This information is intended for education of both the general public and healthcare professionals. If you are experiencing any symptoms please discuss the best treatment options with your doctor.
Understanding Chronic Hand Eczema
Chronic Hand Eczema is characterized by the clinical signs of erythema, vesicles, papules, scaling, fissures, and hyperkeratosis.1 The core symptoms are itch and skin pain, which patients report to be the among the most burdensome.1,2
These signs and symptoms can fluctuate over time and patients can experience recurring flares, which are often in response to an exogenous trigger such as repetitive hand washing but can also occur around periods of stress.2–4

Risk factors
Several risk factors have been identified and relate to biology, environment, and lifestyle:1
Biological factors
- Female sex1,5
• Hand eczema is up to twice as high in females vs males5 - Atopic dermatitis1
- Childhood eczema1
- Early onset of symptoms1
- Mutations in the gene encoding filaggrin, a skin barrier protein1
- Contact allergy1
Environmental factors
- Occupational exposure1
• The incidence of hand eczema is greater in occupations such as nursing, that involve prolonged contact with irritants such as water, soap, and gloves1,6,7 - Domestic exposure
• Prolonged wet work due to domestic tasks such as cleaning and childcare1,8,9
• This has been suggested to be part of the reason why hand eczema is more prevalent in females8,9 - Cold/dry weather conditions1
Behavioural and socioeconomic factors
- Tobacco use1
- Stress1
- Lower educational level1
Subtypes
Chronic Hand Eczema is a heterogenous disease with varying morphologic features. It can be divided into several etiological and clinical subtypes.1
These include irritant contact dermatitis, allergic contact dermatitis, atopic hand eczema, protein contact dermatitis/contact urticaria, hyperkeratotic hand eczema, and recurrent vesicular hand eczema (also known as pompholyx).1,6
Chronic Hand Eczema has a complex morphological picture and classifying it into these subtypes can be challenging for several reasons:1,2,6
More than one etiological and clinical subtype may be present in one individual1,2
Chronic Hand Eczema can evolve over time1
There is no reliable link between the clinical picture and the underlying etiology1,6
Each etiological subtype has a unique immune signature; however, there are some shared aspects of the overarching pathophysiology across subtypes.10
Chronic Hand Eczema pathophysiology
The pathophysiology of Chronic Hand Eczema is characterized by skin barrier dysfunction and inflammation of the skin10–12
Abbreviations
JAK1/2/3, Janus kinase 1/2/3; JAK-STAT, Janus kinase and signal transducer and activator of transcription; TYK2, tyrosine kinase 2.
Learn more about the causes, triggers, and pathophysiology of Chronic Hand Eczema

The pathophysiology of Chronic Hand Eczema
A short animation explaining the key aspects of Chronic Hand Eczema pathophysiology including skin barrier disruption, inflammation of the skin, and JAK-STAT signaling pathways10–12,14
Duration: 03.50
Related content

Chronic Hand Eczema overview
Chronic Hand Eczema is a multifactorial, inflammatory skin disease1,2

The burden of Chronic Hand Eczema
Chronic Hand Eczema can cause visible and functional impairments to the hands, so it can have a profoundly negative impact on patient quality of life2,7,16,17

Diagnosing Chronic Hand Eczema
Chronic Hand Eczema is hand eczema that lasts for more than 3 months, or relapses twice or more often in a year1