The chronic hand eczema (CHE) management landscape is rapidly evolving with emerging evidence supporting the efficacy and safety of new treatments, some of which are not included in current guidelines. Preventive measures remain a cornerstone in the management of CHE across all etiological and morphological subtypes. The array of topical therapies for CHE is expanding with mounting evidence for newer agents that directly target the underlying pathophysiology of CHE compared to older agents that are more broadly anti-inflammatory. Phototherapy remains an effective option for CHE, but access and inconvenience remain barriers in many regions. Several advances in targeted systemic therapies for CHE have been made, with some agents approved for the treatment of moderate-to-severe atopic dermatitis exhibiting efficacy in hand and foot eczema, while other agents have evidence specifically for efficacy in CHE. With this evolving treatment landscape, an updated algorithm for the management of CHE is proposed.
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