Chronic hand eczema guide

Chronic hand eczema care online, after an in-person diagnosis

For adults 18 or older whose hand eczema a clinician already diagnosed in person. Steroid creams did not work well enough, or you cannot use them.

Start online

Start a $59 online review for Hand eczema (already diagnosed).

This guide starts after a doctor, nurse practitioner, or physician assistant has looked at your hands in person and told you that you have hand eczema. Hand eczema is a skin problem. It makes your hands dry, red, itchy, and cracked. Chronic means it lasts more than 3 months, or it comes back 2 or more times in a year. Steroid creams are the first treatment. Some people need more. This visit is for adults 18 or older in Virginia or West Virginia. You send 4 photos of your hands. The doctor reads your answers and looks at your photos. Then the doctor sends a plan. The plan starts with hand care. The doctor may also send one prescription cream, Anzupgo (delgocitinib), when it is safe for you. This cream is a JAK inhibitor. It can make it harder for your body to fight infections. This visit cannot tell you what a rash is. We do not order tests. Signs that need care right away, or an exam in person, send you there before you pay. The visit price is shown before you pay. You pay the pharmacy for the medicine. We cannot file insurance approvals.

If treatment is appropriate, your physician can send a non-controlled prescription to your pharmacy and provide portal instructions for the next step.

Start this visit See response times

Already in ongoing care with us for this? Check-ins are $39 (your first one is free).

Quick facts

You must be physically located in Virginia or West Virginia at the time of request.
Starts at $59
No insurance needed
No app download
Physician review around the clock
Non-controlled prescriptions can be sent to your pharmacy when appropriate
A work or school note can be included when medically appropriate
Response times apply 24/7, every day

Common symptoms

Dry, red, itchy hands
Cracked skin on your hands
Hand eczema that lasts more than 3 months, or comes back 2 or more times in a year
Steroid creams that a clinician prescribed did not work well enough

May fit online care

Adults 18 and older
You are 18 or older and in Virginia or West Virginia
A doctor, nurse practitioner, or physician assistant looked at your hands in person and told you that you have hand eczema
The last in-person exam of your hands was in the past 2 years, or you have a note from that clinician about this same problem
Your hand eczema has lasted more than 3 months, or has come back 2 or more times in the last 12 months
Your hand eczema is moderate or severe: your worst itch or pain in the last week was 4 or more out of 10
A steroid cream that a clinician prescribed for your hands did not work well enough after 4 weeks, or you cannot use one
You can send 4 photos: the back and the palm of each hand
You have none of the warning signs listed below

Look for another care setting

Trouble breathing, or wheezing (call 911 or go to the ER now).
Chest pain or tightness (call 911 or go to the ER now).
Swelling of your lips, tongue, face, or throat, or trouble swallowing (call 911 or go to the ER now).
Trouble speaking, weakness or numbness on one side of your body, or a drooping face (call 911 or go to the ER now).
New groups of small blisters, or open sores that look punched out, that are different from your usual eczema blisters (call 911 or go to the ER now).
A new rash with blisters or peeling skin over large parts of your body, especially after a new medicine (call 911 or go to the ER now).
Skin that newly turned dark or numb over hours and is not its usual color, or skin with a foul smell (possible severe tissue infection) (call 911 or go to the ER now).
If any of the signs above start after you begin the cream, stop the cream and call 911 or go to the ER now.
Pain, swelling, or tenderness in one leg (go to the ER or urgent care today).
Eye pain with redness, sensitivity to light, or blurry vision (go to the ER or urgent care today).
A fever of 100.4 F (38 C) or higher, together with skin on your hands or arms that quickly got more red, warm, swollen, or painful, or that has red streaks (go to the ER or urgent care today).
If any of the signs just above start after you begin the cream, stop the cream and go to the ER or urgent care today.
A fever of 100.4 F (38 C) or higher, or shaking chills (see a doctor in person today).
Pus or yellow crusts on your hands, or around a nail (see a doctor in person today).
Skin on your hands or arms that quickly got more red, warm, swollen, or painful, or that has red streaks (see a doctor in person today).
A band or stripe of blisters, or burning pain, on one side of your body (see a doctor in person today).
If any of the signs just above start after you begin the cream, stop the cream and see a doctor in person today.
A spot, mole, or sore on your hands or arms that is new, growing, changing, bleeding, or crusted, or that does not heal, and is not like your usual eczema (see a doctor in person within 14 days).
If a spot, mole, or sore like that starts after you begin the cream, stop the cream and see a doctor in person within 14 days. To use the cream again, start a new visit.
No doctor, nurse practitioner, or physician assistant has looked at your hands in person and told you that you have hand eczema, or you are not sure (see your own doctor).
The last time a clinician looked at your hands in person was more than 2 years ago, and you have no note from that clinician about this same problem (see your own doctor).
The rash is on one hand only, or it has a ring-shaped edge with scale at the border, or you have athlete's foot or thick, crumbly toenails (see your own doctor).
Scaly, well-edged red patches on your elbows, knees, scalp, or nails, or a doctor told you that you have psoriasis (see your own doctor).
A clinician told you that you need patch testing for your hands, and you have not had it (see your own doctor).
Your hands now look different from when the clinician told you that you have hand eczema (see your own doctor).
Pregnant, might be pregnant, or planning to get pregnant in the next 3 months (see your own doctor).
Using another JAK inhibitor, as a pill or a cream, or you are not sure (see your own doctor).
Taking a medicine that weakens the immune system, like steroid pills, methotrexate, azathioprine, cyclosporine, or a biologic (see your own doctor).
HIV, an organ transplant, or chemotherapy now or in the past year (see your own doctor).
A pill, a shot, or light treatment for your skin from a skin doctor now (see your own doctor).
An infection now, or taking an antibiotic, antiviral, or antifungal medicine for one (see your own doctor).
Getting infections often, or a serious infection in the past year (see your own doctor).
Tuberculosis, or being near someone with tuberculosis (see your own doctor).
Hepatitis B or hepatitis C now or in the past, or a blood test that showed it (see your own doctor).
Skin cancer, a pre-cancer spot, lymphoma, or another cancer (see your own doctor).
An allergic reaction to Anzupgo or to one of its ingredients (see your own doctor).
Age 50 or older, and you have not had both doses of the shingles vaccine, or you are not sure (see your own doctor).
A live vaccine in the last month, or plans to get one in the next month (see your own doctor).
You used this cream before, and no clinician has looked at your hands in person in the 12 months before this new request (see your own doctor).
Under 18 (see your own doctor).
Hand eczema that has lasted 3 months or less, and has come back once or not at all in the last 12 months (use our eczema visit).
Your worst itch and pain were only 0 to 3 out of 10 in the last week (use our eczema visit).
You have not used a steroid cream that a clinician prescribed for your hands, as directed, for at least 4 weeks in the last 12 months, no clinician told you that steroid creams are not advisable for your hands, and steroid creams have not caused you a problem, like thin skin, easy bruising, or an allergic reaction (use our eczema visit).
If more than one fits, follow the first one.

What to have ready

4 photos in daylight with no flash: the back and the palm of each hand
Who told you that you have hand eczema, and when a clinician last looked at your hands in person, or a line from a clinic note
Which steroid cream a clinician prescribed for your hands, how long you used it, and how it worked
Every medicine, vitamin, and supplement you take, and any allergy or bad reaction to a medicine

What happens next

Standard

$59

Within 6 hours

Priority

$99

Within 3 hours

Rush

$149

Within 1 hour

Start the request on the website, answer a few questions to check that this visit fits you, and choose how fast you want an answer (the response window). If your concern still fits this service, a physician reviews it and sends you a secure update after you sign in. When appropriate, non-controlled prescriptions can be sent to your pharmacy, and a basic work or school note can be included at physician discretion.

Your physician

Every visit is personally reviewed by Ankur Fadia, MD. He is board-certified, has extra training in heart care (a cardiology fellowship), and is a member of Alpha Omega Alpha, a medical honor society. He is licensed in Virginia and West Virginia, and your care is never handed off to someone else.

About Ankur Fadia, MD Verify Virginia medical license Verify West Virginia medical license Verify board certification

Can you diagnose hand eczema online?

No. A doctor, nurse practitioner, or physician assistant must have looked at your hands in person and told you that you have hand eczema. The last in-person exam must be in the past 2 years, or you must have a note from that clinician about this same problem. This visit cannot tell you what a rash is. We do not order tests. Your photos help the doctor see that your hands look like what was diagnosed. If your photos show a warning sign from the lists on this page, you get no medicine. We tell you what that list says. If your photos do not look like moderate or severe hand eczema, you also get no medicine. We tell you to see your own doctor. If we find any of this out after you pay, the visit price is usually not refunded.

What does a steroid cream not working mean?

Steroid creams are the first treatment for hand eczema. This visit starts after a steroid cream that a clinician prescribed for your hands did not work well enough. You used it as directed for at least 4 weeks in the last 12 months, and your hand eczema did not clear well enough or came back. This visit also starts when a clinician told you that steroid creams are not advisable for your hands, or when they caused you a problem, like thin skin, easy bruising, or an allergic reaction. Use our eczema visit instead if all of these are true. You have not used a steroid cream that a clinician prescribed for your hands, as directed, for at least 4 weeks in the last 12 months. No clinician told you that steroid creams are not advisable for your hands. Steroid creams have not caused you a problem, like thin skin, easy bruising, or an allergic reaction.

Do you order blood tests or a skin check?

No. This visit orders no blood test, swab, patch test, skin biopsy, or scan, now or at any check-in. We ask about your history instead. If you already have a hepatitis B or C result, a patch test result, or a clinic note, you can type it in the notes box. The doctor reads it. If you were never tested for hepatitis B or C, ask your own doctor about a test before you start and while you use the cream. We cannot examine your skin. See your own doctor once a year for a skin check while you use the cream.

Will my insurance cover it?

We cannot file insurance approvals. Anzupgo is a brand-name cream. It can cost a lot, and your insurance may not cover it yet. Ask your pharmacy or your insurance plan what it will cost before you pay for the visit. You pay the pharmacy for the medicine. The visit price is shown before you pay. The maker lists savings programs for some people.

Can I start my leftover cream again if the eczema comes back?

No. A relapse is a new visit with the full questionnaire. Do not start the cream you have left on your own. Do not ask for more cream in a message. Start a new visit. You answer all the questions again and send new photos. The doctor decides before we send any cream. The visit price is shown before you pay. If you used this cream before, a clinician must have looked at your hands in person in the 12 months before the new visit.

Can I use this cream again later?

A new request needs a clinician to have looked at your hands in person in the 12 months before it. If that did not happen, please see your own doctor first. Each new visit asks all the questions again, and you send new photos. The doctor decides before we send any cream.

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