What is Housewife’s Eczema?
Housewife’s eczema, also known as dyshidrotic eczema or pompholyx, is a chronic form of hand eczema that occurs mainly on the fingers, palms, and soles of the feet. Like dishydrotic eczema, it is a common type of eczema that affects the hands. Once afflicted with housewife’s eczema, it is often difficult to cure, and even minor lapses can easily lead to recurrences. When symptoms are severe, it can significantly impact one’s ability to perform daily tasks.
Who is Prone to Housewife’s Eczema?
Some individuals have a inherent tendency to develop housewife’s eczema due to their skin being particularly sensitive, dry, and prone to peeling on the hands. In addition to this genetic predisposition, lifestyle factors also play a role. In daily life, our hands inevitably come into contact with various chemical substances like cleansers, dish soap, laundry detergent, bleach, and alcohol, which can strip away the skin’s natural oils and cause dryness, weakening its defenses.
However, it’s not just chemical agents that can trigger housewife’s eczema. Some natural foods like onions, garlic, and other spicy ingredients, as well as citrus fruits, may also provoke symptoms.
Symptoms and Complications of Housewife’s Eczema
Housewife’s eczema, also known as “fat-deficient hand eczema” or “degenerative eczema”, causes dryness, peeling, and redness on the first finger joints after exposure to irritating substances. The palms may also exhibit dry, cracked skin, though blisters and bleeding are uncommon, especially on the dominant hand.
“Chronic palmoplantar eczema” or “idiopathic palmoplantar dermatitis” refers to dry, hardened skin with fissures on the fingers. In severe cases, the cracks may lead to bleeding wounds and loss of fingerprints.
Some long-term sufferers may even develop nail complications like deformities, paronychia (nail infections), and discolored nails over time.
Hand Eczema is Not the Same as Housewife’s Eczema!
“Hand eczema” is often mistaken for housewife’s eczema. However, hand eczema, like athlete’s foot, results from fungal infection of the skin. It often co-occurs with athlete’s foot, colloquially known as “Hong Kong foot/hand”, and primarily manifests as peeling of the entire palm, typically on just one hand.
Why Does Housewife’s Eczema Worsen in Autumn/Winter?
In the cooler, drier autumn and winter months, skin lacks its natural oils and moisture, leading to dryness – the arch-nemesis of housewife’s eczema. When skin becomes overly dry, symptoms worsen for those with the condition. Therefore, diligent application of hand cream and avoiding cracked skin are crucial during this period.
Is Steroid Cream Necessary for Treating Housewife’s Eczema?
The most common treatment is the use of steroid-containing topical ointments. With daily application, symptoms can improve within about 2 weeks. Subsequent maintenance with moisturizers, glove-wearing, and avoidance of water, cleansers, and irritants can reduce recurrence rates.
Steroid vs Non-Steroid Use
Western medicine often employs antihistamines and steroids to treat skin conditions. Steroids work by suppressing the body’s inflammatory response to reduce eczema flare-ups. Different steroids have varying potencies, but can only provide temporary relief, not a cure. Due to their numerous side effects, they should only be used for a few days until symptoms are controlled, then tapered off to avoid long-term adverse effects. Non-steroid ointments are slower-acting but can be used on affected areas. If eczema is complicated by bacterial infection, oral antibiotics may be required.
Use of Steroids
Steroids are commonly used medications that can be administered orally, topically, or by injection. For eczema treatment, topical steroid creams are most prevalent, while oral or injectable steroids may be used for chronic or severe eczema to achieve faster results.
Long-term oral steroid use can lead to side effects like buffalo hump, moon face, weight gain, and osteoporosis. Prolonged application of topical steroid creams may cause skin thinning, discoloration, spider veins, and excess hair growth. Regardless of the administration method, caution is advised for long-term steroid use. The exact duration considered “long-term” varies based on the frequency of use and individual physiology, so it’s best to consult a doctor for proper diagnosis, dosage, and monitoring. Self-medication with over-the-counter steroid creams should be avoided.
However, patients should not refuse steroids outright due to fear of side effects. For most eczema patients requiring only short-term treatment, the benefits likely outweigh the risks.
Steroids are effective because after penetrating cell membranes and binding to cytoplasmic receptors, the resulting complexes interact with DNA to produce proteins with anti-inflammatory, anti-metabolic, immunosuppressant, and anti-proliferative effects.
Use of Non-Steroidal Ointments
Non-steroidal ointments, also called topical immunomodulators, include brands like Protopic and Elidel. These prescription drugs may cause a temporary burning sensation for some users, but this typically subsides over time. They tend to act more slowly and may be less effective for severe cases.
Non-steroidal ointments are suitable for short or long-term use in mild to moderate cases and can be applied to various body parts to relieve discomfort and prevent scratching of affected areas. Start by applying to the most severe areas first until the skin adjusts, then spread evenly in a thin layer—over-application can paradoxically lead to inflammation due to excessive skin irritation.
Is Steroid Cream Necessary for Housewife’s Eczema?
Non-Pharmacological Treatments? To truly cure housewife’s eczema, prevention through lifestyle changes is crucial. For example, wearing gloves (ideally cotton gloves lined with latex/rubber gloves to absorb moisture while providing a waterproof barrier) when handling water, cleansers, or engaging in chores that may cause irritation.
Use cold or lukewarm water when washing hands and choose mild, gentle cleansers or soaps. After washing, immediately apply petrolatum or a quality hand cream to moisturize and protect the skin. Pay close attention to ingredients when purchasing hand creams.
What to Consider When Applying Hand Cream?
First, apply hand cream immediately after drying your hands, while the skin still retains some moisture. This helps lock in hydration for maximum effectiveness.
If hands feel very dry, especially in winter, try soaking them briefly before patting dry and applying cream.
Choose an oil-based, nourishing hand cream or lotion without irritants.
Use only a thin layer—too much can make skin look and feel greasy, counteracting the effects. Adjust application frequency based on season and dryness levels, creaming up to 5-10 times per day if extremely dry.
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