to heal.