What is hand eczema?
Eczema of the hands (or dermatitis of the hands) is a pathology that can remain isolated or appear in a context of more generalized eczema. Like all chronic inflammatory dermatoses, it is an alternation of flare-ups. The skin gets red and itchy in this case. And lulls in which the skin has a dry appearance.
Hand eczema mainly affects adults (the majority of affected patients are women) because it is often caused and aggravated by household or professional products. Another case concerns atopic dermatitis that appears in childhood and persists in the form of chronic hand eczema. Reaching the hands is particularly disabling daily, especially in socio-professional, friendly, or romantic contexts. It is often accompanied by pruritus or pain, profoundly affecting the quality of life. It can cause insomnia, depression, social phobia, or incapacity. The goal of treatment is to obtain chronic eczema of “whitened” hands, “healthy” hands, for a marked improvement in the quality of life.
The causes of hand eczema are very varied.
One of the leading causes of hand eczema is contact with potentially allergenic products. Eczema of the hands can, in particular, be of professional origin. Hands can be in contact with metals such as nickel, chromium, dyes (hairdressing for example), perfumes, certain plants, etc. The main aggravating factors of hand eczema are cold and excess heat, washing dishes without gloves, household detergents, maceration, multiple washes and conventional soap, contact with allergens, friction, etc.
Aside from allergic hand eczema, it can be an atopic dermatic. Hand eczema can appear during periods of stress or anxiety, exposure to the sun, for some people with dyshidrosis. Hand eczema is very often associated with environmental factors
The clinical forms are varied:
- Dyshidrotic eczema (small blisters which can join or rupture)
- Hyperkeratotic eczema (very dry and thickened skin
- Acropulpitis (isolated attack of the pulp of the fingers, which becomes dry and cracked).
In addition to these symptoms, irritation, allergy, atopy, and dyshidrosis can occur as well. These aspects of the disease will generally complicate diagnosis and management a little more.
The basic treatment to treat eczema of the hands consists of firstly in looking for irritation factors. Contact with irritants, too frequent hand washing, exposure to cold, maceration linked to wearing gloves too long ( more than 20 minutes). If necessary, the specialist will look for contact eczema, thanks to patch tests. He will then provide an eviction list and explain it to the patient. Daily, preventive measures must be individual and professional. It is necessary to adopt good gestures:
- Protect yourself from the cold to limit dryness of the skin.
- Apply the treatment well.
- Wash your hands with lukewarm water. After that, gently dry your hands with a tampon.
- Put on restorative cream or moisturizers regularly to keep sensitive skin hydrated.
- Avoid allergens.
- Avoid washing your hands too often (even if this goes against hygiene and disease prevention campaigns).
- Use an over-fatty soap as hydro-alcoholic solutions can sting. They will be preferred as soon as the hands no longer have cracks or as an alternative to repeated hand washing by caregivers.
- What creams for hand eczema? The use of the so-called “barrier” and insulating creams is particularly interesting in the management of hand eczema.
Treatments for inflammation:
The treatment of hand eczema follows in 2 phases:
- First, you need to heal your hands quickly. First-line dermocorticoids (class IV) are used on the hands because the skin is often thicker, and the eczema plaques more difficult to treat in the hands. The dermocorticoid is applied daily in the evening, sometimes under occlusion, for example, under wet cotton gloves, to be left in place overnight. One can use other topical immunosuppressant, localized phototherapy, oral retinoid, or even systemic immunosuppressant if remission fails.
- Once the hands heal (no redness, no cracks, or itching), it is necessary to fight against recurrence. In the second phase, emollients are used, sometimes combined with keratolytic (if the skin is much thickened). These creams must be chosen with care (with a minimum of ingredients, a strong hydrating power, without fragrance) and applied daily, several times a day, if necessary.
What can you do in case of eczema?
Daily hygiene measures increase the effectiveness of the treatment prescribed by the doctor and prevent relapses. Local care is essential because it helps restore the skin barrier compromised by eczema.
- It is necessary to wash less often and only with mild soap, by banishing the perfumed soaps or containing dyes. Then dry your hands by dabbing with a cotton towel.
- Apply your moisturizer several times a day to the skin, containing no colorings, fragrances, preservatives, peanut, almond or sesame oil, or wheat or egg proteins.
- To soften the crusts, then detach them carefully, you can ask your pharmacist to prepare a “fresh modified Galien cerat.” It is a mixture of white beeswax, rose distilled water, borate from sodium, and paraffin oil.
- Make sure your nails are well cut or put on cotton gloves overnight to avoid scratching lesions.
- It is possible to spray the lesions with a mineral water sprayer to calm the itching.
- No diet, for example, with oils rich in unsaturated omega-six or omega-three fatty acids, is useful in the treatment of eczema.
- Over the counter treatment:
- Eczema is a chronic condition that progresses by relapses, interspersed with episodes of the lull. Eczema of the hands is, therefore, a disease the treatment of which is long-term.
- The treatment of contact eczema begins with the ousting of allergen in question, which is essential to obtain a cure. You should, therefore, ask the doctor which products contain the allergenic substance you should avoid. And, if possible, obtain a list of these products.
- Treatment of hand eczema relies on the use of local corticosteroid drugs, or “dermocorticoids” (Betneval, Diprosone, etc.). These drugs are available only by prescription. The prescribed dosages should be strictly observed.
It is possible to use them in the form of creams (for oozing lesions, folds) or ointments (for dry and thickened skin).
The application must be made once a day, preferably in the evening at bedtime or after bathing, on the areas of skin where lesions exist. It is not necessary to massage or put a thick layer of product. It is crucial to continue treatment until the lesions have entirely disappeared. In practice, doctors prefer to prescribe sufficiently powerful dermocorticoids for a short time.
This treatment is effective in the event of an eczema flare-up to calm the inflammation and itching. But it does not prevent recurrences. When the lesions have disappeared, there is, therefore, no point in continuing to apply the local dermocorticoid.
It is useful to count the tubes of dermocorticoids used between two medical consultations. It can help your doctor to assess the development of atopic eczema in children.
Dermocorticoids have a terrible reputation with the fear of undesirable effects. These effects include weakening of the skin, infection, addiction, repercussions on growth in children, etc. These are very rarely observed. They only appear after too intense and prolonged treatment. On the contrary, in reality, the procedure is often insufficient due to the inadequate use of the prescribed corticosteroid. It is because of the fear of these side effects, and this fear is the source of treatment failures.
- When the eczema lesions itch and are troublesome, the doctor may prescribe an antihistamine H1. It helps to relieve the itching associated with eczema. Their effectiveness has not been sufficiently demonstrated.
- Only in the case of bacterial superinfection, the doctor can prescribe antibiotics, local or oral.
- Dry skin is one of the hallmarks of atopic dermatitis. The use of emollients and moisturizing creams is an integral part of the treatment because it helps prevent outbreaks of eczema and irritation of the skin. They must be applied every day and everywhere, outside the inflammatory zones.
- In severe cases of atopic dermatitis or which resist well-conducted first-line treatment, phototherapy with UVA or UVB can be used, possibly with a “photosensitizer.”
- In children over two years of age, adults who have moderate to severe eczema and those whose body does not respond adequately to dermocorticoids. It is possible to apply a local immunomodulator or “IML” (ointment containing “tacrolimus” or “pimecrolimus”). They will act on the skin’s immune system. Tacrolimus 0.1% is used mainly in facial disorders in adults. The prescription of tacrolimus is for exceptional medicines. Only dermatologists and pediatricians can prescribe this.
- In the case of the superinfection of the skin, antibiotic treatment is necessary before starting treatment. The presence of a progressive herpes infection is a short-term contraindication to local immunomodulators.
The most effective essential oils against eczema:
The three essential oils to have in your wardrobe:
- Roman chamomile
- Geranium rosat
- Lavender aspic
Why use essential oils for eczema?
This inflammation of the skin causes itching and sometimes happens without warning. The anti-inflammatory and analgesic properties of essential oils play a significant role in playing to calm the pain and act on the origin of your disorders. Healing and regenerating skin, essential oils also accelerate the skin renewal process to fight your eczema as soon as possible!
Three essential oils against eczema:
ROMAN CHAMOMILE, ANTI-INFLAMMATORY:
Roman chamomile’s essential oil is full of benefits. The essential oil of Roman chamomile fights against skin inflammations while calming irritations and itching of the skin. Is it a little extra? Its calming and soothing properties will quickly soothe you.
Use: Pour two drops of Roman chamomile essential oil in 1 teaspoon of vegetable oil (Calophyllum, evening primrose). Massage the affected areas morning and evening for a maximum of 3 consecutive weeks. Take a week’s break before trying again.
Precautions: Perform a skin test before application. It may not be suitable for pregnant women under three months, children under three months, and people with epilepsy.
ROSAT GERANIUM, REGENERATING, AND SOOTHING SKIN
Geranium rosat is very popular in perfumery with its sweet scent close to rose. Its essential oil fights skin disorders. It is because of the molecules of aldehyde and monoterpene esters present in it. Also regenerating the skin, geranium rosat essential oil restores radiance to damaged tissue, while calming and soothing irritated skin
Use: Pour two drops of essential oil of geranium rosat in 1 teaspoon of vegetable oil (calophylle, evening primrose). Massage the affected areas morning and evening. For a maximum of 3 consecutive weeks. Take a week’s break before trying again.
Precautions: Perform a skin test before application. Do not apply pure on the skin. It might not be suitable for pregnant or lactating women, children under three years, and people with epilepsy or asthma. In case of any drug interaction, consult your doctor.
LAVENDER ASPIC, SKIN ANALGESIC
Flower of the south of France, the lavender aspic grows in abundance in the wild at low altitude. Its essential oil calms skin pain thanks to the linalool and the camphor it contains. Anti-inflammatory and healing, lavender aspic essential oil is also a must against dermatological disorders, including eczema.
Use: Pour two drops of lavender aspic essential oil in 1 teaspoon of vegetable oil (calophylle, evening primrose). Massage the affected areas morning and evening for a maximum of 3 consecutive weeks. Take a week’s break before trying again.
Precautions: Perform a skin test before application. It may not be suitable for pregnant or breastfeeding women. Do not use it on children under six years old. People with asthma, epilepsy, or convulsants or subjects taking medication must avoid it. It is because of the risk of possible drug interactions. In this case, consult your doctor. Neurotoxic people must never overdose.
To know more, Click here.