The Efficacy to Prevent Irritant Hand Eczema: an Overview of the Interventional Procedures

Interventional procedures to prevent hand eczema (HE), comprising educational programs, are widely used for primary, secondary, and tertiary prevention of irritant contact dermatitis on the hands. This review gives an overview of randomized controlled trials (RCTs) addressing the efficacy of interventional procedures and educational programs in HE prevention. RCTs on HE prevention differ with respect to form and implementation of interventions, populations, and follow-up times. Overall, the education has focused on use of moisturizers, gloves, and substitution of hand washes with alcohol-based hand rubs. Regarding outcome measures, the effect of interventions on prevalence (i.e., primary prevention) has been inconclusive. Meanwhile, educational programs aiming at HE patients (secondary prevention) had a positive effect on behavior in four out of five RCTs and a decrease in HE severity in four out of six RCTs (one with group-based and three with individual-based education). Positive effect on knowledge and on health-related quality of life was only found in few studies. Overall, preventive educational programs are useful. Along with intensified, individual-based educations rather than group-based education, a shorter follow-up time seems to influence outcome measures positively. Future studies should investigate the long-term benefit from repeated educational sessions to maintain the positive benefits.