Monday, November 10, 2014

Eczema on Hands and Fingers: Triggers, Tips & Treatments

Eczema - if you know what this word entails, and I mean really know on a deep personal level, I feel you. Eczema is a bitch, there's no other way around it. You may remember that in my Fall Nail Polish post I complained about the state of my fingers and cuticles, which is how this post came about. Now, I don't claim to be an eczema expert or even that I have it particularly bad; I'm aware that for some people it's a lifelong condition that covers most of their body, and mine is only limited to my hands, and oftentimes, I'm even able to completely get rid of any flare-ups. But when I do have it (like now), it's a veritable pain in the ass, and I thought it may be helpful to share how I deal with it, especially if you've just started getting the symptoms.
While it's very common for eczema to first strike in the early childhood, I only started getting sporadic flare-ups as a teenager, and then I got a very bad flare-up a couple winters ago, and since then I've been struggling on and off. My mom also suffers from eczema on her hands, and her flare-ups and their pattern are extremely similar to mine, so I do think there must be a genetic link.

I've considered including photos of my typical eczema patch but honestly, it's pretty gross - even writing about it isn't pretty. Mine takes the form of a reddened, rough area of skin that develops small blisters, which burst after a day or so (sorry!), and then that area starts drying up to the point of cracking and flaking. Other symptoms include ichting, burning, occasionally bleeding from deeper cracks. Told you it wasn't pretty!

Some of the flare-up triggers, established through personal experience, my mom's experience and talking to my dermatologist, include frequent hand washing and soaking in water, low temperatures but also humid climates, as sweat also seems to make things worse, contact with harsh chemicals (for example, in home cleaning products or nail polish remover), contact with established allergens (I'm allergic to cats and petting one makes things more itchy in mere minutes), lack of UV exposure, moisture trapped under rings or other jewelry. My mom believes eczema is at least partly a form of skin allergy and pinpointing your specific allergens should help in recovery, but my dermatologist was skeptical - essentially, it's an autoimmune condition and anything can become a trigger.

Consequently, avoiding the triggers I've listed above generally helps in keeping things under control. What this means in practice is that I always do the dishes and other house chores in rubber gloves (my mom, who worked in a chemical lab all of her career, especially recommends talc-free single-use nitrile gloves), try to keep my hands above water when taking a bath, often don't put on my engagement ring and wedding band, re-apply handcream multiple times a day and always always after washing my hands, always wear gloves in the fall and winter.
As for the treatments, I use a combination of different products, both prescription and over the counter. If you've observed your symptoms gradually getting worse, I would strongly recommend making an appointment with a dermatologist, because unfortunately, the single ointment that always stops blisters and itching in its tracks is a topical corticosteroid, which is prescription only. Steroid creams can have different strength but they're generally very effective - the downside being that they have some serious side effects. On top of being very drying, they thin out your skin over time and can even disrupt internal organs' function in large quantities; so they're kind of 'the last resort' type of treatment, and should be used sporadically to help manage the worst flare-ups.

Here's my typical course of treatment: as soon as I notice a new eczema patch, I apply my usual hand creams and then apply a thin layer of the steroid ointment over the patch and leave it overnight. If I really want to make sure I don't rub it off on the sheets, I'll also put on some cotton gloves; as a bonus, they help to trap moisture in the skin as well. My mom recommends to repeat this process every day until the flare-up completely goes away, but I try not to do more than 2 or 3 consecutive nights. The steroid medication helps to dry out the blisters but leaves behind very dry, flaky skin, so I really load up on hand cream the next week or so. Unfortunately, my flare-ups tend to reoccur in the exact same spots, but using the steroid cream seems to prolong the eczema-free stretches of time.

In the photos, you can see some of the creams and potions I'm using on my hands. The L'Occitane Shea Butter Dry Skin Hand Cream ($28 for 5.2 oz) works nicely and absorbs fast, but most of the time I prefer to stick to less expensive options, like the Neutrogena Norwegian Formula Fragrance-Free Hand Cream ($3.50-$4.50 for 2 oz) or CeraVe Moisturizing Cream or Lotion ($10.99 for 12 fl oz). I find that occlusive creams, or the ones that leave a layer on your skin to trap the moisture inside, generally work best, which is why I really like using Neosalus Cream, a $$$ prescription moisturizer than leaves a layer on the skin even through hand washing. A fun thing to try are these nourishing sheet Hand Masks (the ones in the photo are from The Face Shop), although I've found that a thick layer of a hydrating face mask (like the Avene Soothing Moisture Mask) under a pair of cotton gloves works just as well for less.

I think that's all I can think of for now - let me know if you have any more questions, and of course please share your experiences with eczema and your favorite treatments in the comments! Oh, and a little update on my steroid-mangled fingernail: it doesn't look too hot right now but continues to grow out. Thanks for reading!

9 comments:

  1. I can empathize and sympathize. I have the same problems. Doesnt getAS bad but I always get it and usually ALWAYS on the same fingers every time the weather changes drastically. I also find a steroid cream to work the fastest butdont continue it because of the reasons you mentioned. Nice hand cream recommendtions. I also like the HempHand Proptector from the bodyshop! Feel better soon!

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    1. Hi Dee! I haven't tried the Hemp hand cream from The Body Shop, only the almond one and rose, and they were ok but nothing special. I'll try the Hemp one next!

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  2. I heard so many good things about L'Occitane Shea Butter Dry Skin Hand Cream on Eczema. I guess I have to stock this up so that whenever i notice patches of it, this will help.

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  3. *high fives* I just noticed my first season of eczema patch showed up, on my hands usually on the outer side of my pinky finger, that itching red, blistery feeling *shudder.* Yes, totally agree, upon first sight of spot like that I reached for my steroid top off with some Aquaphor. I think I did try the Neosalus but decided Aquaphor is cheaper (plus I probably need it for a week or so before weaning myself off to something like CeraVe). Yes, thanks for reminding me about Neutrogena, that was a good handcream that I've totally forgotten!

    I'm knocking on woods that my son does not get eczema -- so far so good, DH does not have it but my whole family has it (my dad has it the worse, poor guy). Another thing that is a trigger for me is too much dairy product (the bane of my existence as I thrive in cheese, yoghurt and such) -- I just have to back it down a little then proceed slowly. Humidifier helps, we usually run them when the heater gets too drying in the house. Hmm.. what else? Oh, using scented handcream also a trigger, but then again I just have to back it down a bit then start sparingly (I like my handcream scented sometimes, too!) -- when it gets really bad sometimes I just used the pure shea butter to coat my hand a bit, not as tacky as Aquaphor but does the job well.

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    1. What an awesome comment, Claire! Haha, twinsies, I just had a patch last week on the side of my pinky as well :) Totally forgot about the humidifier, it does help - we were using ours all winter last year. I've never tried Aquaphor for my eczema before, I'll definitely check it out once I run out of the Neosalus, which unfortunately may be quite soon. I tried pure shea butter a couple years back but it didn't do anything for me :( But my flare-ups were really bad back then. Thanks for all the tips my dear!!!

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    2. Neosalus has that very nice skin feeling, Aquaphor is not as pretty: it is basically a bit glorified Vaseline but does the job. Sometimes when it gets really dry & itchy, I even layer CeraVe then Aquaphor to seal on top. Same thing w/ shea butter: it's basically the layer that seals all the good deeds beneath it -- so probably won't work by itself. Ah... the things we do to keep eczema at bay..

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  4. I feel your pain. I suffer from psoriasis & eczema. NOT FUN & also can be embarrassing! I have tried everything from the drugstore and nothing was working. So I went to get a topical steroid from my dermatologist and that helps when I have flareups but I still needed something that was a great daily moisturizer. When my dad was going through chemo & radiation for his cancer his bald head/skin was extremely dry, the hospice nurse recommended an over the counter lotion. I tried it on my self and it was amazing! Its called Cortizone 10 Intensive Healing Lotion, for Eczema and Itchy, Dry Skin. It doesnt leave a sticky residue which I hate. It soaks in and feels great! I highly recommend you try it!

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    1. Hi Mandi, thanks for sharing that! I haven't tried that lotion, but hydrocortisone (which is the active ingredient in Cortizone 10) is a topical steroid as well, I guess it's just milder and in lower concentration than the prescription-only ones - and since I'm already using a steroid cream I try to avoid that in my moisturizer. But it's good to know there are options in the drugstore as well!

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  5. Try Aveeno and Neutrogena's eczema hand creams--miraculous stuff!

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