Hand eczema: how to treat it?

About 18.5 million of the population suffer from eczema or nearly 10% of the world population. Among its locations: the hands. What are its causes? How to take care of it?

Eczema is among the most common skin diseases after acne. It concerns 30% of dermatological consultations.

Hand eczema: what are the causes?

Located on the hands, "chronic eczema can be of genetic origin, linked to atopic dermatitis (editor's note: also called atopic eczema) with a preferential location on the hands," says Dr. Antoine Badaoui, dermatologist-allergist. It can also be allergic eczema due to perfume, a preservative ... In wearers of gloves such as housekeepers, hairdressers, eczema can be allergic or irritative. "

Hand eczema: recognizing the symptoms

The symptoms of hand eczema are the same, whether it is a permanent or temporary allergy.

"Small patches that peel off and cause itching. Most of the time, eczema of atopic origin has very limited borders, unlike allergic eczema, where the latter is more “on a geographical map”, less clearly delimited. "

How is the diagnosis made?

Hand eczema is diagnosed by physical examination. The patch tests (also called patch tests), on the other hand, let you know if it is an allergy or not. The patch tests consist of applying, in the back and under occlusion, thirty allergens which correspond to the battery of the European standard, possibly supplemented by other batteries according to the patient's questioning.

"To perform these patch tests, a patient needs to take three 48-hour rounds each time, "says a doctor about skin disease. The first for the installation of the patches on the back, the second intended to take off them, and the last for the final reading. If the test patches are negative, an allergy to the molecules tested can be ruled out. "

Itching: limit scratching thanks to sophrology

Sophrology, as a psycho-corporal method, apprehends the human being in all its richness: it takes into account its bodily, mental, and emotional dimensions.

“Stress has consequences for the body, which can appear in the form of eczema”. Sophrology can therefore be a valuable remedy against "eczema attacks". "In particular, thanks to the exercise of the fans which can reduce itching," says the sophrologist.

Starting position:

Sit upright with enough room around you, feet parallel and pelvic width apart.
The back is straight, the arms and shoulders are relaxed, the head is in the extension of the spine.
Close your eyes and bring your attention to the rhythm of your breathing.

The course of the exercise (repeat 3 times)

Raise both arms in front of you horizontally, inhaling deeply through your nose.
Hold your breath and wave your hands like fans (hence the name of the exercise!), Slowly bringing them closer to your chest. Give meaning to your movements by imagining dropping the sensations of scratching, tingling. By shaking your hands, release them from unpleasant itching sensations.
Once both hands are closer to the chest, release the arms along the body, blowing gently through your mouth.

Take a natural breath, and take a moment to observe the sensations in your hands. Focus on the sensations on your palms, your fingers. Become aware of all the sensations associated with the movements of your hands.

Repeat twice, always giving more meaning to your gestures: shake your hands, imagining that the unpleasant sensations of scratching escape from your hands, that the itching slips from your fingers towards the ground, to free and purify your skin.

After exhaling through your mouth, observe and carefully identify your feelings: are they changing? How? Do you feel lighter in your hands? More freshness? More fluidity in your movements?
Finish each time by becoming aware of your bodily, mental, and emotional feelings.

You can practice this exercise as soon as you feel the urge to scratch. Remember to coordinate your movements with your breathing (time to inhale, time to hold air, time to exhale), and always give more meaning to your practice!

How to treat hand eczema?

Whether it is atopic dermatitis or chronic hand eczema or allergic eczema, the treatment is the same.

"A corticosteroid cream should be applied three days after symptoms have disappeared. Since inflammation may be latent under the skin, it is essential to stop the process. "

The treatment continues for more than six months, at the rate of one time per day.

"The corticosteroid cream-based treatment should be supplemented by the multi-daily application of a moisturizer to restore the skin barrier," adds the dermatologist. You have to choose the fattiest creams like Cicalfate, Eucerin, Cicaplast… ”

How to use topical corticosteroids properly?

When corticosteroid cream is not enough

When hand eczema does not respond to treatment with a corticosteroid cream, "we use oral treatment with alitretinoin,". It is a naturally occurring endogenous hormone related to vitamin A that has anti-inflammatory effects.

“The treatment lasts between 2 and 6 months at the rate of one tablet per day,”. It requires monitoring of the liver and cholesterol levels and, for women, effective contraception. "Alitretinoin may cause birth defects in a newborn baby, and this may lead to miscarriage.

Can hand eczema be prevented?

It is important to avoid all irritating factors that can accentuate hand eczema, and in case of allergy, to remove the allergen of course.

The advice of Dr. Antoine Badaoui to limit outbreaks:

Wash your hands briefly in lukewarm or cold water with a super-rich soap and if possible avoid hard water.

Do not use dish soap to wash your hands, it is irritating.
Rinse his hands well and dry them well by dabbing.
Wear gloves when washing dishes, cooking certain irritating foods such as tomatoes, lemon… and for cleaning.

Covid-19 and hand eczema: what precautions?

Facing the virus requires frequent hand washing, to prevent the virus from spreading.

But, when you suffer from eczema, frequent hand washing weakens the skin, which is often dry and bruised. It is therefore recommended to use "soap-free" soaps, special soaps for atopic skin, or even washing oils. And, if possible, opt for fragrance-free products. Once the hands are washed, they should be dried gently, without rubbing.

As for the use of hydroalcoholic gel, it can cause stinging and burning. It is therefore essential to rehydrate the skin by applying an emollient cream.

Wearing latex or vinyl gloves is not recommended because they promote perspiration and maceration of the skin, which can aggravate the eczema of the hands.