Did you know nurses are at higher risk for this disease?

As a dermatologist, I frequently treat nurses who suffer from chronic hand eczema (CHE), a disease that can seriously impact well-being and professional performance. Thyssen and colleagues define CHE as eczema on the hands lasting more than 3 months or recurring at least twice a year. The disease impacts approximately one in ten adults worldwide.

As described by Dalgard and colleagues and Lee and colleagues, CHE is more than dry or irritated skin. It causes itching, pain, redness, thickening, blistering, swelling, and cracking—symptoms that can interfere with everyday tasks and patient care. For nurses, whose hands are essential tools, this disease can be especially debilitating.

Risk factors

Several studies (including from Crépy and colleagues, Lynde and colleagues, and Thyssen and colleagues) note that some people are more vulnerable to developing CHE due to environmental, biological, and lifestyle factors.

• Environmental factors. Employees in wet work trades, such as nurses, are exposed to wet conditions, frequent handwashing, and harsh disinfectants, which can contribute to skin damage.
• Biological factors. Being female, having a history of atopic dermatitis or childhood eczema, early onset hand eczema, and certain genetic mutations increase susceptibility for some people.
• Lifestyle factors. Tobacco use and stress also can increase risk.

The impact of CHE extends beyond the skin. A 2025 Ipsos survey of patients’ perspectives on living with CHE found the following:

• 53% of patients surveyed said the emotional and social impact of CHE is just as bad as the physical pain.
• 56% said that keeping a positive attitude due to physical discomfort is a struggle.
• 45% said CHE impacts their ability to perform daily tasks and activities.

CHE is more than a skin disease—it can be a serious, often misunderstood condition. For some, living with CHE can mean struggling with routine tasks, feeling embarrassed in front of patients and colleagues, and even considering career changes due to discomfort or stigma.

Many people don’t realize they have CHE. According to Elsner and Agner, they may accept it as a basic life condition and ignore or self-treat it in the early stages, which can contribute to a delay in diagnosis and specific treatment.

Take action

With the right diagnosis and education, nurses can better understand what triggers CHE flare-ups, how to prevent them, and how to manage symptoms. If you think you might have CHE, visit learnaboutCHE.com to learn more and find a healthcare provider.

Dr. Linda Stein Gold is the director of clinical research in the department of dermatology at Henry Ford Health.

References

Crépy MN, Molin S, Giménez-Arnau AM, Apfelbacher C, Brignoli L, Morillo A, et al. Exploring the relationship between chronic hand eczema, occupation, and household/leisure activities. Presented at: European Society of Contact Dermatitis (ESCD) Congress; September 4-7, 2024; Dresden, Germany. Poster 19.

Dalgard FJ, Gieler U, Tomas-Aragones L, et al. The psychological burden of skin diseases: A cross-sectional multicenter study among dermatological out-patients in 13 European countries. J Invest Dermatol. 2015;135(4):984-91. doi:10.1038/jid.2014.530

Elsner P, Agner T. Hand eczema: Treatment. J Eur Acad Dermatol Venereol. 2020;34(Suppl 1):13-21.  doi:10.1111/jdv.16062

Grant L, Seiding Larsen L, Burrows K, et al. Development of a conceptual model of chronic hand eczema (CHE) based on qualitative interviews with patients and expert dermatologists. Adv Ther. 2020;37(2):692-706. doi:10.1007/s12325-019-01164-5

Jamil W, Svensson Å, Josefson A, Lindberg M, von Kobyletzki LB. Incidence rate of hand eczema in different occupations: A systematic review and meta-analysis. Acta Derm Venereol. 2022;102:adv00681. doi:10.2340/actadv.v102.360

Lampel HP, Patel N, Boyse K, O’Brien SH, Zirwas MJ. Prevalence of hand dermatitis in inpatient nurses at a United States hospital. Dermatitis. 2007;18(3):140-2. doi:10.2310/6620.2007.06024

Lee GR, Maarouf M, Hendricks AK, Lee DE, Shi VY. Current and emerging therapies for hand eczema. Dermatol Ther. 2019; 32(3):e12840. doi:10.1111/dth.12840
LEO Pharma Inc. Data on File.

Lynde C, Guenther L, Diepgen TL, et al. Canadian hand dermatitis management guidelines. J Cutan Med Surg. 2010;14(6):267-84. doi:10.2310/7750.2010.

Quaade AS, Simonsen AB, Halling AS, Thyssen JP, Johansen JD. Prevalence, incidence, and severity of hand eczema in the general population—A systematic review and meta-analysis. Contact Dermatitis. 2021;84(6):361-74. doi:10.1111/cod.13804

Tauber M, Vocanson M. Biomarkers for chronic hand eczema. Could etiological and clinical subtypes truly be the starting point? An open question. J Eur Acad Dermatol Venereol. 2024;38(6):997-8. doi:10.1111/jdv.20023

Thyssen JP, Schuttelaar MLA, Alfonso JH, et al. Guidelines for diagnosis, prevention, and treatment of hand eczema. Contact Dermatitis. 2022;86(5):357-78. doi:10.1111/cod.14035

Voorberg AN, Loman L, Schuttelaar MLA. Prevalence and severity of hand eczema in the dutch general population: A cross-sectional, questionnaire study within the lifelines cohort study. Acta Derm Venereol. 2022;102:adv00626. doi:10.2340/actadv.v101.432