Expert Insights: Managing Chronic Hand Eczema Effectively

Learn how dermatologists are evolving treatments for stubborn chronic hand eczema. Strategies are shifting beyond initial remedies to provide patients with lasting relief. The focus is on long-term management for this persistent skin condition.

Treatment Strategies

At the 2025 SDPA Annual Summer Dermatology Conference, Adam Friedman, MD, discussed effective approaches for chronic hand eczema (CHE). He highlighted that many standard treatments lack specific approval for this condition. Therefore, healthcare providers must closely analyze how patients are using their prescribed medications to make any necessary adjustments. This includes evaluating steroid use, the potential for calcineurin inhibitors, and the use of off-label medications.

“In my own practice over the years, I have found intramuscular analogue to be a nice band-aid on the problem. I find CHE responds very nicely to intramuscular analogue, but of course, that comes with limitations in terms of ongoing use. But what I like about it is that it buys you time.”

—Adam Friedman, Professor, Chair of Dermatology

The prevalence of eczema has risen in recent years. According to the National Eczema Association, more than 31 million Americans have some form of eczema, emphasizing the need for improved and more effective treatment methods (Source 2024).

Long-Term Management

Friedman advises healthcare professionals to consider systemic options early in the treatment plan due to the chronic nature of hand eczema. This strategy helps to control the condition for extended periods. He aims for a six-month symptom-free period before even contemplating a reduction in systemic treatments.

The shift in focus towards a long-term strategy is crucial for managing this chronic condition. It underscores the necessity of an investment by the patient and ongoing care to maintain control of hand eczema. The goal is to prevent recurrence and to provide patients with a higher quality of life.