Medical disclaimer: This page is for information only. It does not constitute medical advice. If you think you have pompholyx or any other skin condition, please consult your GP or a dermatologist.

Pompholyx Treatment: Your Options

I’ve been living with pompholyx for over 40 years and running a site about it since 2008. When I first started writing about treatment, calamine lotion came up in serious conversations about managing flares. That tells you something about how limited the options were.

That’s changed. In 2024 and 2025, the first treatments ever specifically approved for chronic hand eczema arrived. A cream called delgocitinib (brand name Anzupgo) was approved in the UK in 2024 and by the FDA in the US in July 2025. It’s one of the main reasons I relaunched this site: there are real developments worth knowing about, and they’re not getting through to most sufferers.

This page covers the full treatment landscape, from what your GP can offer through to the newest options a dermatologist might discuss. I’ve tried to write it the way I’d want to read it: in plain language, without jargon left unexplained, and honest about what the evidence actually shows.

One thing worth saying upfront: GPs are generalists managing hundreds of conditions, and the treatment landscape for hand eczema has shifted significantly in the last couple of years. Your GP may not yet be familiar with the newest options, or may have a favoured approach that predates recent developments. That’s not a criticism. It’s a practical reality, and it’s one of the reasons why understanding the options yourself matters. Come to appointments informed and don’t be afraid to ask about specific treatments by name.

This isn’t medical advice. What works for one person won’t work for another, and treatment should always be guided by a doctor or dermatologist who knows your situation.

How pompholyx treatment works: the basic idea

Most dermatologists start with the simplest, safest options and move up if those aren’t enough. Most people are managed with the basics. Only a minority need the more intensive treatments. Knowing where you sit in that picture helps you understand what to ask for and when.

Step one: skin protection and emollients

Before any medicated treatment, the foundation is protecting the skin barrier and keeping it moisturised. This sounds basic. It is basic. It also makes a genuine difference and shouldn’t be skipped.

Emollients, sometimes called moisturisers or barrier creams, reduce water loss from the skin and soothe dry, irritated skin between flare-ups. Applied regularly and generously, they can reduce the frequency and severity of flare-ups. Consistency is what matters: a small amount applied occasionally won’t do much, but applied several times a day, particularly after handwashing and before bed, the effect accumulates.

Many dermatologists recommend applying emollient before putting on gloves for wet work, as it provides an extra layer of protection. Products worth knowing: Aveeno, Doublebase, Diprobase, Epaderm, and Hydromol are all widely used. If one doesn’t suit you, try another. Avoid anything with added fragrance.

Skin protection alongside emollients matters equally: protective gloves when handling water or irritants, fragrance-free products throughout your household, and avoiding your known personal triggers. This isn’t treatment in the medicated sense, but it’s the platform everything else sits on.

Step two: topical corticosteroids (steroid creams)

For most people, steroid creams or ointments are the first line of medicated treatment. They reduce inflammation, relieve itching, and help blisters resolve more quickly.

They come in different strengths. Mild over-the-counter hydrocortisone 1% is not usually strong enough for pompholyx. I’ve used it myself over the years and it works reasonably on the mild eczema I get on my legs, but it makes little real difference to my pompholyx flare-ups. Mid-to-high potency steroids are typically what’s needed: betamethasone valerate (Betnovate) or clobetasol propionate (Dermovate) are commonly prescribed.

A word of caution: using potent topical steroids on the same area of skin repeatedly over time can cause the skin to thin. This is a real side effect worth being aware of. Your doctor will usually advise short courses during flare-ups rather than continuous application for this reason. If you’ve been applying the same steroid cream to your hands for months without a break, it’s worth discussing with your GP.

Ointments generally work better than creams for pompholyx because they stay on the skin longer and penetrate more effectively. They’re greasier, which is genuinely annoying. Wearing cotton gloves over ointment at night is often recommended, though I’ll be honest: I’ve never loved wearing gloves because the extra warmth seems to make my hands more irritable. If that’s your experience too, it’s worth mentioning to your dermatologist, as there are alternatives.

Step three: tacrolimus and pimecrolimus

These are prescription anti-inflammatory treatments that aren’t steroids. They come as a cream or ointment and work on the immune response in the skin without the skin-thinning risk that comes with long-term steroid use.

Tacrolimus (Protopic) and pimecrolimus (Elidel) are both available on prescription. They’re particularly useful for people who’ve been using topical steroids for extended periods and need an alternative.

They’re not suitable during an actively infected flare-up. They work partly by dampening the local immune response in the skin, which can make it harder for your body to fight an active infection. If your blisters are showing signs of infection, such as increasing redness, warmth, swelling, or pus, see your doctor before using these.

They can cause a burning or stinging sensation when first applied, which typically settles after a few days.

Step four: delgocitinib cream (Anzupgo) – the newest option

This is the development that most pompholyx and dyshidrotic eczema sufferers haven’t heard about yet, and it’s the most significant news in this space in years.

Delgocitinib cream 2% (pronounced del-go-SIT-in-ib, brand name Anzupgo) is the first treatment ever specifically developed and approved for chronic hand eczema, rather than being borrowed from treatments for other conditions. It’s applied twice daily as a cream directly to the affected hands.

How it works, in plain English: it belongs to a class of drugs called JAK inhibitors. JAK inhibitors block a specific signalling pathway that tells your immune system to produce inflammation in the skin. By switching off that signal at the skin level, the cream reduces the inflammation that causes blistering, itching, and pain. Because it’s a cream applied to the skin rather than taken by mouth, the amount that gets into the bloodstream is very small, which limits side effects compared to oral versions of similar drugs.

The approval timeline: the UK approved it in 2024. The US FDA approved it on July 23, 2025, making it the first treatment specifically approved for moderate-to-severe chronic hand eczema in the US.

What the clinical trials showed: in large, rigorous studies comparing delgocitinib cream against a dummy cream in people with moderate-to-severe hand eczema, up to 37.7% of people using delgocitinib achieved clear or almost clear skin after 16 weeks of twice-daily use. Itch and pain scores also improved significantly. Separate comparison data suggests it works about as well as dupilumab injections for hand eczema.

Who it’s for: adults with moderate-to-severe chronic hand eczema who haven’t responded adequately to topical corticosteroids, or for whom steroids aren’t suitable. It’s a step up from steroid creams, not a replacement for them at first line.

How to access it: in the UK, via a dermatology referral. In the US, following the July 2025 approval. If you’ve been struggling with hand eczema that isn’t responding to steroid creams, it’s worth asking about by name at your next dermatology appointment.

Step five: phototherapy

If topical treatments aren’t providing enough control, phototherapy (light therapy) is often the next step before moving to medications taken by mouth.

PUVA (psoralen plus ultraviolet A light) has been used for pompholyx for decades. The affected skin is soaked in a psoralen solution, which makes it more sensitive to light, then exposed to UVA. Treatment is typically two to three sessions a week over several months. Some people achieve significant periods of remission following a course. It doesn’t work for everyone but for those it suits, the results can be substantial. One reader reported eight months of clear hands following a three-month PUVA course.

Narrowband UVB is a simpler form of light therapy without the psoralen soak, now more commonly used in many centres. The evidence for hand eczema is reasonable and the side effect profile is somewhat better.

The main practical drawback of phototherapy is that it requires regular attendance at a hospital or specialist clinic over months. It’s not suitable for everyone, as certain medications and skin types affect eligibility. Ask for a dermatology referral if you want to explore it.

Step six: systemic treatments

For severe or persistent pompholyx that hasn’t responded to topical treatments or phototherapy, medications that work throughout the body may be considered. These are all prescribed and managed by a dermatologist.

Oral corticosteroids. Short courses of oral steroids (prednisolone) can bring a severe flare-up under control quickly. They’re not a long-term solution because of side effects with prolonged use, but as a short-term intervention during a particularly bad episode they have a role.

Alitretinoin (Toctino). An oral treatment specifically licensed for severe chronic hand eczema that hasn’t responded to potent topical steroids. Available in the UK on the NHS via dermatologist prescription. It requires monitoring and isn’t suitable for women who might become pregnant. For people with severe, longstanding hand eczema who haven’t found adequate relief elsewhere, it’s worth asking about.

Methotrexate. An immunosuppressant used when other treatments have failed. Requires regular blood monitoring. Not a first choice but it has a place in severe, treatment-resistant cases.

Ciclosporin. Another immunosuppressant that can produce rapid improvement in severe eczema. Typically used in short courses because of effects on the kidneys and blood pressure with longer-term use. Sometimes used to gain control of a severe flare-up while transitioning to a longer-term treatment.

Biologics: dupilumab and tralokinumab

This is where treatment for dyshidrotic eczema is developing fastest.

Biologics are injectable treatments that target very specific parts of the immune system. In plain terms: rather than broadly suppressing the immune system the way older immunosuppressants do, they block one particular signal that drives inflammation. More targeted, and generally better tolerated.

They were developed for widespread atopic dermatitis (eczema across the body) but research increasingly shows they work for hand eczema including pompholyx.

Dupilumab (Dupixent). Given as an injection under the skin every two weeks, dupilumab blocks two proteins that act as key triggers for eczema inflammation. A 2025 systematic review of 20 studies found it consistently effective for hand eczema, improving severity scores and quality of life. It’s not licensed specifically for hand eczema as a standalone condition in most countries, but dermatologists do prescribe it for this purpose, particularly where someone also has eczema elsewhere on the body. Main side effects: injection site reactions and eye inflammation (conjunctivitis), which affects some people.

Tralokinumab (Adtralza). Similar to dupilumab but targets a single inflammatory protein rather than two. Licensed for moderate-to-severe atopic dermatitis. In studies specifically looking at hand and foot eczema, 42% of patients reported clear skin after three months, rising to 53% at nine months. The evidence base for pompholyx specifically is smaller than for dupilumab, but the results are encouraging.

Access to biologics for hand eczema varies. In the UK, NICE criteria determine NHS eligibility. In the US, insurance coverage and specific licensing affect access. If you have severe pompholyx that isn’t responding to the treatments above, biologics are worth raising with a dermatologist.

Other treatments sometimes mentioned

Antihistamines. Oral antihistamines don’t treat pompholyx directly but can help with the itch. I’ve had some success with them myself, though it’s inconsistent: they help sometimes and make little difference at others. Sedating antihistamines like chlorphenamine are sometimes used short-term when itching is disrupting sleep. Worth trying during a bad flare-up.

Botulinum toxin (Botox). Injections into the palms can reduce sweating and, in some cases, reduce flare-ups in people where sweating is a clear trigger. Not a mainstream treatment but some specialist dermatologists offer it.

Aluminium chloride. A topical solution that reduces sweating. May help where sweating is a consistent trigger, used alongside other treatments.

Antibiotics. Not a treatment for pompholyx itself, but necessary if a flare-up becomes infected. Signs of secondary infection: increasing redness, warmth, swelling, and pus. If you suspect infection, see a doctor promptly.

What about natural remedies?

Sea water is the one natural approach that comes up consistently and that I have some personal experience with. I’ve noticed that time in the sea seems to correlate with a reduction in itching and blisters drying up more quickly. Whether that’s the salt water itself, the cold temperature of British coastal water, or simply being outdoors and less stressed, I can’t say for certain. But there’s enough consistency in my own experience, and in what readers have reported over the years, that I mention it as something worth trying if you have access to the sea.

What I’d caution against: unverified online protocols, particularly aggressive dietary elimination programmes, prolonged bleach baths, or unproven supplement regimes. Some of these can cause harm and none have meaningful evidence behind them for pompholyx specifically.

How to approach treatment if you’re not getting results

If your pompholyx isn’t responding to what your GP has prescribed, the most useful step is a referral to a dermatologist. GPs manage many skin conditions well, but delgocitinib, biologics, phototherapy, and alitretinoin are all typically only available through dermatology.

When you see a dermatologist, it’s worth asking specifically about: patch testing if you haven’t had it, delgocitinib cream given the 2024/2025 approvals, whether biologics might be appropriate if the condition is significantly affecting your quality of life, and a full review of your trigger management.

Keep a record of what you’ve tried, for how long, and what effect it had. This helps a dermatologist understand what the next appropriate step is rather than starting from scratch.

Frequently asked questions

What next?

If you recognise what’s described on this page, the right first step is to see your GP or a dermatologist. They can confirm the diagnosis, identify possible triggers, and discuss treatment options with you.

This site covers all of those areas in detail. You might find these pages useful next:

What is Pompholyx?, Causes and Triggers, Living with Pompholyx and Reader Stories.

The information on this page has been researched and written by Andy Brown, who has lived with pompholyx for over 40 years and has been running pompholyx information sites since 2008. It is intended for general information purposes only and does not constitute medical advice. This page has been reviewed for clinical accuracy by [Medical Reviewer Name, Qualifications]. Individual symptoms, causes, and appropriate treatments vary. Always consult a qualified GP or dermatologist for advice specific to your situation. If your skin condition is severe, worsening, or infected, seek medical attention promptly.