Calm itchy, flaky skin · 8 weeks
Hand Eczema Recovery
For sore, cracked, itchy hands from wet work, detergents, hair chemicals or cooking: a guideline-based skin-protection plan.
- Length
- 8 weeks
- For
- Women, Men
- Evidence A
- Strong evidence: guidelines or reviews of trials
- What to expect
- Better in 2–4 weeks. Ask about allergy (patch) testing if not settled by about 3 months.
The goal: Healed hands and a glove-and-cream routine that prevents relapse.
ESCD 2022 guideline (A for steroids; consensus for emollients and gloves). Darker hands often show thick, dark patches rather than redness.
Start this program
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The plan
Weeks 1–2
Protect & heal
Cream after every wash, gloves for wet work, night ointment; steroid for a flare if advised.
Removing irritants and restoring the barrier lets cracks heal (ESCD).
Morning
Cream after every wash and through the day
Fragrance-free lotion by day, greasier ointment at night; cover the whole hand including finger webs, backs and fingertips.
Why: The ESCD hand-eczema guideline recommends frequent emollients as the base of treatment and prevention.
Alcohol hand rub instead of soap when hands look clean
When hands are not visibly dirty, use an alcohol hand rub; save soap and water for visible dirt.
Why: Hand rub is gentler on the skin barrier than repeated soap washing (ESCD).
Evening
Night ointment + cotton gloves
Thick layer of petroleum jelly or ointment, then clean cotton gloves overnight.
Why: Occlusion overnight helps cracks heal.
Habits
Gloves for wet work
Rubber or nitrile gloves for dishes, cleaning, hair chemicals and food prep; cotton liners if longer than 10 minutes; keep them dry inside; single-use gloves once only; rings off.
Why: Wet work and detergents are the main triggers of hand eczema (ESCD).
Steroid ointment for a flare (doctor or pharmacist)Doctor or pharmacist
For a red, itchy, cracked flare, a doctor or pharmacist may give a short course of steroid ointment of the right strength for hands. Do not use "3-in-1" creams. Your doctor or pharmacist will advise the dose and how long.
Why: Topical steroids are ESCD Grade A first-line treatment; the right strength and short use avoid thinning.
Work-skin protection
Hairdressers, barbers, cleaners, cooks, mechanics and health workers: ask your employer or trade group about skin-protection training; never clean hands with petrol, kerosene, solvents or abrasives.
Why: Skin-protection education reduces relapse in controlled studies.
Food
Hydration
Water with each meal and whenever thirsty; more in heat and harmattan.
Why: Supports overall health; skin hydration is mostly about the barrier, so pair water with moisturiser.
Weeks 3–8
Stay healed
Keep the glove and cream habit; find triggers.
Hand eczema relapses quickly if protection stops.
Morning
Cream after every wash and through the day
Fragrance-free lotion by day, greasier ointment at night; cover the whole hand including finger webs, backs and fingertips.
Why: The ESCD hand-eczema guideline recommends frequent emollients as the base of treatment and prevention.
Alcohol hand rub instead of soap when hands look clean
When hands are not visibly dirty, use an alcohol hand rub; save soap and water for visible dirt.
Why: Hand rub is gentler on the skin barrier than repeated soap washing (ESCD).
Evening
Night ointment + cotton gloves
Thick layer of petroleum jelly or ointment, then clean cotton gloves overnight.
Why: Occlusion overnight helps cracks heal.
Habits
Gloves for wet work
Rubber or nitrile gloves for dishes, cleaning, hair chemicals and food prep; cotton liners if longer than 10 minutes; keep them dry inside; single-use gloves once only; rings off.
Why: Wet work and detergents are the main triggers of hand eczema (ESCD).
Work-skin protection
Hairdressers, barbers, cleaners, cooks, mechanics and health workers: ask your employer or trade group about skin-protection training; never clean hands with petrol, kerosene, solvents or abrasives.
Why: Skin-protection education reduces relapse in controlled studies.
Ask about patch testing if it keeps coming backDoctor or pharmacist
If your hands are not settled by the end of this program, or keep flaring, ask a doctor about patch testing for allergies (hair dye, rubber, preservatives, fragrance). Your doctor or pharmacist will advise the dose and how long.
Why: An allergy found by patch testing can be avoided; ESCD recommends testing for persistent hand eczema.
Weekly progress photo
Same place, same daylight by a window, no filter, no makeup; front, left and right.
Why: Change is slow; consistent photos show progress memory cannot.
Food
Hydration
Water with each meal and whenever thirsty; more in heat and harmattan.
Why: Supports overall health; skin hydration is mostly about the barrier, so pair water with moisturiser.
Milestones
Your weekly check-in
Ask yourself these once a week. If an answer worries you, stop and see a doctor or pharmacist.
Stop and see a doctor if
- Pus, honey-coloured crusts or red streaks: see a doctor
- Painful blisters
- Not better at 4 weeks, or lasting more than 3 months (ask about patch testing)
- Rash spreading to the face or eyelids (possible allergy to hair dye or nail acrylates)
In an emergency, call 112112999911911.
Sources
- Thyssen et al. ESCD guidelines for diagnosis, prevention and treatment of hand eczema (Contact Dermatitis, 2022)
- DermNet: Paronychia
- DermNet: Patch tests
Education, not diagnosis. This plan cannot examine you; pending physician review where marked.
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