From Hands to Pockets: the High Cost of Managing Chronic Hand Eczema

The financial burden related to the costs of managing chronic hand eczema (CHE), which is often underestimated, represents a source of psychological distress and may be a barrier to care for individuals living with this skin disease. Findings from a study presented at the 2025 Fall Clinical Dermatology Conference in Las Vegas, Nevada showed that living with CHE translates into significant economic strain due to high healthcare resource utilization and out-of-pocket costs.

Chronic hand eczema (CHE) is a type of hand eczema that lasts 3 months or longer or returns at least two times a year. Because of its persistent nature and its significant impact on physical and mental health, this inflammatory skin disease often requires long-term management, which is associated with significant costs. Studies conducted in multiple countries suggested that CHE is associated with high healthcare resource utilization, with patients experiencing a significant financial burden (Apfelbacher C et al. Br J Dermatol 2025;192(6):1047–1054). 

Researchers used data from the CHECK-US study to provide a snapshot of the economic burden of CHE in the United States, including healthcare resource utilization and out-of-pocket costs associated with the management of CHE, stratified by disease severity. CHECK-US was an online survey conducted among 10,636 adults who were representative of the general population in the United States, recruited via online panels between March and May 2025. 

Nearly 1,000 participants with a mean age of 37 years self-reported a physician diagnosis of CHE and completed the full questionnaire. The average time since diagnosis was 12.3 years, and nearly two-thirds of participants (65.1%) reported living with moderate-to-severe CHE, based on self-assessment using a validated photographic guide. Raj Chovatiya, MD, PhD, an assistant professor of dermatology at the Northwestern University Feinberg School of Medicine in Chicago, and co-authors found that individuals living with CHE, particularly those with more pronounced severity, have a considerable financial burden related to out-of-pocket costs and office visits for the management of their disease. 

A majority of respondents (88.9%) said they had met with a healthcare provider, most often a dermatologist or a general practitioner, in the past 12 months. Participants with moderate-to-severe CHE were more likely to see a provider compared to those with mild CHE (92.6% vs. 82.1%). Most participants (89%) with moderate-to-severe CHE had at least one office visit in the past 12 months, whereas only 74.3% of those with mild CHE reported at least one office visit over the same period. 

Participants with moderate-to-severe CHE also had significantly higher mean monthly out-of-pocket costs for emollients or other topical treatments than those with mild CHE ($134.1 vs $105.9). Overall, mean out-of-pocket costs for emollients or other topical treatments totaled $124.2 per month over 12 months. Patients also paid $107 per month on average for other items relevant to the management of CHE (e.g., gloves, wound care, gauze bandages, special soaps and cleansers). A majority of participants reported being treated with either systemic therapies, phototherapy, or topical corticosteroids, and 8.9% reported being treated only with other topicals. 

“Health related costs may be a source of significant stress and a barrier to care, particularly for the uninsured,” the authors concluded. “This mandates the need to optimize long-term CHE care to avoid excess healthcare resource utilization.” 

Shining a light on these factors may help providers optimize care planning and patient support, and may reduce financial barriers for individuals affected by CHE. A patient-centered approach based on supportive care and education, along with the stepwise escalation of topical and systemic treatments, as needed, are some strategies that providers can utilize to reduce the overutilization of resources for the treatment of CHE.