| TL;DR Eczema on hands, clinically called hand eczema or hand dermatitis, affects approximately one in ten adults and is one of the most functionally limiting skin conditions because hands are in constant use and constant contact with irritants. There are several distinct types with different causes: irritant contact dermatitis, allergic contact dermatitis, atopic hand eczema, and pompholyx. Most cases require potent topical steroids rather than mild ones, combined with consistent emollient use and strict irritant avoidance. |
Your hands are the most heavily exposed part of your body. They are washed repeatedly, exposed to soaps, detergents, cleaning products, metals, food substances, rubber gloves, and countless other daily contacts that the rest of your skin never encounters. For people who develop eczema on their hands, this constant exposure turns a manageable skin condition into something that disrupts work, relationships, sleep, and basic daily function.
Among those with severe chronic hand eczema, 70% report difficulties performing everyday activities, and 58% say it interferes with their ability to work. This guide covers everything you need to know — what type you have, what is causing it, and what treatments are available in the UK right now.
What Is Eczema on Hands?
Hand eczema — also called hand dermatitis or chronic hand eczema (CHE) when persistent — is an inflammatory skin condition affecting the hands and wrists. Chronic hand eczema is diagnosed when symptoms last more than three months, or recur two or more times within a year. It affects approximately one in ten adults.
What makes hand eczema clinically distinct from eczema elsewhere on the body is the anatomy. The hands have increased stratum corneum thickness, a high degree of motion, minimal subcutaneous tissue, and frequent environmental exposure. These factors contribute to the characteristic findings of hyperkeratosis, fissuring, and oedema that distinguish hand dermatitis from other forms of eczema.
The palms of the hands have the thickest skin on the body — which means mild topical steroids that work adequately on other sites are rarely sufficient for hand eczema. This is one of the most consistently misunderstood aspects of treating it.
The Different Types of Hand Eczema — Why It Matters Which One You Have
Irritant contact dermatitis, atopic hand dermatitis, and allergic contact dermatitis account for at least 70% of all hand eczema diagnoses. Getting the type right matters because the primary intervention differs significantly — removing an allergen can resolve allergic contact dermatitis; managing atopic skin requires long-term emollient therapy; pompholyx needs specific acute treatment. Many people have more than one type simultaneously.
Irritant Contact Dermatitis — the Most Common Type
Irritant contact dermatitis is the most common type of hand dermatitis and results from skin exposure to exogenous substances that abrade, irritate, or damage the stratum corneum. Symptoms can occur in anyone and typically include burning, itching, and tenderness at the site of exposure.
The damage is cumulative and often insidious. Repeated exposure to water, soap, detergents, and cleaning products — individually tolerable — progressively strips the skin’s protective lipid barrier. Once damaged, the barrier allows further irritants to penetrate more easily, creating a worsening cycle. This is the mechanism underlying hand eczema in healthcare workers, cleaners, caterers, hairdressers, and parents of young children who wash their hands dozens of times a day.
Allergic Contact Dermatitis — Triggered by a Specific Allergen
Allergic hand eczema arises as a result of an allergic reaction to a particular substance in the environment. Common causes of contact sensitivity include nickel, fragrance ingredients, preservative chemicals, rubber, and various plants. Once a person’s immune system has identified a substance as harmful, they will react to it every time their skin is exposed, and the reaction becomes more severe on each exposure.
The critical distinguishing feature is that even trace exposure to the specific allergen — however brief — triggers a response, whereas irritant contact dermatitis is dose-dependent. This is why patch testing is so important in allergic cases: identifying the specific allergen allows targeted avoidance, which can resolve the eczema entirely.
Atopic Hand Eczema — When Childhood Eczema Follows You
People with a personal or family history of atopic eczema, asthma, or hay fever have a significantly elevated risk of developing hand eczema as adults. Atopic patients have a 13.5-times greater risk of developing occupational dermatoses than non-atopic patients. When atopic individuals enter high-exposure occupations — healthcare, hairdressing, catering, cleaning — their pre-existing barrier dysfunction means they develop hand eczema far more readily than non-atopic colleagues doing identical work.
People who have irritant contact dermatitis often have a history of eczema in childhood. For many adults, the hand eczema they develop in their 20s and 30s is effectively a continuation of the atopic skin they had as children, now expressed on the hands because of occupational or domestic exposure.
Pompholyx (Dyshidrotic Eczema) — Blistering on Palms and Fingers
Pompholyx, also called dyshidrotic eczema, is a specific and distinctive presentation of hand eczema that deserves separate consideration. Pompholyx eczema involves the development of intensely itchy, watery blisters affecting the sides of the fingers, the palms of the hands, and soles of the feet. It can occur at any age but is usually seen in adults under 40 and is more common in women.
The blisters of pompholyx are small, deep-seated, and extraordinarily itchy — many people describe the sensation as burning or prickling before the blisters visibly appear. They can coalesce into larger blisters and may weep, crust, and become infected if scratched. The blisters of dyshidrotic eczema may last three to four weeks before clearing.
Triggers include stress, heat, sweating, and metal contact — particularly nickel. Nickel sulfate was the allergen with the highest positivity on patch testing in pompholyx patients. Some people experience seasonal flares, typically in spring and summer when temperatures rise.
Hyperkeratotic Hand Eczema — Thick, Fissured, and Stubborn
Hyperkeratotic eczema presents as thick areas of scale on the palms and soles. It is usually seen in men of middle age and is notably resistant to treatment, persisting for years. The skin becomes progressively thickened, cracked, and may develop deep painful fissures — splits in the skin that bleed and sting. This is the variant most likely to interfere with work, particularly manual work.
What Causes Eczema on Hands?
Hand eczema often results from a combination of both genetic (constitutional) factors and contact with irritants. In addition some patients may have a contact allergic dermatitis. The causes are rarely singular — most cases involve two or three contributing factors operating simultaneously.
Wet Work
This term deserves specific attention because it has a clinical definition that most people are not aware of. Wet work is defined as work that involves having wet hands for more than a quarter of the working day, or wearing waterproof gloves for equivalent periods. Water itself decreases the protective capacity of the skin, and occlusion further increases its irritant effect. In many wet work occupations, lipid-soluble chemicals are added to water to achieve a cleaning effect — in the skin this is unfavourable because intracellular lipids are washed away, removing important components of the skin’s protective capacity.
Healthcare workers, nurses, dentists, caterers, cleaners, childminders, hairdressers, and bar staff all routinely perform wet work. If your job involves any of these, your hands are being biochemically damaged every working day — emollient protection before, during, and after exposure is not optional, it is essential.
Occupation-Specific Risks
People with a history of hand eczema need to carefully consider their choice of career, as certain occupations carry heightened risk of contact with substances that cause irritation or allergy. These include hairdressing, catering, healthcare professions, metal work, floristry, mechanics, domestic and cleaning work, some types of engineering, and printing.
For people with atopic skin considering careers in these fields, this risk is substantially elevated. The National Eczema Society advises that anyone with a history of atopic eczema should factor occupational exposure risk into career decisions — not to be excluded from these roles, but to go in with proper protective strategies from day one.
Contact Allergens — The Most Commonly Missed Driver
Nickel is the most prevalent contact allergen in hand eczema, found in costume jewellery, belt buckles, watch straps, coins, and tools. Rubber chemicals from latex gloves are another major source — the very gloves worn to protect the hands can themselves be causing the eczema if latex allergy is present. Fragrance is the most common allergen in personal care products. Preservative chemicals in cosmetics and creams, fragrance ingredients, and rubber are among the most common causes of allergic contact dermatitis on the hands.
The Filaggrin Gene Connection
A significant proportion of people with atopic hand eczema carry mutations in the filaggrin gene — a structural protein of the skin’s outer layer critical to barrier function. Loss-of-function filaggrin mutations cause dyskeratinisation, increased water loss through the skin, and increased transfer of antigens through the barrier. This genetic predisposition explains why some people develop severe hand eczema with relatively modest exposure while colleagues doing identical work are unaffected.
Treating Eczema on Hands: The Full UK Treatment Ladder
Step One: Emollients and Irritant Avoidance
No treatment for hand eczema works well without these two foundations in place. Emollients should be used frequently throughout the day to enhance the skin’s barrier function — even when the eczema is not flaring. They keep the skin hydrated and help prevent irritants and allergens from entering it.
For the hands specifically, the practical challenge is the frequency of hand washing stripping products back off. Keeping small tubes of emollient at the sink, at your desk, and in your bag — so that every hand wash is followed by immediate emollient application, is the single most impactful habit change. Apply a non-perfumed emollient liberally, as often as required, throughout the day.
Our Epaderm Cream works as both a leave-on moisturiser and soap substitute — replacing conventional hand soap entirely for daily washing, which removes one of the most consistent irritant exposures in hand eczema.
Simultaneously, every soap, detergent, perfumed product, and known irritant must be eliminated from hand contact. Replace hand soap with an emollient soap substitute. Use gloves for all washing-up, cleaning, and gardening. Ointment-based emollients are the most effective type for very dry skin — apply an ointment before bed and wear a pair of 100% cotton gloves overnight.
Step Two: Potent Topical Corticosteroids
This is the critical point where hand eczema management differs fundamentally from eczema elsewhere. Potent or super-potent topical steroids are often needed to treat hand eczema — for example, betamethasone valerate 0.1% or clobetasol propionate 0.05%. The palms have the thickest skin on the body, and mild or moderately potent steroids that are sufficient for arm or body eczema simply cannot penetrate adequately to produce the needed anti-inflammatory effect on the hands.
The steroids used for hand eczema are prescription-only and should be used under clinical guidance. Speak to your GP or pharmacist for assessment and a prescription.
The Cotton Glove Occlusion Technique — Underused and Highly Effective
This technique significantly enhances the effectiveness of topical steroids, particularly for dry, thickened, or fissured hands. If the hands are not weeping, the effects of treatment can be enhanced by night-time occlusion using either cotton gloves or clingfilm wrapped around troublesome areas.
The method: apply emollient generously, then apply your topical steroid cream or ointment to active eczema areas, put on a pair of 100% cotton gloves, and wear them overnight. The occlusion prevents evaporation, increases skin hydration, and drives greater penetration of the topical steroid into the thickened skin of the palms and fingers. Clinical reports describe clearance of previously therapy-resistant discoid and hand eczema with this approach.
Steroid-Impregnated Tape and Plasters for Fissures
Deep, painful fissures on the hands — a particularly debilitating feature of hyperkeratotic hand eczema — can be treated with steroid-impregnated products that stay in contact with the skin for extended periods. Haelan tape (fludroxycortide tape) and Betesil medicated plaster (betamethasone valerate) can both be left on for up to 24 hours before reapplying. These are prescription products specifically useful for persistent fissures.
Potassium Permanganate Soaks — For Pompholyx Specifically
When pompholyx eczema is actively weeping and blistering, potassium permanganate soaks are an effective drying and antimicrobial treatment. Potassium permanganate soak may be advised when skin is weeping, oozing, and crusting. It is usually obtained on prescription as Permitabs, but can be bought over the counter from a pharmacy. When the acute flare of pompholyx subsides, the soaks should be stopped, usually after 3 to 7 days.
The dilution used is 1:10,000 — one tablet dissolved in 4 litres of water — and hands are soaked for 10 minutes. It stains skin, nails, and fabrics brown, which resolves after the course ends. This is a useful, accessible treatment for the acute blistering phase before transitioning back to emollients and topical steroids.
What Changed in 2026: NICE Approves Delgocitinib for Chronic Hand Eczema
This is the most significant development in hand eczema treatment for decades, and it is something most existing online guides have not yet covered.
NICE has issued evidence-based recommendations on delgocitinib (Anzupgo) for treating moderate to severe chronic hand eczema in adults when topical corticosteroids have not worked or are not suitable. This guidance was last reviewed in November 2025.
Following NICE’s recommendation, delgocitinib will now be made available on NHS prescription in England and Wales, with other UK nations expected to follow. An estimated 62,000 patients could be eligible.
Delgocitinib is a topical JAK inhibitor — a new class of cream that works by blocking the JAK1 and JAK2 enzymes that drive inflammatory signaling in the skin. Unlike topical steroids, it does not thin the skin with prolonged use, making it suitable for long-term management of a chronic condition. Clinical trials demonstrated it is more effective than alitretinoin (the previous specialist oral option) with a significantly better side effect profile.
Delgocitinib has a 12-month shelf life once opened, making it easier for people to restart treatment when symptoms flare without needing a new hospital appointment. This is a practical advantage for a condition defined by its relapsing and remitting nature.
Access is through specialist services — your GP would need to refer you to dermatology if you have tried potent topical steroids without adequate control. This is a meaningful step forward for people whose hand eczema has been debilitating and poorly managed for years.
When Specialist Escalation Is Needed
For hand eczema that has not responded adequately to potent topical steroids and trigger avoidance, several specialist options are available through NHS dermatology:
Alitretinoin (Toctino) — an oral retinoid specifically licensed for severe chronic hand eczema that has not responded to potent topical steroids. It is highly effective for hyperkeratotic and chronic variants but requires monthly monitoring and strict contraception in women of childbearing age due to teratogenicity.
Extremity PUVA phototherapy — psoralen-sensitized ultraviolet A light therapy applied specifically to the hands. Delivered at NHS dermatology departments, it requires multiple weekly sessions but can produce significant clearance of resistant hand eczema.
Systemic immunosuppressants — ciclosporin, methotrexate, and azathioprine are used in secondary care for severe, refractory cases. They carry systemic side effects and require careful monitoring.
Preventing Flare-Ups — Practical Daily Strategies
Glove Use — Getting It Right
Wearing protective gloves is essential, but they must be done correctly to avoid making eczema worse.
For general purposes and household tasks, rubber or PVC gloves with a cotton flocked lining, or worn over 100% cotton gloves, should suffice. Even when eczema has cleared, the hands remain very sensitive, so wearing cotton gloves underneath rubber or PVC gloves can be helpful when performing wet tasks.
Critical points: gloves must be removed every 15 to 20 minutes if worn for prolonged periods during wet tasks — the inside of a rubber glove becomes a warm, humid environment that can itself worsen eczema. Never use barrier creams as a substitute for gloves in occupational settings. People with hand eczema should always use protective gloves — which should be provided by the workplace — and never barrier creams.
If a rubber allergy is confirmed on patch testing, nitrile or vinyl gloves should be substituted.
Diet, Food Handling, and Ring-Related Exposure
Do not peel citrus fruit, onions, chillies, or garlic with bare hands — many fruits and vegetables are irritants. If you do handle them, wash your hands as soon as possible afterward and apply an emollient immediately.
Rings — particularly those made from cheaper metals containing nickel — can trap moisture and irritants against the skin of the fingers, creating a small localized zone of constant irritation. If your eczema is worst around your ring finger, remove rings during wet tasks and ensure rings are platinum, gold, or verified nickel-free.
The Washing Routine
Every time hands are washed with soap, the skin barrier is partially stripped. Replacing all conventional hand soap with an emollient soap substitute removes one of the most consistent daily irritants. Rinse with lukewarm rather than hot water. Pat dry gently rather than rubbing. Apply emollient within one to two minutes of drying while the skin still retains some moisture.
Stress Management
Stress is a known trigger for many skin conditions, and stress management can play a role in preventing eczema flare-ups. Practices such as mindfulness or relaxation exercises can be helpful for some people. For pompholyx in particular, emotional stress is a well-documented trigger, and managing stress directly is a legitimate part of long-term eczema management.
When to See a GP or Pharmacist
You should see your GP if your hand eczema has not improved with over-the-counter emollients and irritant avoidance within two weeks, if your skin develops signs of infection — yellow crusting, increased pain, spreading redness or warmth — if eczema is preventing you from working or managing daily activities, or if blistering is severe or rapidly spreading.
You should ask for a dermatology referral if your hand eczema is not controlled by potent topical steroids after consistent use, if an allergic cause is suspected and you have not had patch testing, if you are considering oral or specialist treatments, or if you think you may be eligible for delgocitinib under the new NICE guidance.
Our eczema range at Star Pharmacy includes emollients and topical treatments appropriate for hand eczema management. You can also contact our pharmacy team for advice on appropriate products for your specific hand eczema type, or find further information on our eczema conditions page.
Final Thoughts
Eczema on hands is not a minor inconvenience — for many people it is a daily, painful, work-limiting condition that affects confidence, relationships, and quality of life. The good news is that both the understanding and treatment of hand eczema have advanced significantly. The right treatment combination — potent topical steroids, consistent emollient use, aggressive irritant avoidance, and where needed specialist escalation — controls most cases effectively.
For anyone with severe, persistent hand eczema not adequately controlled by topical steroids, the new NICE-approved delgocitinib cream is a genuine therapeutic advance that should be discussed with a dermatologist.Start by exploring appropriate emollient options from our eczema range at Star Pharmacy. If you need guidance on which product suits your specific type of hand eczema or want to discuss treatment options, contact our pharmacy team for a confidential conversation with our registered pharmacists.
FAQs
Why is eczema on hands so much harder to treat than eczema elsewhere?
Several factors make the hands uniquely difficult. The palms have the thickest skin on the body, which means topical treatments penetrate less easily — requiring potent steroids rather than mild ones. Hands are in constant motion and constantly contacting irritants, meaning any improvement achieved during a rest period is immediately challenged on return to normal activity.
What is the best cream for eczema on hands?
No single cream is best for all hand eczema. The treatment should match the severity and type. For daily barrier maintenance and hand washing, an emollient soap substitute and leave-on cream like Epaderm Cream is essential. For active inflammation, a potent topical corticosteroid prescribed by a GP is the clinical standard. For severe cases unresponsive to steroids, delgocitinib cream — now NICE-approved and available on NHS prescription in England — is the new targeted option.
Does hand eczema ever go away completely?
For some people, yes particularly those with irritant contact dermatitis who successfully eliminate the causative exposure. If the eczema is driven by a single identifiable allergen and that allergen is avoided, complete resolution is possible. For atopic hand eczema or pompholyx with multiple triggers, remission rather than cure is a more realistic goal — long periods without symptoms, managed by consistent emollient use and trigger avoidance, with flares treated promptly when they occur.
Can I use the same eczema cream for my hands as the rest of my body?
The same emollients can be used on the hands as on the body. However, the topical corticosteroid strength required for the hands is typically higher — a mild steroid that controls eczema on the elbow or back will rarely achieve adequate effect on the thick skin of the palms. Potent or super-potent topical steroids are often needed to treat hand eczema.
What occupations are most at risk of developing hand eczema?
Occupations carrying the highest risk of hand eczema include hairdressing, catering, healthcare professions, metal work, floristry, mechanics, domestic and cleaning work, some types of engineering, and printing. Any role involving repeated hand washing, prolonged glove use, or regular contact with chemical irritants or known allergens carries elevated risk.