Hand eczema

Hand eczema, also known as dyshidrotic eczema, is a chronic inflammatory skin condition. Its causes are complex. It is worth noting that it is a non-infectious condition, but it often recurs. Periods of improvement (remission) alternate with periods of visible skin changes. Eczema can significantly decrease the quality of life for patients due to bothersome symptoms. It is sometimes considered an occupational disease, particularly affecting individuals who have frequent contact with water or irritating substances.

Hand eczema is a complex condition whose development results from the interaction of many factors, both internal and external. Genetic predispositions play a key role in weakening the skin's natural protective barrier, leading to abnormal immune system reactions. Often, the issue is also triggered by allergens such as:

• nickel,
• plant pollens,
• dust mites,
• animal dander,
• mold,
• foods.

Equally dangerous are irritating substances including detergents, soaps, chemicals, and some cosmetics. Additionally, the following factors exacerbate symptoms:

• stress,
• hormonal imbalances,
• unfavorable weather conditions,
• frequent hand washing,
• mechanical irritations.

All these factors can provoke reactions, both allergic and non-allergic.

How does eczema on the hands manifest itself? Symptoms vary depending on the stage of the disease. In the initial, acute phase, the hands intensely itch, become red and swollen. Also characteristic are small bumps and fluid-filled blisters. When these blisters burst, they leave oozing erosions that eventually become covered with scabs. At that point, the skin can be very painful, easily cracking, leading to the formation of sores and an increased risk of infection.

The chronic phase progresses quite differently. In this stage, the skin is noticeably dry and flaky. Thickening of the skin, known as lichenification, is often observed. Permanent scars and discoloration also appear.

Hand eczema can manifest in various ways. However, key to effective treatment is recognizing the symptoms. Let's take a look at the most commonly encountered types of eczema.

Contact dermatitis occurs when the skin reacts to allergens or irritants. It's nothing but allergic skin inflammation, often referred to as contact eczema of the hands.

Atopic dermatitis (AD) is a chronic condition, usually with genetic factors underlying it. It is also known as atopic eczema.

Pompholyx eczema is easily recognizable by small fluid-filled blisters that are extremely itchy. This type of eczema is also known as vesicular eczema.

Apart from the mentioned types of eczema, there are other forms, such as:

• occupational eczema — directly related to the type of work being done;
• discoid eczema — characterized by round skin lesions;
• seborrheic eczema — also known as seborrheic dermatitis;
• photoallergic eczema — a rare variant triggered by sun exposure.

To effectively treat eczema on the hands, consultation with a specialist - a dermatologist or allergist, is necessary. The therapy includes various methods tailored to the individual needs of the patient:

• use of topical medications to combat inflammation, such as steroidal ointments (e.g. hydrocortisone) and calcineurin inhibitors (e.g. tacrolimus, pimecrolimus),
• in more advanced cases, oral medications may be prescribed, including antihistamines (to relieve itching), antibiotics (to combat infections), as well as immunosuppressive drugs (e.g. cyclosporine, methotrexate, azathioprine) or retinoids (e.g. acitretin),
• treatment with phototherapy using UV light,
• conducting allergy tests, especially patch tests, to identify triggers of eczema.

The selection of the most effective form of therapy must be based on test results and the assessment of the specialist.

Home remedies can effectively help in dealing with hand eczema. They utilize natural ingredients with anti-inflammatory and antibacterial properties that help alleviate troublesome symptoms.

Relief can be found in various baths, including those with added oat flakes, as well as hypochlorite and potassium permanganate baths.

Directly on the skin, it is worth applying:

• aloe vera gel,
• coconut oil,
• shea butter,
• honey,
• tea tree oil.

Diet is also important. It should be rich in omega-3 fatty acids, omega-6, and gamma-linolenic acid. It is also worth taking care of antioxidants that support skin health.

You can also consider supplementing with probiotics, which help maintain a healthy gut microbiome.

Regular moisturizing and lubricating of the skin is an important element in combating eczema. Emollients are essential for skin care - creams, ointments, and emulsions that effectively rebuild the skin's natural protective barrier. These specialized preparations are rich in active ingredients, such as ceramides, urea, allantoin, and D-panthenol. These substances intensely moisturize the epidermis, improving its elasticity and overall condition.

To prevent eczema relapses and exacerbations, it is necessary to:

• avoid irritating factors,
• use only mild hand cleansing agents, preferably soap substitutes with a low pH,
• wash hands with lukewarm water,
• gently dry hands after washing,
• wear protective gloves (vinyl or cotton) that effectively protect delicate hand skin during contact with detergents, chemicals, or water,
• reduce stress,
• avoid excessive hygiene, which prevents skin dryness and protects it from unwanted reactions.