Hand eczema (HE) is commonly used to describe inflammation of the hands characterized by redness, scaling, edema, vesicles, hyperkeratosis, fissures, and erosions1. Exogenous HE comprises of irritant contact dermatitis, atopic contact dermatitis, and urticaria/protein contact dermatitis; endogenous HE comprises atopic HE, hyperkeratotic, and acute recurrent vesicular2. Contact dermatitis is related to domestic or occupational exposures such as detergent, soap, diapers, dye, chemicals, cosmetics, or metal accessories3. The range of HE prevalence in studies is relatively wide. In a Norwegian cohort, the lifetime prevalence of HE was 11.3%, and work-related HE was 4.8%4. Lifetime prevalence reached 15% according to a review study5. Among the ∼22,000 patients who visited the dermatology department of 24 university hospitals in South Korea that were diagnosed with a skin disease of the hands, 36.3% were irritant contact dermatitis, and 9.7 % were allergic contact dermatitis6.

HE is mainly treated by topical corticosteroids, UV light, and systematic therapy depending on the severity of symptoms7. Avoiding risk factors and changing lifestyles are also needed. Unfortunately, the prognosis of HE is poor. According to a 15-year follow-up study in Sweden, 12% of HE patients complained of continuous eczema during the period8. In another study of occupational HE in Denmark, only 19.3% of patients were completely healed at the 5-year-follow-up9.

Topical cream containing bee venom has shown a therapeutic effect on atopic dermatitis (AD) by reducing inflammation10,11. This study hypothesized that bee venom acupuncture (BVA) is effective for eczema and contact dermatitis. With the two case reports here, we aim to suggest alternative treatments for HE by providing insights into the effectiveness of BVA and herbal medicine. Further, we conduct an animal study to verify the effect of BVA on eczema, especially focusing on the benefits of co-administration with herbal medicine.