When you have hand eczema, it can cause chronic problems. The itching and irritation may have serious consequences for your everyday life. You may find it hard to work or go to school. You may be missing too many days or struggling to enjoy life. When hand eczema symptoms are severe, they can be debilitating.
The goal of treating your hand eczema is to improve your symptoms, so you will get relief. By treating your hand eczema and avoiding triggers when you can, you may be able to get your condition under control. The best treatment option for you will depend on what’s causing your hand eczema. It also will depend on how severe and debilitating your hand eczema symptoms are.
For a long time, treatment for hand eczema focused mainly on moisturizing creams or emollients. Topical steroids are another medication that’s long been used for hand eczema. But now there are other medicines you can try to tackle the underlying processes in your body that are causing the itchy or painful inflammation on your hands.
While you will have options to consider, there haven’t been many medicines approved specifically to treat hand eczema. Doctors have often used treatments approved for atopic dermatitis, sometimes referred to as eczema, when topical treatments haven’t worked. But chronic hand eczema isn’t always related to atopic dermatitis, which is an autoimmune condition that affects many parts of your body.
Basic steps for managing hand eczema
Some basic things you might buy over-the-counter or try at home to help with your hand eczema include:
- Ice packs or cold compresses
- Petroleum jelly
- Moisturizing creams containing more oil than water
- Bleach baths
- Wet wraps
- Trigger avoidance, including wearing gloves when doing wet work or handling irritants
Medication options for hand eczema
Existing treatments doctors may use for hand eczema include:
- Topical steroids (corticosteroids)
- Topical calcineurin inhibitors
- Topical phosphodiesterase inhibitors
- Topical aryl hydrocarbon receptor (AhR) modulators
- Oral steroids
- Retinoids
- IL inhibitors
- JAK inhibitors
- Biologics
The best choice of medication for you may depend on whether you have signs of eczema or atopic dermatitis on other parts of your body or not. It may depend on what’s causing or triggering your chronic hand eczema and its symptoms. It also will depend on whether your hand eczema symptoms are mild, moderate, or more severe, and how much they’re impacting your life and ability to work or do other everyday activities. You’ll likely start with basic steps you can take at home or at work and topical therapies first. If topical therapies and other steps you can take to protect your hands aren’t working, talk to your doctor about systemic medicines you could try for your hand eczema.
Topical Corticosteroids for Hand Eczema
Topical steroid ointments or creams are a main way to treat hand eczema that’s chronic. There isn’t a lot of evidence to show how well it works if you only use topicals for short periods. Using topical steroids for the long term may help, especially once hand eczema is under control, to help keep it from flaring back up. Talk to your primary care doctor or dermatologist about what kind of topical corticosteroid to use. Corticosteroids come in different:
- Types
- Strengths or potencies
- Concentrations of active steroid
- Formulations
It’s usually best to choose a stronger ointment for hand eczema. Ointments will lubricate your skin more. Ointments also do a better job compared to creams in creating a barrier on your skin that will help to hold moisture in. Depending on the type of hand eczema you have, it might also help to wrap plastic dressings around your hands to help the topical steroid soak into your skin better.
Talk to your doctor about potential side effects of topical corticosteroids and ways to make them less likely. For example, topical steroids can damage your skin barrier over time or cause your skin to atrophy. Talk to them also about how many times per day you should apply topical corticosteroids to your hands.
Calcineurin Inhibitors for Hand Eczema
Calcineurin inhibitors are another kind of topical you might try for your hand eczema. They’re anti-inflammatory medicines you can get as ointments without steroids in them. They suppress the immune system in your skin by targeting a protein called calcineurin. Calcineurin is involved in signals that activate immune responses. Two calcineurin inhibitors are approved for atopic dermatitis. They’re called pimecrolimus and tacrolimus. But these medicines aren’t approved specifically for hand eczema.
There’s some evidence from studies that tacrolimus might help with hand eczema. But the data is limited. There’s very little evidence showing how well pimecrolimus works for hand eczema. Still, doctors may recommend you use a calcineurin inhibitor if topical steroids aren’t working for you. Calcineurin inhibitors also might be a better option if you need to use a topical treatment for your hand eczema for a long time. That’s because calcineurin inhibitors don’t have some of the side effects that come with topical corticosteroids.
In some cases, you might use a topical steroid or calcineurin inhibitor a couple times a week to prevent your hand eczema from flaring back up. If basic steps to manage your hand eczema together with topical moisturizers and steroids haven’t resolved your hand eczema symptoms, ask your primary care doctor or dermatologist if you should think about a topical calcineurin inhibitor.
PDE Inhibitors for Hand Eczema
PDE inhibitors are topical treatments that target an enzyme called phosphodiesterase-4 (PDE4). This enzyme plays a role in skin inflammation. PDE levels in your skin may be higher when you have atopic dermatitis, including hand eczema.
These medicines are approved for atopic dermatitis and may also help when you have atopic hand eczema. PDE inhibitors approved for atopic dermatitis include crisaborole and roflumilast.
AhR Agonists for Hand Eczema
AhR is short for aryl hydrocarbon receptor. An AhR agonist is a topical treatment for atopic dermatitis. It can lower inflammation by activating AhR along with proteins that may help your skin barrier work better.
The AhR agonist tapinarof is approved for moderate-to-severe atopic dermatitis, which may include hand eczema. Studies have shown it can help clear your skin and reduce itching.
Systemic Steroids for Hand Eczema
Oral corticosteroids are taken by mouth to suppress your immune system. Steroids can lower inflammation and reduce your redness, swelling, and irritation on your hands.
While oral steroids sometimes are used to treat severe eczema flares, you shouldn’t keep using them. When taken for longer periods of time, oral steroids come with serious side effects. Oral steroids are used to treat a wide range of conditions, but it’s not likely you’ll take systemic steroids for your hand eczema unless you’re having a flare that’s especially severe.
JAK Inhibitors for Hand Eczema
JAK inhibitors limit inflammation by targeting proteins known as Janus kinases (JAKs). These enzymes receive signals from many different interleukins to drive inflammation. The JAK pathway plays a role in many inflammatory or immune-related conditions, including atopic dermatitis. You’re more likely to take one of these medicines if you have hand eczema associated with moderate-to-severe atopic dermatitis.
JAK inhibitors for atopic dermatitis include:
- Abrocitinib
- Baricitinib
- Upadacitinib
- Ruxolitinib
- Delgocitinib
Common side effects of JAK inhibitors include:
- Infections, including the common cold
- Headache
- Nausea
More serious side effects include:
- Blood clots
- Pneumonia
- Tuberculosis
Some JAK inhibitors are taken by mouth as a pill. But the JAK inhibitor ruxolitinib is a topical treatment that works in the same targeted way for treating mild to moderate atopic dermatitis in people 12 and up.
Delgocitinib is a topical pan-JAK inhibitor. That means it blocks all enzymes in the JAK family. Delgocitinib ointment is approved in some countries for atopic dermatitis. The FDA approved it for hand eczema in 2025 under the brand name of Anzupgo. This medicine may be a good option for treating moderate-to-severe hand eczema when other basic skin care and topical corticosteroids don’t work.
IL Inhibitors (Biologics) for Hand Eczema
IL stands for interleukin. Interleukins are signals your body makes to communicate with your immune system. Interleukins can be important drivers of hand eczema when it’s related to atopic dermatitis. IL inhibitors work by blocking these signals. These medicines also are called biologics because they’re monoclonal antibodies made by living cells. Biologic medicines targeting different interleukins are considered an emerging treatment for chronic hand eczema. You’d need to take them as an injection or infusion. They’re approved for treating atopic dermatitis that’s moderate or severe.
Biologic IL inhibitors that may treat atopic hand eczema and atopic dermatitis include:
- Dupilumab
- Lebrikizumab
- Nemolizumab
- Tralokinumab
Side effects of biologics include:
- Allergic reactions
- Eye problems or pain
- Fatigue or weakness
- Irritation where the needle entered your skin
- Joint pain
Oral Immunosuppressants for Hand Eczema
You might take an oral immunosuppressant to treat your hand eczema. But there’s not a lot of evidence about how well they work. Immunosuppressants include:
- Azathioprine
- Cyclosporine
- Methotrexate
Your doctor could prescribe one of these drugs off-label. Off-label means that you’re using a medicine for an indication it hasn’t been approved for. It’s most likely you’d consider this if other treatments aren’t working and your chronic hand eczema is severe.
Immunosuppressants work by weakening your immune system. But they can come with a wide range of side effects, including an increased risk for infection.
Retinoids for Hand Eczema
Alitretinoin is an oral vitamin A derivative, or retinoid. It’s approved in some countries for severe chronic hand eczema. Treatment with this medicine usually lasts up to 24 weeks. You might take it longer if your hand eczema doesn’t go away completely. You might also take it again if your hand eczema goes away and then comes back after treatment stops.
Studies have shown alitretinoin can help to control hand eczema and its symptoms. You will have to take precautions when taking this medicine to avoid getting pregnant.
Common side effects include:
- Headache
- High cholesterol
- Elevated liver enzymes
- Decreased thyroid function
Another retinoid called acitretin also might be an option for chronic hand eczema. But it’s approved for psoriasis, and data showing how well it works for hand eczema is lacking.
Retinoids might be used together with light therapy (phototherapy). That’s because the combo can help ultraviolet light penetrate your skin so you can use lower doses.
Light Therapy (Phototherapy) for Hand Eczema
Phototherapy uses certain wavelengths of ultraviolet (UV) light to treat eczema, including hand eczema. It can help your symptoms, including itchiness and inflammation.
You’re more likely to try light therapy for your hand eczema if topical treatments aren’t working. You’ll need to go to your dermatologist’s office to get this type of therapy.
Common side effects of phototherapy include:
- Sunburn or tender skin
- Early signs of aging
- Skin eruptions
- Skin cancer
- Cataracts
Your doctor may prescribe other medicines to help the phototherapy work better. Those medicines also can have side effects, including:
- Nausea
- Vomiting
- Sun sensitivity
- Cataracts
Questions to Ask About Medication Options for Hand Eczema
- If basic skin care isn’t working for my hand eczema, which medication should I try first?
- What type of moisturizer is best for chronic hand eczema?
- What type of topical steroid do you recommend for hand eczema?
- What should I do if topical steroids aren’t working or I need to use them all the time?
- Should I try another type of topical medicine for my hand eczema?
- Is an oral or systemic medicine an option for treating my hand eczema?
- What are pros and cons of biologic medicines for atopic hand eczema?
- Are there any new treatment options for hand eczema?
- What are common side effects of medicines for hand eczema?
- Should I consider a clinical trial?
Show Sources
Photo Credit: iStock/Getty Images
SOURCES:
Journal of Cutaneous Medicine and Surgery: “A Review of Existing and New Treatments for the Management of Hand Eczema.”
Lancet: “Hand eczema,” “Efficacy and safety of delgocitinib cream in adults with moderate to severe chronic hand eczema (DELTA 1 and DELTA 2): results from multicentre, randomised, controlled, double-blind, phase 3 trials.”
Dermatology Times: “The Complex Clinical Landscape of Chronic Hand Eczema.”
StatPearls: “Calcineurin inhibitors.”
National Eczema Association: “FDA Approves VTAMA® (tapinarof) cream, 1% for the Treatment of Atopic Dermatitis in Adults and Children 2 Years of Age and Older,” “Prescription Oral Treatments for Eczema,” “Phototherapy.”
American Academy of Dermatology Association: “JAK Inhibitors: What Your Dermatologist Wants You to Know.”
Cleveland Clinic: “Immunosuppressants,” “Dupilumab Injection.”
Clinical Cosmetic and Investigational Dermatology: “Update on the use of alitretinoin in treating chronic hand eczema.”
