Topical timolol, a novel therapeutic option for chronic hand eczema: a randomized double blind-controlled study

Chronic hand eczema (CHE) is a relapsing inflammatory skin condition often treated with topical corticosteroids, which can cause long-term adverse effects. Topical timolol, a non-selective beta-blocker, has shown promise as an alternative therapy. This study aims to compare the efficacy and safety of topical timolol 0.5% versus desoximetasone 0.25% in CHE. In this randomized, double-blind study, CHE participants applied timolol and desoximetasone to opposite hands twice daily for 8 weeks, followed by 4 weeks of petrolatum application. The Hand Eczema Severity Index (HECSI), itching, disease severity, and adverse events were assessed. Total nineteen participants completed the study. Both treatments significantly reduced HECSI scores (p < 0.05) with no significant difference between groups. A rebound phenomenon occurred after desoximetasone discontinuation. Timolol was associated with dryness, itchiness, cracking, and stinging, while desoximetasone caused epidermal atrophy and hypopigmentation. No serious adverse events were reported. In conclusion, timolol is an effective and safe treatment and may be an alternative therapeutic option for CHE.