Since using a strong topical steroid like clobetasol propionate with salicylic acid for a year has not provided relief, it is important to consult your dermatologist to adjust your plan. Long-term steroid use on the hands can thin the skin. Alternative topical options include vitamin D analogs (calcipotriol), calcineurin inhibitors (tacrolimus), or coal tar preparations. If topicals are ineffective, your doctor may suggest phototherapy (light therapy) or systemic medications such as methotrexate, acitretin, or modern biologics. Meanwhile, keep your hands hydrated with thick, fragrance-free moisturizers and wear protective gloves during daily chores to prevent further irritation.