Q: I have early signs of skin irritation on my right thumb and fourth finger. I recently started working in a restaurant and I believe the source of the problem is constant contact with lemons. It happened before when I was a bartender and did not get any better until after I left that position. My question is what is the best topical treatment for this problem? And is there anything that would possibly work as a protective shield against the citric acid while I am at work so the problem doesn't get any worse?

A:You are having hand eczema of fingers which is aggravated by working with various irritants including lemon. The best treatment for such a problem is avoidance of the factors responsible for it and change of job with no such work. No other thing is best treatment. At the moment, you can use Propynate cream locally twice daily for a week and then switch over to MMS cream once daily for 2 weeks, that will make you feel better. Then regularly use vaseline or Dermashield cream on the hand after washing hand and before working with vegetables. Use protective gloves (long ones up to elbows) during work time. For further treatment consult your dermatologist.