Eczema on hands and nails: what to know

Hand eczema may appear on the palms, backs of the hands, finger webs or fingertips. The skin can feel rough, sore, tight or itchy, and repeated inflammation may cause splits that sting when exposed to water. Nail changes are less specific: nearby skin inflammation can affect the nail fold, while ongoing irritation may leave nails ridged, brittle or uneven. A clinician can distinguish eczema from infection, contact allergy and other nail conditions. Eczema is a presentation of Atopic Dermatitis; it does not mean every hand rash has the same cause.

After a flare settles, darker or lighter areas can remain, particularly where inflammation was intense or scratching continued. This is called Post-Inflammatory Hyperpigmentation when the leftover colour is darker.

Use a fragrance-free, thick moisturiser after washing and whenever the skin feels dry. Wash with lukewarm water, choose a gentle cleanser, and pat rather than rub. Wear protective gloves for wet work, with a comfortable cotton layer if sweating or rubbing becomes a problem. Keep nails short and avoid cutting or pushing back irritated cuticles. A prescribed anti-inflammatory treatment may be needed during a flare; apply it exactly as directed and do not use someone else’s medicine.

Arrange an assessment if the rash keeps returning, interferes with sleep or work, or does not improve with careful moisturising. Seek prompt care for rapidly increasing redness, warmth, swelling, pus, yellow crusts, severe pain or fever, because broken skin can become infected. A nail that lifts, changes colour, or becomes very painful also deserves examination.

Could this be hand eczema, contact dermatitis or a nail infection? Which cleanser, moisturiser and treatment should I use, and how should I protect the nail folds during wet work?