Stress-related eczema on the hands: What to know

Eczema can appear anywhere on your body. But it is particularly common inside the elbows, behind the knees, and on the hands.

The root causes of eczema are thought to be a mixture of environmental and genetic factors. Contact with certain triggers can make symptoms flare up.

Stress is a known trigger for eczema symptoms. It can make symptoms worse and cause flare-ups on your hands.

Knowing more about the connection between stress and eczema, as well as the symptoms of hand eczema, can help you to explore ways to reduce stress and seek other treatment options for managing eczema flare-ups on your hands.

Eczema on the hands

Hand eczema usually looks like discolored, itchy, and inflamed skin on the hands and fingers. Common symptoms include:

• dryness
• cracking
• blistering
• scaling
• pain and bleeding, in severe cases

The condition can significantly affect your daily activities and quality of life.

Dyshidrotic eczema is the name for the type of eczema that only affects your hands and feet. It is also known as pompholyx, foot-and-hand eczema, palmoplantar eczema, or vesicular eczema.

It is very common for emotional stress to trigger or worsen this type of eczema.

Dyshidrotic eczema usually affects adults ages 20–40. It can happen as one isolated episode, but you are more likely to have flare-ups again and again over time. Although stress does not cause dyshidrotic eczema, it can trigger flare-ups or make it worse.

Other types of eczema that can affect your hands

• Atopic dermatitis: This is the most common type of eczema. It’s associated with an overactive immune system. Reducing stress, getting good sleep, and maintaining a healthy diet can help manage your symptoms. Atopic dermatitis may be inherited from biological parents, particularly in people with asthma, hay fever, or food allergies.
• Contact dermatitis: This is triggered by contact with allergens. It can appear suddenly and usually goes away when the allergen or irritant is removed.
• Neurodermatitis: This can be triggered by stress. It usually affects specific patches of skin and requires management to break the itch–scratch cycle.
• Nummular eczema: This looks like circular, itchy, and sometimes oozing patches. It commonly appears on the arms, legs, torso, and hands, with affected areas taking on a coin-like shape.

In addition, if the herpes simplex virus infects a patch of eczema, it can lead to eczema herpeticum. This can occur on the face, neck, and hands. Symptoms include itchy and painful blisters that may ooze pus. Other signs include high fever, swollen glands, and feeling unwell.

Seek immediate medical attention if you suspect eczema herpeticum.

The role of stress in eczema

Stress has a considerable effect on the development and worsening of eczema symptoms. When you experience stress, your body releases hormones called cortisol and norepinephrine. These can trigger an inflammatory response, leading to eczema flare-ups.

A 2019 study suggests that stress has a significant effect on your skin barrier, how much oil protects your skin, how inflamed your skin gets, and your immune system. This would explain why hand eczema gets worse if you are feeling stressed.

What’s more, stress can worsen itchiness and discomfort, causing you to scratch your skin more and making your eczema worse.

Reducing stress

To reduce stress-related eczema flare-ups, it is important to manage stress effectively. Here are some strategies that may help:

• Identify stress triggers: Recognize and understand the situations or factors that trigger stress in your life. This awareness can help you develop targeted coping mechanisms.
• Practice stress management techniques: Meditation, deep breathing exercises, yoga, or hobbies that promote relaxation can help calm your mind and reduce your body’s response to stress.
• Seek support: Share your feelings and concerns with trusted friends, family members, or a support group. Talking about your stressors can provide emotional relief.
• Maintain a healthy lifestyle: Prioritize self-care by trying to adopt healthy habits such as regular exercise, adequate sleep, and a balanced diet. These lifestyle factors contribute to overall well-being and can help reduce stress levels.

Eczema treatments for hands

When managing eczema flare-ups on your hands, it is essential to follow a comprehensive treatment plan. Here are some options to consider:

• Moisturizers: Regularly applying moisturizers to your hands can help restore your skin’s moisture barrier and prevent dryness. Choose fragrance-free and hypoallergenic (meaning they won’t cause an allergic reaction) moisturizers that are specifically formulated for sensitive skin.
• Emollient soap substitutes: Using these to wash your hands is much better for your skin than soap or plain water. Gently pat your hands dry using a soft towel afterward, avoiding rough paper towels.
• Avoiding triggers: Identify and avoid triggers or activities that irritate your hands, such as harsh soaps, detergents, allergens, or prolonged exposure to water. Wearing protective gloves when handling irritants can also help you minimize contact.
• Phototherapy: This involves using UVB rays through a specialized light box that you place your hands or feet in. If phototherapy is accessible in your local area, assessments and treatments (2–3 times a week) are usually conducted in a dermatology department.

Medications

• Corticosteroids: During flare-ups, applying topical corticosteroid creams or ointments to the affected areas on your hands can help reduce inflammation and relieve itching. In more severe cases, a doctor might recommend that you use oral steroids. The most common is prednisolone (Millipred).
• Topical calcineurin inhibitors (TCIs): These nonsteroidal creams or ointments help suppress the immune response in the skin and reduce inflammation. They are typically used when corticosteroids are not suitable or effective. TCIs for eczema include:
  • pimecrolimus (Elidel)
  • tacrolimus (Protopic)
• JAK inhibitors: These medications treat inflammation by targeting the immune responses that cause it. Topical JAK inhibitors for eczema include:
  • ruxolitinib (Jakavi)
  • crisaborole (Eucrisa)
• Antihistamines: If itching is severe and affects your sleep or daily activities, a doctor might recommend oral antihistamines to alleviate the itch and promote better sleep. Examples include:
  • fexofenadine (Allegra)
  • cetirizine (Zyrtec)
• Antimicrobial medications: These include antibiotic, antiviral, and antifungal medications. A doctor might prescribe these if your skin has developed an infection.

A healthcare professional can help you identify which type of eczema you have and develop a comprehensive treatment plan.

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Summary

Stress and eczema are closely intertwined, with stress often triggering or making eczema flare-ups worse, particularly on the hands.

By using stress reduction techniques and following a treatment plan, you can effectively manage and reduce the effect of stress-related eczema on your hands.

Remember to consult with a healthcare professional for personalized advice and guidance in managing your specific condition.

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