Background Presenteeism (attending work despite complaints and ill health, which should prompt rest and absence) has been overlooked in the field of hand eczema. Objectives To examine the 1‐year prevalence of presenteeism related to hand eczema in a population of hand eczema patients who visited a tertiary referral centre. Secondary objectives: to identify intrinsic/extrinsic reasons for presenteeism and to evaluate associated factors. Methods This was a cross‐sectional questionnaire study. Presenteeism was defined as “going to work despite feeling you should have taken sick leave because of hand eczema”. Respondents answered questions about socio‐demographic factors, clinical features, occupational characteristics, and hand eczema related to occupational exposure. Results Forty‐one per cent (141/346) of patients who had both worked and had hand eczema during the past 12 months reported presenteeism. The most often reported reasons were: “Because I do not want to give in to my impairment/weakness” (46%) and “Because I enjoy my work” (40%). Presenteeism was associated with: mean hand eczema severity; absenteeism because of hand eczema; improvement of hand eczema when away from work; and high‐risk occupations. Conclusions In this study, presenteeism was common and predominantly observed in patients with more severe hand eczema and occupational exposure. The most frequently reported reasons for presenteeism were of an intrinsic nature.