Article: First cream created to treat hand eczema approved to be rolled out on the NHS

Sly Saint

Sly Saint

Senior Member (Voting Rights)
The first cream created to treat hand eczema is to be rolled out on the NHS after winning approval from the health watchdog.

Trials show the cream, delgocitinib, significantly reduces itchiness and redness within days.

Applied twice a day, it also has far fewer side effects than current NHS treatments.
Hand eczema, which leaves hands and wrists weeping, cracked and sore, is most common in people such as hairdressers or cleaners who work with irritating chemicals.

Experts say the drug, which was approved by the National Institute for Health and Care Excellence (NICE) last week, could benefit more than 10,000 British sufferers.

‘Delgocitinib is marvellous because it appears to be very effective and safe,’ says Dr Anthony Bewley, consultant dermatologist at Barts Health NHS Trust in London, who led a major trial of the drug.
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In Daily Mail.
It was actually approved last year:

Delgocitinib approved to treat adult patients with moderate to severe chronic hand eczema​

The Medicines and Healthcare products Regulatory Agency has approved the medicine delgocitinib (Anzupgo) to treat moderate to severe chronic hand eczema in adults when topical corticosteroids are inadequate or inappropriate.
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www.gov.uk

Delgocitinib approved to treat adult patients with moderate to severe chronic hand eczema

The Medicines and Healthcare products Regulatory Agency has approved the medicine delgocitinib (Anzupgo) to treat moderate to severe chronic hand eczema in adults when topical corticosteroids are inadequate or inappropriate.
www.gov.uk www.gov.uk

I think the quoted figure of 10,000 in the Mail piece is way lower than the actual number of people who are affected, and it's certainly not only hairdressers and cleaners! Loads of people must get allergic contact dermatitis with many different potential allergens.

In Europe the new treatment is under 'additional monitoring'

Anzupgo | European Medicines Agency (EMA)

www.ema.europa.eu www.ema.europa.eu

I hope this does turn out to be 'effective and safe' in the long-term unlike the standard corticosteroid treatments, and note that under the NHS it will only be available to those who 'do not respond' to the standard treatment. How long, and up to what strength of corticosteroid treatment would this apply to I wonder. It's also only available on prescription (as it should be, up to 1% hydrocortisone cream is easily available otc) so will depend on your GP, or ,if you are lucky enough to see one, your dermatologist.
 
That would be amazing! Bane of my life for years.

Trouble is it's going to be buried deep in my medical records, because I was taught strategies to manage it by a couple of different nurses. It mainly involves wearing disposable gloves, which is a right royal pain as well as a significant cause of plastic pollution (re-usable gloves are too bulky, especially with severe hand arthritis).
 
Sly Saint said:
Unfortunately but not surprisingly (for me) I wouldn't be able to use it because of the base cream ingredients.

For those who maybe have problems with emollients that your skin tolerates I found this useful document.
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what i should have mentioned was the NHS Emollient guidance document is only helpful in so much as it shows that about 85% of the emollients prescribed by the NHS contain known sensitisers, and in the remaining 5 products, two contain lanolin, which a lot of people with any kind of skin problems cannot tolerate. They will prescribe the cheapest, and although it says that patients should be able to choose, they can only choose from this list, which is basically no choice at all. A number of the products also have serious warnings on them for ocular toxicity, these are actually one of the widest prescribed emollients.
 
I solved my hand eczema by stopping using handwash.

I don't react at all to Dermol 500, and my hands have been completely fine ever since I started using it—I forget I even have hand eczema until I run out. Expensive, but worth it for me.
 
Kitty said:
I solved my hand eczema by stopping using handwash.

I don't react at all to Dermol 500, and my hands have been completely fine ever since I started using it—I forget I even have hand eczema until I run out. Expensive, but worth it for me.
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Depending on which handwash you used, many of them contain isothiazolinones, see my various posts on these preservatives.

Dermol 500:
2 potential sensitisers in that product to watch out for.
The ingredients in Dermol 500 Lotion include:
  • Benzalkonium Chloride (0.1% w/w)
  • Chlorhexidine Dihydrochloride (0.1% w/w)
  • Liquid Paraffin (2.5% w/w)
  • Isopropyl Myristate (2.5% w/w)
  • Cetostearyl Alcohol
  • Macrogol Cetostearyl Ether Cetomacrogol 1000
  • Phenoxyethanol
  • Purified Water
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Cetostearyl alcohol and Phenoxyethanol (preservative)
 
Yes, but I'm clearly not sensitive to those—that's what's key. Finding something you can tolerate.
 
Kitty said:
Yes, but I'm clearly not sensitive to those—that's what's key. Finding something you can tolerate.
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but they are sensitisers, which means that a person may be ok with them now but with time and regular exposure can become allergic. That's why many people are fine with some products for years and then suddenly they're not.

So ok you might be alright with it but someone else might become sensitised. Personally I would prefer to avoid collecting any more sensitivities/allergies if I could avoid it.

eta:
scienceinsights.org

What Is a Sensitizer Chemical? Definition and Types

Sensitizer chemicals trigger immune reactions that can make you permanently reactive to a substance. Learn what they are, how they differ from irritants, and which ones are most common.
scienceinsights.org scienceinsights.org
 
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Sly Saint said:
but they are sensitisers, which means that you may be ok with them now but with time and regular exposure you can become allergic. That's why many people are fine with some products for years and then suddenly they're not.
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I'll just have to move on. Been 12-13 years so far, so I'll shear that yow when her turn comes!
 
Sly Saint said:
Phenoxyethanol (preservative)
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Moreover, the accumulation of phenoxyethanol in aquatic environments can have detrimental effects on marine life. Studies have indicated that in high concentrations, phenoxyethanol can be toxic to aquatic organisms, affecting their reproduction and growth rates. An article in the Aquatic Toxicology journal pointed out that phenoxyethanol could have adverse effects on fish, causing alterations in their hormonal and metabolic processes.

The rate at which phenoxyethanol is broken down in the environment also depends significantly on certain conditions, such as temperature, the presence of sunlight, and the type of microorganisms available. These factors greatly influence the persistence of phenoxyethanol in the environment and its potential to cause harm.

It's important to note, too, that the environmental impact of phenoxyethanol is not solely a consequence of its physical and chemical properties. The volume of its use in consumer products and the efficiency of wastewater treatment plants in removing this compound before it's discharged into natural water bodies play a significant role. Enhancements in wastewater treatment technologies may reduce the environmental load of phenoxyethanol, but the increasing use of this compound in a wide array of products suggests that more comprehensive measures may be necessary.
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