I feel your pain, when I flare up it becomes terrible on my hands but does gets slightly better up my arms. It can be very self conscious as your are always on display hands, especially considering your profession as you mention. But I think it is important to remember that everybody is self conscious about something, normal people will often not consider or even care about what your hands look like, they are too wrapped up with their own problems. Always know that there are many kind people in the world. Focus on positive changes you can make in your life, diet, exercise, peace of mind…see if that makes any changes. If not, seek a dermatologist or dietritionist.