THE’ eczema is here second skin disease most frequent after acne. It concerns 30% of dermatological consultations.
Hand eczema: what are the causes?
Located in the hands, “chronic eczema can be genetic origin, linked to atopic dermatitis (editor’s note: also called atopic eczema) with a preferential location in the hands, specifies Dr Antoine Badaoui, dermatologist-allergist. It can also be a allergic eczema due to a perfume, has a conservative… In carriers of gloves like housekeepers, hairdressers, eczema can be allergic or itchy. ”
Hand eczema: recognizing the symptoms
Whether it is atopic or allergic, the symptoms of hand eczema are similar.
“It manifests itself by red patches which peel, which itch, by vesicles which ooze, cracks, details Dr. Badaoui. Most of the time the eczema of atopic origin has very limited borders unlike the allergic eczema where the latter are rather “in geography map”, less well delimited. ”
How is the diagnosis made?
Hand eczema is diagnosed by physical examination. The patches tests (also called patch tests), they make it possible to find out if it is an allergy or not. The test patches consist of applying, in the back and under occlusion, thirty allergens which correspond to the battery of the European standard, possibly supplemented by other batteries according to the questioning of the patient.
“To perform these patch tests, three appointments at 48 hour intervals are necessary,” says the dermatologist. The first for the installation of the patches on the back, the second intended to take off them and the last for the final reading. If the test patches are negative, an allergy to the molecules tested can be ruled out. “
Itching: limit scratching thanks to sophrology
Sophrology, as a psycho-corporal method, apprehends the human being in all its richness: it takes into account its bodily, mental and emotional dimensions.
” The skin organ ”Being from the same embryonic strain as the nervous system, the stress has consequences on the body, which can be manifested by the appearance of eczema ”, explains Clementine Joachim*, sophrologist. Sophrology can therefore be a valuable remedy against “eczema attacks”. “In particular, thanks to the exercise of fans which can reduce itching », Specifies the sophrologist.
- Sit upright with enough space around you, feet parallel to the width of the pelvis.
- The back is straight, the arms and shoulders are relaxed, the head is in the extension of the spine.
- Close your eyes and pay attention to the rhythm of your breathing.
Sequence of the exercise (repeat 3 times)
- Raise both arms in front of you horizontally while inhaling deeply through your nose.
- Hold your breath and shake your hands like fans (hence the name of the exercise!) by slowly bringing them closer to the chest. Give meaning to your movements by imagining dropping the sensations of scratching, tingling. Shaking your hands, release them from unpleasant itching sensations.
- Once both hands are closer to the chest, release the arms to your sides, blowing gently through your mouth.
- Take a natural breath, and take a moment to observe the sensations in your hands. Focus on the sensations on your palms, your fingers. Become aware of all the sensations associated with the movements of your hands.
- Repeat twice, always giving more meaning to your actions: shake your hands imagining that the unpleasant scratching sensations are escaping of your hands, let the itchiness slide down from your fingers to the ground, to free and purify your skin.
- After exhaling through the mouth, observe and carefully identify your feelings: are they changing? How? Do you feel lighter in your hands? More freshness? More fluidity in your movements?
- Finish each time by becoming aware of your bodily, mental, and emotional feelings.
You can practice this exercise as soon as a want to scratch occurs. Remember to coordinate your movements with your breathing (time to inspire, time to hold air, time to expire), and always give more meaning to your practice!
How to treat hand eczema?
Whether it is atopic dermatitis or chronic hand eczema or allergic eczema, treatment is identical.
“During flare-ups, you have to apply a corticosteroid cream, at a rate of once a day until two or three days after the disappearance of the symptoms, specifies Dr. Badaoui. As inflammation may be latent under the skin, it is essential to stop the process. ”
This treatment should be repeated for each eczema outbreak or continued 2 to 3 times a week for prevention.
“The corticosteroid cream-based treatment must be completed by the multiquidual application of a moisturizer in order to restore the skin barrier, adds the dermatologist. You have to choose the most fatty creams like Cicalfate, Eucerin, Cicaplast… ”
When corticosteroid cream is not enough
When hand eczema does not respond or no longer responds to treatment with a corticosteroid cream, “an oral treatment with alitretinoin », Specifies the doctor. It is an endogenous hormone naturally present and related to vitamin A and which has anti-inflammatory effects.
“The treatment lasts between 3 and 6 months at the rate of one tablet per day,” explains the dermatologist. It needs liver and cholesterol monitoring and, for women, taking a effective contraception. »Alitretinoin can cause serious birth defects in the unborn child, as well as miscarriage.
Can hand eczema be prevented?
It is important to avoid all irritating factors can accentuate an eczema of the hands, and in the event of allergy, to remove the allergen of course.
The advice of Dr. Antoine Badaoui to limit flare-ups:
- Wash hands briefly in lukewarm or cold water with asurgras soap and if possible avoid hard water.
- Do not use dish soap to wash your hands, it is irritating.
- Rinse his hands well and dry them well by dabbing.
- Wear gloves when washing the dishes, cooking certain irritating foods such as tomatoes, lemon… and for cleaning.
Covid-19 and hand eczema: what precautions?
The epidemic of Covid-19 requires applying the barrier gestures whose frequent hand washing is part of it, because it represents an effective bulwark against the spread of the virus.
But, when you suffer from eczema, frequent hand washing weakens the skin, often dry and bruised. It is therefore recommended to use ‘soap-free’ soaps, special soaps for atopic skin, or even washing oils. And, if possible, opt for fragrance-free products. Once the hands have been washed, they should be dried delicately, without rubbing.
As for the use of hydroalcoholic gel, it can cause stinging and burning. It is therefore essential to rehydrate the skin by applying an emollient cream.
Wearing latex or vinyl gloves is not recommended because they promote perspiration and maceration of the skin which may aggravate hand eczema.
Hand eczema: an app to follow its development The app ‘Living with chronic hand eczema’ was designed by patients of the French Eczema Association and ResoEczema dermatologists. It offers different sections: my hand eczema, my follow-up, my treatment, my therapeutic education program, preparing for my consultation… in order to help patients better understand their disease and manage their treatment well. Free, it is available for Android: https://bit.ly/2RujgUU and for IOS: https://apple.co/2D9HJtS