Dry, chapped, and itchy skin on the hands that doesn’t improve with moisturizer may be a sign of hand eczema. Symptoms can include red, itchy, inflamed skin with blistering that can lead to oozing, crusting, and cracking. People who have their hands in water all day or work closely with irritants such as detergents or solvents are more likely to develop this type of eczema. If you had atopic dermatitis as a child, you may also have a higher risk of developing hand eczema. Applying a cream after washing hands or wearing gloves may help protect hands from future flare-ups.
Guidance on prescribing topical steroids reminds practitioners to prescribe the least strong steroid which is effective for the least possible length of time. A balance must be struck between efficacy and reducing adverse effects. Education is crucial to maximise efficacy and reduce adverse effects. Use of printed information may be helpful (including detail of how to use emollients and topical steroids) and education involving practice nurses to help improve efficacy of treatments and information for patients. Examples can be obtained from the British Association of Dermatologists and the National Eczema Society.