Advice for managing pompholyx eczema on hands

[Kickinthenostalgia]

has anyone had or got this and tells me what works please. Drs diagnosed me with pompholyx, a type of eczema, on my hands where you get tine little white spot/blister and when they pop it looks like 5/6 layers of skin have disappeared. They told me to buy emollients, rather than actually prescribing something. I’ve tried hydrocortisone cream and that’s not really worked. It did for a few patches but everything seems to still be going strong. Now it’s getting worse when I wash my hands, I have ocd and wash my hands maybe 10-20 times per day. I’ve had this for years so I know it’s not that, it seems to appear during about the 5th heatwave. And hasn’t left. I’ve ordered some e45 cream to see if that works.was just wondering if anyone had any advice on this particular subject.

Don't use soap when washing. Aldi Lacura do an excellent Hydrating Cleanser with ceramides, which comes in a pump dispenser. Use that when washing your hands. I'd also recommend Aveeno Dermexa emollient - I get mine on Amazon. A little goes a long way and it restores the skin barrier. Good luck!

No hand wash especially not carex or anti bac, just use a bar of soap. I had it for ages then realised when I stayed at my dad's house it cleared up because they didn't use hand wash.

Pretty sure the GP gave me Timovate too.

Pompholyx needs a serious steroid and a serious emollient. Hydrocortisone and E45 are not that.

You need to
wear gloves for any cleaning
wash your hands only with soap substitute like Dermol, never soap and definitely not handwash
apply a thick emollient every time you wash your hands - ideally an ointment like Epaderm but if you can't stand the greasiness then a cream like Epimax. Lotion is too weak
get a high potency steroid to apply like Betnovate from your GP. As you have found out hydrocortisone just doesn't cut it.

Thanks guys, dr was pretty useless tbh, just told me to buy emollients. Didn’t give me any advice on which one. Was over the phone and I sent pictures. I’ll check out the aveeno aswell. Problem is I have emetophobia so not using anti bac is gonna cause some issues on the health anxiety front. We’ve been using the same one at home for years, the ineos brand so I know it’s not that, I wonder if it’s the cheap one they have at work.

Mine gets worse with sun cream annoyingly so always flares up in the summer. Not sure what ingredient does it but it always happens. Seconding always wear rubber gloves when washing up etc

Lots of us have this in our family. Firstly, never pop or scratch the blisters. Use disposal gloves to wipe yourself after going to the loo and then dispose of gloves. Saves you washing your hands. Try to wash your hands only when absolutely necessary (difficult I know as you say you have OCD). Nursem Handcream manages mine now without medication (pricey but oh so worth it). You could push for a prescription such as
Trimovate Cream. And if that doesn’t work, Dermovate Cream.

I swear by washing hands with Dermol 500 too. If what your GP provides isn’t helping, push for a Derm referral.
careful with the E45, it made me significantly worse!

I tried loads and mine was awful. I think it was cetraben that sorted mine out.

I put up with this in and off for years, avoided soap, rubber gloves, emollients, none of it improved it but they did stop it progressing to cracking. Betnovate worked but it would come back eventually. I got to the end of my tether about 10 years ago and went back to the GP, he was very young and I watched him google eczema and start printing out sheets that said "avoid soap, use E45" and I lost my patience and said, sorry, no, I clearly know more about this than you, please refer me for allergy testing, he got the senior partner in who agreed. They diagnosed me with nickel allergy but we couldn't see where the nickel contact was coming from, they said most commonly it's shop workers (coins) or those who carry/use keys all the time. They were going to prescribe me a mild immune suppressant to break out of the steroid cycle but before I had picked up the prescription I did a bit of googling, the penny dropped that I had been wearing an old "silver" ring from the 80s. Took the ring off, eczema went, has never come back, I can use any handsoaps, not bother with handcream, used handgel throughout the pandemic no bother at all and still do sometimes. So I'd suggest asking for a a stronger steroid initially but if it keeps coming back try and get tested (nickel allergy is extremely common but it might be something else).

Protopic helps with mine, which is prescription. It’s made worse with heat, handwash and forgetting to use hand cream.

I find certain handwashes make mine worse, also heat, also stress.
I have OCD and wash my hands a lot.
What has really helped has been changing to Pears soap.
The itchy blisters were driving me mad but are completely gone now.

Had it for years. I think everyone reacts to different things though by the sounds of it!
I got rid of mine by avoiding hand washing too often, coating my hands in a beeswax emollient and keeping that up constantly for a few weeks.

I only had it on my right hand so adapted to do everything with my left where possible.

I can tolerate the green Palmolive hand wash (hygiene plus sensitive) but that's about it otherwise I break out again

Bar soap works best for me, I like the dettol one. Bayliss and Harding is the absolute worst hand-wash for me, not sure what is in it that is different from others but my parents use this and I always have a massive flare up if I use it.

Mine is also exacerbated by stress and tiredness.

I havent found steroids help mine much at all. I use O keefe's working hands hand cream as its rich but not too greasy.

The worst bit is in the winter I’ve always suffered with cracked skin, to the point [-it bleeds, used aveeno hand cream which seemed to help, so if I do get this sorted out, it will go from one problem straight to the next. 😬

My image is still under review. I honestly thought I was stuck with it forevermore.

One thing at a time OP.

Mine is terrible. I’ve been at the point where I can’t actually drive because my hand was so sore and bleeding…
It comes and goes… it’s always there but I know it’s going to flare when I want to leave my hands under the hot water tap for relief from itching! This is not a good idea… dries your skin out even more!
I’ve tried all soaps, the Dermol thing…
My hands were actually ok during Covid and the hand sanitiser thing… I have read that eczema people struggle with the normal healthy bacteria on their skin and react to things others don’t. But… if you have OCD around handwashing then that’s probably not the case for you!
My most recent discovery is not to put cream on at night. I wake up scratching, even if I’ve put cotton gloves on.
So, in a bad flare I’ll do Zeroderm ointment (very greasy) with a hydrocortisone mixed in for good measure. I also have a hydrocortisone with an antibiotic in it too if they look infected. Then I’ll put the cotton gloves on and let the creams do their work. But, in the day not the night.
I also take cetirizine (antihistamine) because I get itchy hives on my arms and chest too. This is all year round.
I also have a nickel and a latex allergy.
I have just had a sample of the Moroccan Oil hand cream and it was amazing! But… not at night!

My daughter is prescribed Trimovate. She now knows the feeling she gets when it's about to flare and puts it on before it's really started to appear.

The only things that work for me are either Simple liquid soap or Dove bar soap, plus Aveeno moisturiser. Mine also only flares up if I eat wheat products regularly.

I also have a nickel and latex allergy.

Any kind of soap is going to disrupt your skin barrier - whether it's supposed to be "gentle" or not. Especially given your habit of regular hand washing. Please switch to a cleanser with ceramides instead. That's half the battle, your choice of emollient is the other.

I mentioned the Aldi cleanser earlier because I'm a cheapskate, but any hydrating cleanser with ceramides will protect your skin barrier and give your hands a chance to heal.