Hands are one of the most susceptible areas for eczema in both adults and children. Because our hands are exposed to a variety of substances and do a variety of things every day, hand eczema can easily become a chronic condition. Sometimes patients ask for a cure for hand eczema, and I tell them the secret: protect your hands every day, don’t touch anything, don’t do anything, and then your hand eczema will be cured. In fact, this is only an ideal state, in reality it is very difficult to do, we need to learn some knowledge and methods to prevent and control hand eczema in addition to medication, and protect our hands as much as possible. Why are hands prone to eczema? There are many causes of hand eczema, related to both genetic and environmental factors. In some patients, mutations in the filamentous protein gene in the skin can cause dry, flaky skin that is prone to eczema, and in these patients, the skin on the hands can also be very dry and exhibit coarse hand lines (palmaria), and exposure to various irritants or allergens can trigger eczema on the hands. There are also many external factors that contribute to hand eczema: people who are constantly exposed to water or who work with moisture are more likely to develop hand eczema. Studies have found that exposure to water for more than three hours a day can damage the structure of the skin’s surface layer, resulting in increased sensitivity to external irritants. Some occupations such as hairdressers, health care workers, chefs, housewives or cleaning staff are all occupations that are prone to hand eczema. Exposure to a variety of irritants in daily life or at work is a major cause of irritant dermatitis/eczema on the hands. Examples include detergents, fragrances and preservatives in hand sanitizers or soaps, chemical cleaners in the home, ammonia and organic solvents used in industry, exposure to fruits, vegetables and spices in food processing and manufacturing, and physical irritants such as hardware tools, wood, fiberglass and dust/soil from certain occupational exposures. There are also some hand eczema related to allergens. The most common allergens are metals such as nickel and chromium, fragrances, preservatives, rubber additives, dyes, etc. These exposure allergens are also usually associated with occupational exposure. When eczema of the hands is suspected to be related to an allergen, this can be determined by a skin patch test. Allergic reactions to animal or plant proteins are also frequently seen in people involved in food processing and manufacturing, chefs, or animal and plant breeders, who may experience repeated redness and swelling of the hands after exposure, which is determined by skin prick testing and blood tests for IgE antibodies. How is eczema of the hands treated? The most important part of the treatment of hand eczema is to avoid all possible related irritants or allergens, to enhance protective measures and to use moisturizing emollients liberally. Medical emollients are recommended, preferably creams or ointments, and should be used frequently to keep the skin moist, even after the eczema is under control, and to prevent the skin from drying out. Soaps and detergents used for hand washing may also irritate the skin and aggravate eczema, so it is recommended that soap substitutes be used to clean the skin on the hands. Wearing gloves can protect hands from external irritants or allergens, but regular use of soap substitutes and frequent use of emollients are still needed. While ensuring that gloves provide complete protection, make sure they are dry on the inside. For general use and household tasks, cotton-lined rubber or PVC gloves are sufficient. Even when eczema has healed, hands can still be very sensitive, so cotton-lined rubber gloves are a must when working with moisture. Of course topical anti-inflammatory medications (glucocorticoid ointment) are the preferred treatment to reduce inflammation and promote rash recovery. Short-term oral anti-inflammatory drugs, retinoids, or ultraviolet light therapy are also required for severe cases. The doctor will assess the cause of the eczema on the hands and the characteristics of the rash, and then give appropriate treatment measures. Some practical tips to protect your hands Wash your hands with a soap substitute or emollient hand sanitizer, pat your hands dry with a soft, dry towel after washing, do not use rough paper towels, and remember to apply moisturizer at the end. Do not wash your hands with soap when wearing a ring, as moisture or irritating ingredients in the soap may accumulate under the ring and cause irritation. Pay special attention to the skin between your fingers when drying your hands after washing, as these areas are more prone to dryness and cracking. Remember to use protective gloves lined with cotton when doing housework, and do not wear gloves for more than 20 minutes straight, as this can lead to increased skin perspiration and aggravate hand eczema, and avoid direct hand contact with chemical irritants such as detergents, detergents and stain removers. Patients with hand eczema avoid direct hand contact with citrus fruit peels, onions, peppers, garlic, etc. Many fruits and vegetables are irritants and can cause irritation to the hands. Hands should be washed and emollients applied as soon as possible after direct contact with these fruits and vegetables. Wearing rings (especially rings containing alloys such as nickel) may aggravate hand eczema. Rings should not be worn while doing household chores, even after the eczema has significantly improved, because cleaning agents, dust, etc. may be hidden under the ring and cause skin irritation. Patients with a history of hand eczema should choose their occupations carefully because some occupations may expose them to various irritants or allergens and increase their risk of developing the disease. These occupations include hairdressing, catering, health care, metalworking, floriculture, housekeeping and cleaning, construction work and printing.