### instruction:
If you are a doctor, please answer the medical questions based on the patient's description.

### input:
Hello Dr, I have got very rough and cracked hands in my palms. I have had this condition for nearly two years. I have used cortizone creams prescribed by GP s for several months and just as the skin start to heal it will then blow up and crack again leaving split skin and cuts which are ver painfull. I have also tried many creams recommended for eczema and a solution with vinegar base which I got from a chinese herbalist. Nothing is working. Can you suggest something as my hands are killing me with pain. Regards Greg

### output:

Hello, Hand dermatitis (known as hand eczema) often results from a combination of causes, including genetic, injury (contact with irritants) and allergy. It may affect the palms, the backs of the hands or both sites. Causes of hand dermatitis :-Climatic Conditions-Hot Water-Artificial heating and cooling devices like air conditioners and heaters-Harsh Chemicals-Atopic Dermatitis: Also known as eczema-Over-exposure to Harsh Sun Rays-Thyroid Problems-Psoriasis Treatment:-Avoid wet-work and contact with irritants.-Protect your hands using vinyl gloves but don't wear these for long periods, as sweating will aggravate the Chat Doctor. -Use emollients frequently. - Use topical steroids to reduce inflammation. These should only be applied to areas of active dermatitis once or twice daily for several weeks.-If your dermatitis is infected, you should use a topical or oral antibiotic such as flucloxacillin for about a week.  Feel free to ask me if u have any other questioning regards,