Hand eczema is common and multifactorial. A wide range of approaches is available for the management of the condition, in which moisturizing creams or emollients are important treatment adjuncts, both in the acute phase and to prevent outbreaks of eczema. However, moisturizers contain a great variety of ingredients that have different effects on the skin, some of which may be deleterious. The products can be regulated as pharmaceuticals, medical devices, and cosmetics.
The first-generation moisturizers were occlusive emollients based on petrolatum to reduce transepidermal water loss (TEWL) and to allow the epidermis to heal itself. The second-generation moisturizers contained humectants to bind water and lipids for temporary barrier improvement. Today’s “regular” moisturizers offer occlusive and humectant activity. The future products have occlusive and humectant properties and will contain ingredients for stimulating barrier repair based upon different dry syndromes. Products that not only diminish dryness symptoms but also repair the skin barrier and prevent barrier disruption would be the most valuable moisturizers. Thus, more evidence on their effectiveness compared to no treatment and compared to a reference or placebo is needed.