What should I do if my hands are in severe pain due to eczema?

If you are experiencing severe pain resulting from hand eczema, the first and most important step is to see a dermatologist to assess your condition. Severe pain may be an indicator of a secondary bacterial infection or a flare-up of inflammation that requires urgent medical intervention [3]. Remember that eczema is a chronic condition that requires careful management, and when pain becomes uncontrollable with routine home care, you must seek professional medical advice immediately to obtain a personalized treatment plan [2].

When should you see a doctor immediately?

Severe pain is not just a passing symptom in cases of worsening eczema. You should contact a healthcare provider if you notice any signs indicating an infection or deterioration of the condition, which include: fever, widespread and severe redness, purulent discharge (pus or strange fluid), or a feeling of pain and throbbing in the affected skin area [3]. The doctor may need to clinically examine your skin or take a swab to ensure there are no bacteria, fungi, or viruses that require antibiotics or antifungal medications in specific doses [2].

Professional treatment options for pain relief

After assessing your condition, your doctor may prescribe a range of treatments aimed at effectively reducing inflammation and relieving pain. Among these options, topical steroids (creams or ointments) are the first-line treatment in many cases to reduce inflammation and itching [3]. If these are insufficient, the doctor may resort to topical immunomodulators (TIMs) or phototherapy, a medical procedure in which the skin is exposed to specific wavelengths of ultraviolet light under careful supervision [3]. In rare and severe cases, systemic (oral) medications or biologics that target specific parts of the immune system causing the inflammation may be prescribed [3].

Home care procedures to soothe the skin

While following your doctor's plan, there are essential daily steps that can help reduce the severity of pain and control irritation:

• Intensive Moisturizing: Use heavy moisturizers (creams, ointments, or petroleum jelly) 2 to 3 times daily, preferably applied immediately after washing your hands while the skin is still damp to lock moisture in [3]. Choose products free of fragrances, dyes, and alcohol.
• Avoid Irritants and Triggers: Try to identify what worsens your condition. Common triggers include: harsh soaps, detergents, chemicals, sudden temperature changes, and contact with wool [3].
• Washing Habits: When washing your hands, use lukewarm water and avoid hot water or prolonged exposure; use a gentle, soap-free cleanser [3].
• Prevent Scratching: Keep your nails very short to reduce damage from involuntary scratching, and you can wear light cotton gloves while sleeping if itching increases at night [3].

For more information on how to live with this chronic condition, you can view Chronic Hand Eczema: Causes, Symptoms, and Methods of Treatment and Prevention (Arabic) for a deeper understanding of the environmental and genetic factors that may affect your skin.

Dealing with uncertainties

It is essential to recognize that eczema is an "itch that leads to a rash," where scratching contributes to damaging the skin and worsening the pain, creating a vicious cycle [3]. There is no definitive cure that heals the condition forever, but controlling it is very possible by adhering to the treatment plan and avoiding personal triggers. If you feel that a particular treatment is causing you distress or that symptoms are not responding as expected, do not stop the treatment on your own; rather, discuss your concerns with your doctor to adjust the treatment plan to suit your skin's nature [2].

Medical references

• Eczema
• Atopic Dermatitis
• Atopic dermatitis