Eczema of the hands is a common chronic disease that significantly impairs the quality of life of patients. And because it is not life-threatening, its impact on the general and mental health of those affected is often underestimated. But because the hands are an important part of our daily lives and communication with people, eczema in this area can be a cause of many uncomfortable situations.
Before I start diving into some heavy medical explanations, I want to give an example from my dermatological practice. Years ago I was visited by a young lady on the verge of her professional choice to be a hairdresser. During her training, eczema appeared on the leading right hand, and later on the left. As the weeks progressed and the intensity of the course intensified, the skin problems deepened. I recommended the use of special gloves, but to no avail. The contact with water, paint, detergents and styling products turned out to be a combination that made her reorient herself professionally. And this is how a seemingly "mild" disease affects important life events.
What is the cause of eczema on the hands?
The answer is not easy. Usually the cause is multifactorial. One study saysthat 41% have genetic inheritance, while the remaining 59% have environmental factors. These are actually all triggers that break the integrity of the skin barrier: frequent wetting, contact with irritants, mechanical impact. These factors can be part of everyday life or the professional environment, or both. Eczema on the hands is not always allergic, but impaired skin integrity is a major prerequisite for the penetration of allergens from the environment.
What are the symptoms of eczema on the hands?
There are two forms of the disease: acute and chronic. In the first clinical picture is characterized by redness, papules, small blisters filled with clear contents, edema. While in chronic eczema on the hands there are crusts, thickened stratum corneum of the epidermis, fissures. In both stages of the disease there may be itching, burning, skin pain, as well as disturbed sleep and mood swings.
To be successful in treating eczema of the hands, one must follow several basic principles related to identifying the cause:
- to purposefully search for whether there is an allergic component;
- whether there is a mechanical component;
- whether there is atopic dermatitis;
- there must always be a basic barrier product.
The group of drugs can be divided into local and systemic. The choice of drug depends on the age of the eczema, its severity and accompanying symptoms. Regardless of the choice of active substance, daily use of a barrier cream should be present in each patient. A healthy skin-lipid layer is the most important stage of therapy. In the graph you can follow the steps by which the treatment is upgraded, compared to the worsening of the severity of the exam on the hands:
Elsner P, Agner T. Hand eczema: treatment. J Eur Acad Dermatol Venereol. 2020 Jan;34 Suppl 1:13-21. doi: 10.1111/jdv.16062. PMID: 31860736.