My son had, I say had with a great big smile on my face, as he finally is free of the excema he has had since he was 18 months old, he is now 16. We tried everything but all I can suggest you do is use is Coconut oil, this is the one thing that has worked. A long time ago we realised that he was allergic to the creams the doctors were giving him, thinking about it was probably one of the ingredients which popped up in creams and lotions.
A few years ago, I bought a large tub of coconut oil from Holland and Barratt, it is in their food section, you bring it home and keep it in the fridge to keep it 'fresh'. Only remove enough of the soild white oil using a clean tablespoon, I use to run it under the hot water tap, dry it with a fresh piece of paper towel and put a large tablespoon of the oil in a small bowl (which also had been under the running hot tap and patted dry). This is to stop cross contamination, I prepared a bowl for each foot and each hand.
His excema was very bad and I was very consious of transfereing the infection, which I think may have happened in your clients case, he has been using his hands to rub cream into his feet and infection has happened to spread to his hands? Alternativly he had an infection in his hands and this has spread to his feet?
For my son we found that a short course of antibiotics helped with the initial healing of the excema, then continue with a longer, lower dose of the antibiotics to stop infection re-occuring. He will have to suggest this to his GP as they often dont realise this will help.
Then every evening we used the coconut oil, I had a bowl prepared for each foot and hand (I would avoid using any essential oils until the cuts/welts have healled as it is very painful).
Then I would wear disposable gloves and massage/work in the oil on one foot first and then dispose of the gloves and then use a fresh pair of gloves and work on the other foot. I would have a clean pair of cotton socks ready to put on each foot after the treatment as this will help work the oil into the feet and then he was ready until he went to bed. Before he got into bed I would do each hand, using fresh disposable gloves and pop another clean sock over each hand, this also helped with the itching. He always wore cotton PJ's to bed and a long sleeved cotton T Shirt I tucked the PJ trousers into his socks and the T Shirt sleeves also went into the socks as this stopped him itching and gave him a bit of restful sleep. I did also use the antihystermine at night as this stopped the 'itch' but your client would also need to discuss this with the GP.
Your client should be doing this at home every night, he can also use disposable gloves on his hands, do one foot, then the other, once he is ready for bed do each hand.
Tell him not to use a washing 'powder' as they are not always washed out of the clothes, this can iritate the skin. Dont use fabric softner's either. I use to use the 'baby' products but found out that they didnt clean mud splattered clothes so I use Persil bio tabs, but only put one tab in the washing machine not the two they recommend. It took a few trys until I found a liquid that didnt irritate his skin, but this worked and I use a 'hot' wash, with plenty of rinse cycles.
But the big thing was to use clean socks every night, when he was particularly bad he had a complete set of PJ's as he was like a lizzard shedding skin every night. I also use to vacume the bed and his bedroom every day, evan change the bedding when he was particullary bad. We had to adjust his bedding as he was well wrapped up to make sure he didnt over heat.
Thinking back his 'sugar' intake has gone down, he doesnt want what all the other kids want and this has had an impact on his skin condition. For an adult think about the hidden sugars, ie alcohol this may help, what is his diet like?
A skin condition will not recover overnight and you may think it is on the mend and stop the regime, but do keep on, even after the antibiotics are finished at least for a few weeks. Steve still sleeps with socks on as it does 'protect' his skin when it does itch but thankfully for him he has been clear for quite some time. But I wont say it too loud.
The other thing he found soothing when his feet were really itchy, was to make a bowl up of warm water (not hot - this makes the itch worse) and use 'dead sea salt' a good handful in a kitchen plastic bowl, fill with warm water and he would sit and watch TV with his feet in the water. The water will hydrate the skin as well, pat dry and pop on clean cotton socks until he is ready for the coconut oil. The bowl needs to be rinsed out very well before and after use. I still have the bowl, which thankfully hasnt been used for a long time.
Finally, good luck as it is a long term problem.
Fudge