We have compared the efficacy of local UVB phototherapy with topical (bath) photochemotherapy in 13 patients with bilateral chronic hand dermatitis. In each patient, one hand was treated with UVB phototherapy and the other hand with topical (bath) photochemotherapy. Both treatments moderately improved the chronic hand dermatitis after 6 weeks' treatment. We observed no significant differences in improvement between the modalities, but side-effects occurred more often on the photochemotherapy-treated side. Considering the similar responses and relative incidence of side-effects, we would advise starting treatment with UVB phototherapy and only using topical photochemotherapy if this fails.