Chronic hand eczema

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by Guest Posts on Wed Nov 21, 2018 10:31 am

Chronic hand eczema

I am 67 years old. During childhood I suffered from atopic eczema which resolved during my twenties. This returned on my hands only, in menopause and despite various treatment regimes, a patch about 3" in diameter on the palm of on hand remains. I cannot keep it moisturised enough and the skin is itchy, dry and cracked.

My question is therefore - what is the most effective treatment routine for chronic hand eczema?

thank you
Liz
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Dr Adil Sheraz
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by Dr Adil Sheraz on Fri Nov 23, 2018 1:53 pm

Re: Chronic hand eczema

Dear Liz

Thank you for your question.

Often with eczema on the hand a potent topical steroid will need to be used along with an emollient and then a cotton glove to be worn at night.

The skin on the palm of the hand is relatively thick and tough, therefore in order for an treatment or emollient to be absorbed you will need to have it covered.

I would suggest:

1. Apply a greasy moistutriser at night (such as Hydromol ointment)
2. Apply Elocon (mometasone) ointment on top of this ( this is a steroid - for 2 weeks)
3. If you do no want to use a steroid then can use Protopic 0.1% ointment (which is less effective than steroid)
4. Cover with cotton glove.
5. Avoid normal soap and only use either Dermol 500 or Cetraben for washing.

If this is predominantly a unilateral hand eczema also consider whether it could be a fungal infection (GP will need to take a skin scraping and send off for fungal testing) or a contact allergy to a chemical or product that may be coming into contact with that area. This is often something that you may have been doing or coming into contact for years.

I hope that helps.

Regards

Dr Adil Sheraz
Consultant Dermatologist
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Dr Adil Sheraz
Consultant Dermatologist - MBBS, BMEDSCI(HONS), MRCP (UK), MRCP (DERMATOLOGY) (UK)

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Dr Anton Alexandroff
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by Dr Anton Alexandroff on Fri Nov 23, 2018 1:57 pm

Re: Chronic hand eczema

Dear Liz,

I am so sorry to hear about your skin problem.
Yes there is a very strong steroid ointment (Dermovate) which can be used intermittently or a new very effective medicine called Toctino - it usually works.

You can read more about these treatments on my website www.alexandroff.org.uk if it is of interest.

I hope this is helpful.
With Best Wishes,

Dr Anton Alexandroff FRCP(UK) PhD CCT(Derm) FRSM FAAD
Consultant Dermatologist and Honorary Senior Lecturer
The British Skin Foundation Spokesperson
London, Cambridge, Leicester and Bedford

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Dr Anton Alexandroff
Consultant Dermatologist, Honorary Senior Lecturer & BSF spokesperson - FRCP, CCT (Derm), PhD, FRSM, FAAD

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