Stuck in an endless cycle of steroid cream - arghhh!!

[itchyhands]

I get eczema on my hands, quite badly it's on every finger in atleast one area and down the backs of my hands/on to the wrists too. Steroid cream gets rid of it within days, but then within days it's back again and I just get through so much steroid cream it worries me. I've tried so much other stuff and it's just relentless and steroid cream is the only thing that helps (that I've tried). I'm only 27 and my hands are so wrinkly and constantly itchy and rashy and I hate it. I used the cream for a couple of days after a bad flare up where it was red and angry and this is just 2 or 3 days later.. back again although it had cleared up. It's never ending.

Does anyone have some miracle recommendation?

Anybody

Try taking oral omega 3 capsules and use bio d un fragranced hand wash, try a loofah too

I don't have an answer because I don't have eczema. I do however have psoriasis and have had it for most of my life.

I currently have small patches on my elbows which I treat with steroid cream and I have a patch on the base of my spine where my bum starts and I do get patches under my breasts. All treated with Betnovate as and when it itches and before it gets to the bleeding stage.

In the past when I have had flare-ups where my whole body has been covered and the cream stopped working and I have been bleeding and in pain I have had light treatment / UVB therapy at the hospital which worked and stopped everything coming back for a long time.
In that department I saw lots of people who came in for treatment for hands. It is a sort of last resort for some and again dos not work for all but hell it is surely worth a try.
Ask your doctor. Mine referred me and virtually saved my life.

read up on topical steroid withdrawal and run from them!

How do I know it's eczema or psoriasis? I had eczema as a child on the backs of my knees and where my arms bend but that was it and it cleared up in my teenage years. This started a couple of years ago on my hands and has been pretty constant ever since. I have wondered if it's psoriasis. My doctor has never looked at it I just said I think my eczema is back and he put me back on betnovate! Will look into light therapy thank you.

I wouldn't use steroid on that.
You need to use emollient ointment many times a day and preferably under cotton gloves at night. 50:50 works the best

Hi @itchyhands

I have suffered from eczema since a teenager and get it really bad on my hands too.

I was recently refered to the hospital where they said you need to gradually taper off using steroid cream. Don’t just stop using it as that causes rebound eczema.

I have been trying to withdraw for months now, I went from Dermovate to betnovate to eumovate but still use 2/3 times a week.

also have you looked into allergy testing so that you can avoid what flates your eczema. I am on a waiting list for this.

This is just showing what it's like after clearing up and stopping the cream for a few days. It goes like this and then eventually cracks and bleeds and gets just horrible

Also do you use a moisturiser, you need to use one after every time you wash your hands as dry skin will flare eczema.

Thank you I will look into that!! It's just horrible having it on your hands. It was horrific with all the hand sanitiser during covid - when places said you had to have it on entry and I'd want to cry it would burn so much.

I remember it started when I was pregnant, my midwife at the time said it would probably go afterwards and it never did!

I have eczema mildly and one of my sons quite badly. That looks like it's at the stage that it needs industrial moisturizing, are you doing that or just relying on the steroid cream. When itchy I will use the steroid cream but as soon as stops itching and at the dry flakey stage, as in your photos, try the Palmers cocoa butter (unperfumed version for sensitive skin) multiple times a day. My son finds that the best, so much so he takes about 6 bottles home with him every time he is here as he lives abroad.

I have eczema. It has dried out so will inevitably crack again. You MUST moisturise EVERY time your hands get wet. Try baby aveeno.

OP I am not saying it's not eczema. What I can tell you is that I moisturise my body after showering and apply moisturiser at other times but nothing gets rid of the itching and flaking like the steroid cream. I try not to use it until it is absolutely necessary since I know it thins the skin but hey you do what you have to don't you?
Honestly, ask your doctor about the light treatment. It might arrest it for a while. it was the best thing I ever did. I have had three really bad breakouts in my adult life and the light treatment did the trick for me.

Just seen your latest post, don't use sanitizer or anything with perfume in like handwashes or washing up liquid, just a mild soap like simple or I find 'faith in nature' brand works for me and smells nice💐

Sympathies OP, I'm the exact same. It's been so bad since covid with all the handwashing that I keep meaning to ask the GP for further action but haven't yet (and really should have).

It can get so sore and hot and itchy it keeps me up at night and I feel embarrassed being out sometimes where hands are always on show.

I've had some success with wearing cotton gloves (bought a box on amazon) whenever I'm at home, switching out all handwash to Dermol and avoiding direct contact with cleaning products, too much hot water etc. I moisturise constantly which also helps but ultimately it always flares up again and feels such a battle.

What works for me is to cover my hands with a really thick layer of emollient cream (and I mean as much as you can possibly get on) then cover with cotton gloves overnight. Keep doing this for a few nights. Don't use soap at all, use the emollient to wash with. You want to try and build up a barrier layer which keeps your hands moisturised. Don't do washing up or any cleaning, and if it's cold out wear gloves. Do this until it clears up completely.

Ask your gp about a cream called protopic (tacrolimus) Once you have it under control with steroids, the protopic will act as a preventer. Combine this with frequent use of moisturisers and you will not have to use steroids again.

I suffer with contact dermatitis and have quite severe allergies against cleaning chemicals and things like that. I used to waitress and honestly the GP said he’d never seen hands like mine before.
I cannot advice you on your exact medical issue, nor am I qualified to. I will say though that it really is a vicious cycle with the steroid creams - my skin has thinned out so much over the years that I had to quit the industry, on a good day I got about 6 paper cuts! Do you have an idea of what your triggers are? The pictures you attached look sore and annoying and my skin still gets like that in patches - now from regular swimming. A genius GP a few years ago listened to my pleads to NOT prescribe steroids, and instead prescribed an ointment called Hydromol. It’s used by people who suffer from eczema, psoriasis and other dry skin conditions. It’s basically a soap substitute, can be used liberally and even added to the bath etc.
Before you get your hopes up - it doesn’t CURE the condition. What it does is relieve the itching, and clearly that has a positive effect on my skin or I’d never recommend it. I keep rubbing and irritating my skin by washing hands etc. What I do is I use soap and water as usual, the usual shower gels etc, but every time I’ve washed my hands or had a shower/bath, I apply this ointment afterwards. It keeps the condition at bay for me. I go swimming 6 times a week and need to apply a layer before even entering the pool because the chlorine causes such issues to my skin. I was impressed by the ointment before I started exercising, and now I’m sold.

Good luck, I completely understand your frustration and sadly it’s something you have to live with- but there IS something out there that will help you manage the condition tolerably. You just have to find your thing, and I hope the above helps.

Have you tried cutting out dairy? My eczema (all over my body) went within 2 weeks of stopping consuming dairy.

Do you moisturise OP?

Because that is the main thing. I like O’keefes but find something you like - every time your hands get wet you dry then and then moisturise.

Use Dermol or double base as a handwash.

At night use a hydrating serum (Superdrug do a good cheap one), then use your hand cream when the serum is wet, and the cover it with Vaseline as a barrier cream, then cover your hands with cotton socks or gloves. Leave overnight. It’s not sexy but it works - every night until it’s been back in good shape for two weeks, and then a few times a week.

If you are just using steroids without moisturising I don’t know it’s an issue with steroids because eczema will flare up on dry skin.

I have always been told you need to use steroids for a good week after a flare goes down because if will still be there. Lower doses are fine. You should see a derm
about that, but up the moisturising first - and also give the steroids a bit longer.

We were always told you need to wean off steroid cream very slowly, not just stop. Are you doing that? If you just stop it is guaranteed to come back and may come back worse. So like if you were on eumovate you'd do it once a day until clear, then every other day, then twice a week.

I've also been told it's OK to do twice a week long term as a maintenance dose if the eczema is severe without it.

This may all be old news or not fit your situation but its what I've been told by a dermatologist.

My hands were your hands at that age - I used to wake up crying with my hands cracked and bleeding.

The only thing that helped was being very diligent with my skin care - I had a type of tape impregnated with something, can’t remember what, which when I was bad I would tape all over my hands and then tape cotton gloves then latex gloves over the top. When it was like it looks like in that picture, I would use Medihoney which was absolutely amazing when it was a bit irritated but not infected, no broken skin.

I got both of those on prescription.

I’m nearly 40 now and haven’t had a breakout in years, although every so often I’ll get a small patch which goes away with one application of hydrocortisone.

I have tried various. Dermol cream from the doctors. Working hands Okeefes would make the itching worse. Body shop hemp hand cream I read about online didn't help either and again made them angrier and itchier. Over the years I've tried so many but nothing is enough to break the habit of steroids

Every time you use steroid cream you thin and weaken the skin making it re flare as soon as you stop the cream.
Process of elimination what is causing flare [it will be the steroid plus the original trigger] are you allergic to metals like nickel [jewelry, copper coins] certain soaps, what are your hands in contact with?
Hard water, soak oatmeal in water and use it for washing your hands, use emollient not soap. Use calmurid cream by galderma as soon as hands feel dry and at least 3 times a day. It will sting on broken skin. On top of that CeraVe which seals in the moisture.
Catch 22 keeping hands out hot water and any cleaning products but rubber gloves make it worse.
Stress is the number one trigger but because it's just your hands it must be something you are touching. Hairdressers often have hand eczema.
A water softener gets rid of most eczema as eliminates scum and drying soap residue. They are expensive so a reverse osmosis drinking water unit for hand washing on ebay about 200 also removes calcium minerals that cause the scum and dryness.
While you are keeping off steroids up your salt intake, drink twice a day orange juice with 1/2 tspn salt and of cream tartar to support your steroid damaged adrenal glands. To control the itching take piriton antihistamine [only piriton not others] this will control the itching but can make you sleepy which is a bonus at night when the itch is worse.
I am not a Dr but I was involved in the skin days for eczema society.
There are so many causes but that is a good start, your hands should feel better within 5 days. If you struggle cutting out betnovate/steroid cream, try using a low lever hydrocortisone cream if desperate. There is also a cream by Leo laboratory [if still made] that is antibiotic to stop the infection in broken skin. If you have friends in USA get them to send you Walgreens triple A cream, anesthetic antibiotic and analgesic so numbs the itch while healing.

Bioderma Atoderm range was recommended to us via a dermatologist. You can buy it in boots. not sure if they do a hand specific moisturiser but we like the Bioderma Atoderm Baume as it's thicker.

You need to moisturise multiple times a day. Including while use the steroid (at different times of day).

When you use the steroid and it clears up you need to reduce the steroid use gradually. So say you're using it twice a day, go for 3 times in 48 hrs, then once a day, then once every other day etc until you're able to stop.

Also, can you think of a pattern as to when it flares up worse? Could it be related to a soap, shampoo, conditioner, dish soap, gardening, anything else you get on your hands etc.

Hope you find something that helps you!