Month: November 2021

Steroid cream for Eczema

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Introduction

Topical steroids are medicated creams that can be applied on skin to treat eczema. It is a very effective treatment in addition to emollients (moisturizers). A short course of prescription steroid cream for eczema is enough to clear up an eczema flare. If you use it for short periods, side effects are uncommon. Steroids reduce skin inflammation which occurs in eczema.

Eczema or atopic dermatitis is an inflammation of the skin leading to red, itchy rash.

What are topical steroids?

Steroids also known as corticosteroids belong to a group of medications known as glucocorticoids. Topical steroid is an anti-inflammatory preparation. Apart from being anti-inflammatory, it also acts by being immunosuppressive, anti-proliferative and vasoconstrictive. Steroid containing topical products include creams, ointments and lotions. Creams work best in treating moist or weeping areas of eczematous skin. They are usually white. Ointments are best to treat dry and thickened areas of skin. They are usually clear. Lotions are used to treat hairy regions such as scalp. They are thin creams.

Steroids work by reducing the inflammation of your skin. They are used for many skin conditions and eczema is one of them. Prescription steroid cream for eczema is effective in treating eczema.

There are several types of topical steroids and they are categorized according to their strength. Greater the potency or strength, more effective it will be in reducing inflammation but on the other hand side effects will be more with continued use.

  1. Mild – Ex: 1% Hydrocortisone
  2. Moderately potent – Ex: Prednicarbate
  3. Potent (strong) – Ex: Betamethasone valerate, Mometasone furoate
  4. Very potent – Ex: Clobetasol propionate

How topical steroids are prescribed?

When there is one or more patches of an eczema flare-up, a course of topical steroid is used. Once the flare-up is cleared, the topical steroid treatment can be stopped. The aim is to use the lowest strength of topical steroid to minimize the side effects, but strong enough to clear your flare up.

Ex: 1% Hydrocortisone is used to treat eczema in children

Usually topical steroids must not be used for prolonged periods on large areas of the body. This rule is important especially for children. For severe inflammatory eczema, a very potent topical steroid will be used such as Clobetasol propionate. A small amount should be applied on affected areas while gently massaging into skin.

Sometimes your doctor or the dermatologist will use 2 or more preparations of different strengths at the same time.

Ex:

  • Mild topical steroid for eczema lesions on the face
  • Moderately potent steroid for lesions on arms and legs where your skin is thicker
  • A very potent steroid is needed for eczema on your palms and soles as the skin is thick in these areas.

Usually a short course of topical steroids for 7 -14 days is enough to clear a flare-up although sometimes longer courses are required. Some dermatologists will try a short course of a strong topical steroid usually for 3 days to treat a mild to moderate flare. This method is quick and quite safe. How often a steroid course is necessary will depend on how often you get a flare and it greatly varies from person to person. Once the steroid topical course is over, emollients must be continued daily to prevent further flares of eczema. Therefore, prescription steroid cream for eczema for a short period usually gives relief.

For people with frequent flares of eczema, a steroid can be applied on the usual sites where you get a flare up for 2 days every week. This is known as weekend therapy. It helps to prevent a flare up from occurring.

How to apply topical steroids?

Topical steroids can be applied once or twice a day according to your doctor’s advice. A fingertip unit is the correct dose and it is a small amount that has to be gently rubbed on the areas of inflamed skin until it disappears. Although moisturizers are applied liberally, topical steroids must be applied carefully.

First apply your emollient and wait for 10-15 minutes, before applying the prescription steroid cream for eczema. Wash your hands after application.

What is a fingertip unit (FTU)?

A fingertip unit is the amount of steroid that is squeezed out from a tube (standard size with a 5mm nozzle) along an adult’s fingertip. 1 FTU is enough to treat an area, twice the size of an adult palm with fingers together.

Pros and cons of topical steroids

Topical steroids are especially useful in treatment of any inflammatory skin condition. It is very effective to treat a flare-up of eczema. However there are certain side effects which you have to know.

What are the side effects of topical steroids?

A short course (less than 4 weeks) of topical steroids is generally safe and side effects are rare. Problems arise when you continue to use topical steroids for prolonged periods or if strong steroids are used frequently. Side effects are common if strong topical steroids are used long term. The side effects can be local or systemic.

Local side effects (affecting the area treated and a bit of surrounding skin)

  • Burning or stinging sensation – This is common when you apply a topical steroid for the first time. Once your skin gets used to the treatment, this feeling will subside.
  • Skin atrophy (Thinning of skin) – although uncommon with normal regular use, it occurs especially if a potent steroid is used under occlusion (air tight dressing).
  • Worsening or triggering other skin conditions like acne, Rosacea and perioral dermatitis.
  • Develop striae (permanent stretch marks), telangiectasia (thin spidery blood vessels), easy bruising and discoloration. These are common with long term use of topical steroids.
  • Changing of skin color – This is noticeable more in people with dark complexion.
  • Growth of hair will increase in the treated area of skin
  • Allergic reactions – This may occur usually to the preservatives used in the steroid product. It can irritate your skin and worsen inflammation.

Systemic effects (affecting your whole body)

This is rare with topical steroids but can occur when strong steroids are used for long periods. The steroid can get absorbed in to your blood stream.

  • Affecting the growth of children – If children need repeated doses of strong topical steroids, their growth must be monitored.
  • Increase of blood pressure
  • Increase of blood cholesterol levels
  • Fluid retention (Collection of fluid in legs)
  • Baldness (thinning of hair in scalp)
  • Features of Cushing syndrome – weight gain, skin thinning, mood changes, buffalo hump in the neck, purple color striae, moon face etc.

Although there is a common fear of treatment, the risk of side effects is lower than most of us think, as long as it is applied as prescribed and not used longer than necessary.

What is topical steroid withdrawal?

This can occur when treated with a moderate strength or potent steroid which is stopped suddenly. The symptoms of topical steroid withdrawal include red skin, stinging, burning pain, itching, excessive sweating and peeling of skin. The severity of symptoms may vary from mild short lived to severe long term. The symptoms will gradually settle, sometimes leaving your skin dry and itchy for prolonged periods.

What should you be careful about when using steroids?

  • Do not undertreat because you are too cautious – always apply as prescribed to clear your flare up.
  • Avoid using too much – you might want to continue topical steroids daily, even after your eczema has cleared, in order to prevent a future flare. You should not use steroids for long periods without close supervision by a doctor. However, you can apply moisturizers liberally every day which will help you to prevent a flare up of eczema.

In order to prevent side effects, the strength or potency of the topical steroid needs to be adjusted to the sensitivity and thickness of the skin area which needs to be treated.

Steroids become more potent in your face, eye lids, genitals, inner sides of joints and arm pits because the skin is thin and sensitive. Therefore, steroids of low or medium potency is enough to treat eczema in these regions. Higher potency steroids are needed for scalp, palms and soles as the skin here is thick and the medication should reach deeper layers of skin.

The effect will be stronger when topical steroids are applied to wet skin. It acts better when applied after taking a bath when your skin is damp rather than applying steroids to dry skin. If you cover the area with a wet wrap or a bandage, it will help to absorb the medication more. It is important to keep this fact in mind when applying steroids to diaper (nappy) covered skin regions in babies.

Topical steroids can be combined with other active ingredients such as antibiotics, antifungal agent or calcipotriol. Topical Antibiotic/ steroid preparations should be used rarely, short term only. This is to reduce the risk of antibiotic resistance.

Prescribing topical steroids in pregnancy – Mild and moderate potency steroids can be safely used in pregnancy. But if using strong steroids in to large areas or under occlusion, caution should be used because it can get absorbed.

There can be potent steroids illegally present in some cosmetic products sold over the counter or via internet. These can give rise to side effects unknowingly. Always read the label before you try out any new products on your own.

References:

Probiotics for Eczema

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Introduction

Eczema is a chronic inflammatory skin condition commonly suffered by many people. It affects between 5-20% of people at some point in their life. Numerous clinical trials are on the way and probiotics for eczema are thought to be an effective eczema treatment. Although many doctors are using them increasingly to treat eczema, according to a research review published in Cochrane Database of systemic Reviews,it is suggested that probiotics may not be an effective eczema treatment and the use of probiotics is not evidence based. However, there is no harm in using them and evidence do not show an increase of adverse events. Future research is needed to know the exact benefits of probiotics in treating eczema.

The symptoms of eczema can be annoying. Apart from dry sensitive skin, the itching can be severe, especially at night. You may suffer from loss of sleep due to this. Thickened, scaly, crusty skin with red patches can be unsightly. Sometimes these lesions become raw, swollen and ooze pus. Having lesions on hands and visible areas of the body can affect your job and relationships. Having eczema can severely affect your quality of life. Eczema is not a curable disease and it can give rise to many flare-ups during your life time.

Dealing with eczema can be challenging. Can probiotics be the answer?

What are Probiotics?

Our bodies are full of good and bad bacteria. Probiotics are considered as good bacteria, because they keep our gut healthy. Probiotics are live microorganisms taken by mouth. Mostly probiotics include Lactobacillus bacteria and yeast. They are naturally found in yogurt and unpasteurized milk. Kefir, miso, kombucha, Kimchi, dark chocolate, raw cheese and apple cider vinegar are also rich in probiotics. So, depending on the diet, you may be eating foods that contain probitocs already. Probiotics are known to provide healthy digestion.

Probiotics are available as supplements that commonly contain Lactobacillus and Bifidobacterium. These live bacteria in probiotics protect the gut wall by attaching to it and control the growth of undesirable bacteria. This promotes a healthy balance of gut bacteria while improving the function of your gut.

Although the exact impact on eczema by probiotic use is not clear, there are other proven benefits. Probiotics are known to;

  • Boost your immunity
  • Improve your digestion and improving the gut health
  • Help in preventing urinary tract infections

Research suggest that if a pregnant mother takes probitocs prenatally, the incidence of eczema in children will be reduced. However, supplementing probiotics in pregnancy must be done with caution by a doctor.

Why consider probiotics in eczema patients?

Eczema gives rise to dry skin with red, itchy rash with or without oozing. Scratching can make the lesions bleed and your skin can become thick and crusty. Eczema can greatly affect your quality of life.  Research has found that patients with eczema have different bacteria in their gut when compared to people who do not have eczema. Sometimes there is associated inflammation in their guts. Research suggests that if this mix of gut bacteria is changed or inflammation of the gut is reduced, eczema symptoms can be reduced too.

Evidence shows that bacteria colonies living on the skins of eczema patients are also different from those who don’t have it. As with the gut, the skin’s micro biome is not as diverse in people with eczema. This can leave it vulnerable for the bad bacteria to grow and proliferate. Staphylococcus is an example for a bad bacteria which proliferates on skin especially in people with eczema. Staphylococcus is a bacteria that is linked with flare- ups of eczema. It can trigger inflammatory response on their skin. Those who have eczema tend to have larger populations of this bacteria on their skin.

The aim of topical probiotic therapy is to build a healthier and more diverse skin micro biome in people with eczema. This is done by introducing the right strains of good bacteria on to the skin of eczema patients. This multitude of good bacteria will help to keep the harmful bad bacteria strains in check.

Eczema is associated with your immune system and the immune response is faulty. Probiotics are known to boost the immunity. So they may work in controlling eczema by reducing the immune reaction. Treatment with probiotics should be continued for at least 6 weeks to 3 months to see results.However, currently available probiotics show minimal difference in reducing eczema symptoms especially itching and loss of sleep.

Emollients (moisturizers) and topical steroids are found to be effective in controlling eczema along with antihistamines to reduce itching. Using these treatments in combination with probiotics will provide the best benefit for eczema. Adding probiotics to your diet or taking them as supplements can reduce the number of eczema flare-ups you get.

How should you start probiotics?

If you think of adding probiotics to your diet or take it as a supplement discuss with your doctor or a dermatologist first. Your doctor will help you in prescribing the best combination of probitocs and where to find it.

There are over the counter probiotic supplements. If you decide to use them, make sure to read the instructions and follow them accordingly. Always take the supplement with food because taking them on an empty stomach can give rise to side effects. Before going for supplements try to consume probiotic rich natural foods.

It is best to consult your doctor before starting probiotic supplements if you suffer from bowel conditions, other chronic diseases or a compromised immune system. If you take a probiotic supplement for the first time or change to another brand, you might experience certain symptoms like gas, diarrhea and heart burn until your body adjusts to the supplement. It will be beneficial if you start with a lower dose and gradually increase to full dose.

Topical probiotics for eczema

Research have also been done on topical probiotics to see how it affects the skin. Although this concept is still new, the research has so far been promising towards eczema. Topical probiotic strain namely Roseomonas mucosa can be helpful in treating eczema. This bacteria is found naturally on our skin. There are topical probiotic lotions produced using this bacteria. A study published in 2018 found that using Roseomonas mucosa containing lotion has been effective in reducing the amount of staphylococcus on the skin. Those who applied this lotion regularly, claimed that their severity of eczema was improved.

Another study published in Clinical, Cosmetic and Investigational Dermatology found that a lotion containing the probiotic Lactobacillus johnsonii significantly improved eczema clinically. Therefore various strains of Lactobacillus are found to be effective as topical probiotic treatment as they have the ability to reduce the staphylococcus bacteria on skin.

Small sample size is one of the main drawbacks in these studies. More research is needed to understand the impact of topical probiotics on eczema; whether there is actually a benefit.

Conclusion

Since the effectiveness of probiotics in treatment of eczema is not proven yet, it is important to note that we should not rely solely on probiotics alone as eczema treatment. As there are no increase of adverse effects, it can be used as complementary treatment for eczema. You may also benefit by strengthened immune system and improvement of your gut health by using probiotics. Research offers promising results.

References:

 

 

Eczema Allergy Test

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Introduction

Allergic disorders are increasing across the world and currently affects up to 40% of the population. Eczema is a chronic skin condition which is associated with allergies. Many parents think that knowing the allergens through eczema allergy test will help to prevent eczema flares. Will it be actually beneficial? Read on to find our more on eczema and eczema allergy testing.

What is eczema?

Eczema also known as atopic dermatitis is a chronic, inflammatory skin condition. Symptoms of eczema include dry, itchy skin with red rashes. You may have several flare ups of eczema throughout life. It can immensely affect the quality of life. Eczema is a common skin condition worldwide. According to research, it may affect up to 30% of children and some of them will continue to have eczema in to adulthood. Eczema is found to be caused by an interaction of your genes and many environmental factors. Most of you will have a family history, but not everyone with eczema has a genetic link. But, if you have a sibling or a parent with eczema, there is a higher chance for you to develop eczema. So, allergy testing for eczema in adults is what needed.

An eczema flare is triggered by environmental factors. These triggers include;

  • Irritants and chemicals – soap, detergents, cosmetics, perfume, cleaning products, formaldehyde
  • Cold air
  • Cigarette smoke
  • Hot weather and heat
  • Airborne allergens – dust, pollen
  • Out- door pollutants
  • Certain fabrics – polyester, wool
  • Certain metals –nickel

You may notice that only some of these triggers are allergic substances.

What is an allergic reaction?

An allergic reaction is an immune response that occurs in our body to a substance to which we are already sensitized. This allergic substance causing the allergic reaction is known as an allergen. An allergen can be anything such as dust, pollen, animal dander, chemicals and certain foods. An allergen which can sensitize certain individuals to cause over reaction by their bodies, may be harmless to others who are not sensitized. It is strongly recommended for allergy testing for eczema in adults.

Why do only some people develop allergies?

It is still unclear why some people get allergies and others don’t. Having a family history may make a child more prone to develop allergic diseases, although not all allergies of parents are passed on to the offspring. But you as parents may pass on the predisposition to allergic diseases. So your child may develop an allergic reaction of some sort such as eczema or hay fever. These genetically predisposed people are known as atopic individuals. The families are called atopic families. These allergic disorders may even coexist. We should also consider allergy testing for eczema in adults.

Ex: babies with eczema have a higher chance of developing food allergies

Our skin is a protective barrier which keeps germs (bacteria, viruses and fungi) and allergens away from our bodies. If you have eczema, your skin barrier is disturbed. This will create a route for allergens to enter the body and sensitize.

Allergy test

If your child is getting frequent flares of eczema, you may wonder whether the flares would stop, provided you know what causes the eczema and the allergens responsible. Many parents inquire about eczema allergy testing for children with eczema. However, only some children with eczema will benefit from allergy testing.

Dermatologists believe that all children with eczema do not need allergy testing. This is because;

  • The most effective way to clear a flare up of eczema is to adhere to the eczema management plan given by your doctor. This will include how the child should be given baths, applying emollients (moisturizers) and using eczema medicines like topical steroids when needed. There are many factors which trigger an eczema flare and not only one allergen. You should help your child to avoid these triggers that leads to his or her eczema.

Triggers can be allergic in nature but most often they can be non-allergic and include irritants, stress, heat, soap, sweating, weather changes, tiredness and a respiratory infection. So, it is only sometimes that eczema allergy tests will help to improve your child’s eczema.

  • You should not limit yourself to avoiding allergens because doing only that will not clear a flare up of eczema.
  • Although allergy shots can be given, they are not proven to help an eczema flare. However, allergy shots given to treat lung allergies may have an effect on reducing eczema.

Here are some signs you should discuss with your child’s dermatologist about allergy testing.

  • Despite following the eczema management plan given by the dermatologist for few weeks, still the eczema remains the same or the improvement is seen only slightly.
  • The growth expected in your child is not happening satisfactorily.
  • If you notice that each time your child is given a certain food, the eczema gets a flare up. However you should remove these foods from your child’s diet only if the reaction is severe or if the dermatologists requests.

Types of allergy tests

  1. Patch test

Substances that your child is allergic to are applied to discs. Each disc will contain a different allergen. These discs are taped to your child’s skin at the back. The skin should be free from eczema before the test. Your dermatologist will examine your child’s skin at specific times to look for reactions.

  1. Skin prick test

Small amounts of the substances that your child is allergic to will be placed on your child’s skin. It can be done on the skin of the forearm or back. Then the skin is pricked or scratched. Your doctor will check for reaction on the skin at specific times.

  1. Food challenge test

A blood test or a skin prick test will tell what food allergies your child doesn’t have.

The blood test will tell whether your child has antibodies in their blood which may react to common substances and lead to allergic reactions. Blood test will help to confirm a suspicion of an immediate air borne or food allergy.

During one of these tests, if your child has a positive reaction to a food, the results need to be confirmed with another type of test. This is referred to as a food challenge. There are many different types of food challenges. If this test is decided for your child, your dermatologist will discuss what to expect.

Conclusion

Allergies are more common in children with eczema than in children who do not have it. So, if you think whether your child is reacting to something, an allergic test may be helpful. An eczema allergy test can be performed to determine allergens. Although parents believe that removing the allergic cause would clear their child’s eczema, unfortunately it is not that simple. It is quite rare for childhood eczema to clear even after removing or reducing the exposure of the possible allergen.

 

References:

 

 

Hand Fungus and Eczema

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Introduction

Just like you can get fungal infections on your feet, it is possible to develop fungus in your hands. Hand fungus is called ‘Tinea manuum’ but commonly known as ring worm infection. In Tinea manuum, there is a red, scaly rash with a slightly raised border which is shaped like a ring. Commonly you can get it by touching your groin or feet if they are also infected with Tinea or by touching fungus contaminated objects, soil or infected persons. also infected with Tinea or by touching fungus contaminated objects, soil or infected persons. So it is important and get hand fungus treatment.

Sometimes you may falsely identify a hand fungus as hand eczema as they may have certain similarities. Sometimes both these conditions can be associated with each other.

When eczema arises in your hands it is called hand dermatitis or hand eczema. It is a chronic long- lasting skin condition which is also as common as fungal infections. Hand eczema may lead to severe negative effects on the quality of your life and even on your social status. Hand fungus treatment is therefore mandatory.

Eczema or fungus on your hands will be visible as it is difficult to hide, that may be quite embarrassing when you are among others. It will especially affect negatively on people who use their hands for the occupation such as the chefs, attendants and salon workers. Eczema is not contagious, but hand fungus is. Both these skin conditions can be quite severe, but they are not life threatening.

Hand eczema versus hand fungus

Fungal infection and hand eczema may seem similar as both are red, itchy rashes. Hand fungus typically has a raised border commonly with central clearing. The appearance is like a ring. Hand eczema doesn’t have a raised border and middle of the rash does not clear as the rash spread. So there is difference between hand fungus and hand eczema.

Commonly hand fungus affects only one hand, although you may develop it on both hands. Hand eczema is commonly bilateral and symmetrical. Hand eczema can get several flares and remissions while not responding to over the counter antifungal medications. Even after treatment, eczema can only be controlled and can reappear. However, hand fungus will respond to OTC antifungals and may clear off completely if you treat it properly. If partially treated hand fungus can reappear too and if you develop resistance to treatment, the future treatment of the rash will be difficult.

Hand eczema can be genetic and may run in families. Hand fungus is not familial, but often family members can get infected by close contact as it is contagious.

Although hand fungus can sometimes have associated nail involvement, in hand eczema nails are not involved.

What are the risk factors to develop hand fungus?

  • Those who do sports that involve close skin contact
  • Those using public showers like in gyms etc.
  • Sharing things with infected people such as towels, tools
  • Those who handle or be around animals as Tinea can spread from animals including cats, dogs and cows.
  • Those who wear tight fitting gloves
  • If you sweat too much on your hands

What are the causes of hand eczema?

Hand eczema may be related to occupational exposure or house hold activities. It often affects people who are in to catering, cleaning, hair dressing, mechanical work and health care as they frequently come in to contact with chemicals and other irritating substances.

It is a chronic skin condition which is multifactorial. Contact allergens and irritant substances play a role in triggering hand eczema. The exact cause of hand eczema is unknown. There can be a genetic association for hand eczema and it can run in atopic families. Atopy is the genetic tendency to develop allergic conditions like eczema, asthma and hay fever. Stress can be a risk factor for hand eczema.

As hand eczema is not contagious you cannot ‘catch it’ from another person or spread it to others.

What are the symptoms of hand fungus?

  • The infection usually starts on your palm and may spread to other areas like the back of your hands and fingers.
  • The rash may start small and get larger gradually with time.
  • Itchy, red rash with raised border and the outer surface appears scaly
  • Peeling and flaking of the area
  • Sometimes the fungus can affect your nails which is called onychomycosis or Tinea unguium. Then your nails can get brittle. They appear discolored, thickened and your nail may get separated from the nail bed.

Sometimes a blistering rash on the edges of your palms and fingers may be caused by the fungi. They appear as crops and will contain a sticky clear fluid. They may have a peeling edge. This rash can itch and burn. The reason why hand fungus treatment is necessary.

What are the symptoms of hand eczema?

  • Itching which may be severe – this is a common symptom in almost all hand eczemas.
  • If you scratch continuously the rash can become raw, sensitive and swollen.
  • Skin lesions are red and inflamed. Swelling can occur due to inflammation.
  • The skin of your hand is usually dry and sensitive.
  • There can be small raised bumps that may leak fluid.
  • Oozing and crusting especially when scratched
  • Red or brownish grey dark patches may appear on your hands
  • Long standing hand eczema can give rise to leathery, scaly, cracked and thickened lesions.

Treatment of hand fungus

If your hand fungus is mild, you can use an over the counter anti-fungal cream such as micanazole or clotrimazole. If your rash does not respond, seek help from your doctor or a dermatologist. He or she may prescribe a stronger topical anti-fungal agent. A course of oral antifungal medicine will be added if your lesions are severe or when the rash does not respond to topical treatment alone.

You have to make sure that you stick to the treatment regime as incomplete treatment can lead to resistant forms of fungi.

To prevent further fungal infections avoid touching contaminated objects, soil or animals unnecessarily. Do not share towels or other personal items. Avoid using common tools unless it is necessary. Avoid using public showers if possible. All these things comes under hand fungus treatment and therefor important to apply.

Treatment of hand eczema

Unfortunately there is no cure for hand eczema, but you can successfully control it. Try these home remedies to soothe your lesions.

  • Avoid scratching as it can worsen hand eczema.
  • Identify and avoid triggers that worsen your hand eczema – triggers like pollen, dust, certain foods, strong soaps and detergents,excessive sweating and smoking can worsen hand eczema.
  • Avoid strong soaps and detergents. If you must use them, wear gloves to protect your hands. Use cotton gloves when doing chores.
  • Use a mild soap or a fragrance free cleanser when bathing and washing hands. Pat dry your hands using a soft towel. Do not rub or wipe hard.
  • When you need to clean your hands use lukewarm water instead of hot water.
  • Moisturize your hands well with a good emollient. Get a good hand cream to apply frequently in order to prevent them from drying. Make sure to use an emollient that is alcohol and paraben free with minimal fragrance. If you need help to select the best moisturizer that is suitable for your skin, discuss with your doctor or a dermatologist. Apply moisturizer after a bath and soon after washing hands while your skin is still damp. It helps to absorb and lock in moisture.
  • You can use cold compresses to help soothe your skin especially if it is raw.
  • Over the counter creams like Hydrocortisone can be applied over your lesions. Hydrocortisone is a mild steroid and an anti-itch cream. More potent steroid creams and ointments may be prescribed by your doctor if your lesions are severe (Betamethasone, Mometasone, clobetasol).
  • You can try over the counter antihistamines like Fexofenadine, Cetirizine,Chlorpheniramine, or Loritidine to reduce your itching. Read the instruction leaflet prior to taking any OTC medication.

If your hand eczema does not respond to over the counter medications and home remedies, seek help as stronger medications need to be prescribed. If you think that a certain substance at work or home is the culprit behind your eczema, your doctor will do a ‘patch test’ to identify which irritants or allergens are responsible. Your doctor will also discuss the practices and behaviors that may be contributing to your hand eczema and ways to avoid or modify them.

In summary

Hand fungus is clinically differentiated from hand eczema by following signs.

  • Most hand fungus affect only a single hand.
  • If both your hands are affected, the involvement is not symmetrical.
  • Skin markings become white because the surface is scaling. But in hand eczema skin markings will be increased.
  • The Tinea rash has a raised border
  • Nearby nails can get affected (Tinea unguium)

 

Hand eczema can get complicated with skin infections. This is because of repeated scratching that destroys your skin barrier leading to cracks and open sores. Skin infections can occur with bacteria, viruses and fungi on a hand with eczema.

When your hand eczema gets a superadded fungal infection, it may give a mixed picture.

The itching will be more as both conditions are known to itch. Scratching can lead to erosions and even oozing. Fungal infection can occur especially when you have wet eczema. Fungus thrives on warm moist skin. Treatment will be difficult as the steroids which are used to treat eczema can worsen the fungal infection. Therefore, oral antifungal medications like Itraconazole or Terbinafine may be needed. Sometimes treatment will take a course of 4-6 weeks to eradicate the fungus. Then the eczema can be controlled with local application of steroids.

References:

https://dermnetnz.org/topics/tinea-manuum

https://pubmed.ncbi.nlm.nih.gov/9884898/

https://nationaleczema.org/eczema/types-of-eczema/hand-eczema/

 

 

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