Dyshidrotic eczema, or dyshidrosis, is a skin condition in which blisters develop on the soles of your feet and/or the palms of your hands. The blisters are usually itchy and may be filled with fluid. Blisters normally last for about two to four weeks and may be related to seasonal allergies or stress.
What causes dyshidrotic eczema?
The exact cause of dyshidrotic eczema is unknown. Experts believe that the condition may be related to seasonal allergies, such as hay fever, so blisters may erupt more frequently during the spring allergy season.
Who is at risk for developing dyshidrotic eczema?
Doctors believe that you have a greater chance of developing the condition if you’re experiencing a high level of stress (either physical or emotional) or have allergies. Some doctors think that dyshidrotic eczema may be a type of allergic reaction. You may be more likely to develop dyshidrotic eczema if your hands or feet are often moist or in water, or if your work exposes you to metal salts, such as cobalt, chromium, and nickel.
Dyshidrotic eczema in children
Eczema, or atopic dermatitis, is more common in children and infants than in adults. About 10 to 20 percent have some form of eczema. However, half will outgrow atopic dermatitis or eczema by adulthood.
Conversely, dyshidrotic eczema can affect children, but it’s usually seen in adults ages 20–40.
Symptoms of dyshidrotic eczema
If you have dyshidrotic eczema, you’ll notice blisters forming on your fingers, toes, hands, or feet. The blisters may be more common on the edges of these areas and will probably be full of fluid.
Sometimes, large blisters will form, which can be particularly painful. The blisters will usually be very itchy and may cause your skin to flake. Affected areas may become cracked or painful to the touch.
The blisters may last up to three weeks before they begin to dry. As the blisters dry up, they’ll turn into skin cracks that may be painful. If you’ve been scratching the affected areas, you may also notice that your skin seems thicker or feels spongy.
How is dyshidrotic eczema diagnosed?
In many cases, your doctor will be able to diagnose dyshidrotic eczema by examining your skin carefully. Because the symptoms of dyshidrotic eczema can be similar to those of other skin conditions, your doctor may choose to run certain tests. The tests may include a skin biopsy, which involves removing a small patch of skin for lab testing. The biopsy can rule out other possible causes of your blisters, such as a fungal infection. If your doctor believes that your outbreak of dyshidrotic eczema is directly related to allergies, they may also order allergy skin testing.
How is dyshidrotic eczema treated?
There are a number of ways that a dermatologist can treat dyshidrotic eczema. The severity of your outbreak and other factors determine which treatments they will suggest. It also may be necessary to try more than one treatment before finding the right one for you.
Medications or medical treatments
For mild outbreaks, medications include corticosteroid cream or ointment that you apply directly to your skin. For more severe outbreaks, you may be prescribed a topical steroid, steroid injection, or pill. Other medical treatments used are:
- UV light treatments
- draining large blisters
- various anti-itch creams
- immune-suppressing ointments, such as Protopic and Elidel (this is a rare treatment option)
If your skin becomes infected, then you will also be prescribed antibiotics or other medications to treat the infection.
Over the counter
If you’re having a mild outbreak of dyshidrotic eczema, your doctor may prescribe antihistamines such as Claritin or Benadryl to help decrease your symptoms.
Soaking your hands and feet in cool water or applying wet, cold compresses for 15 minutes at a time, two to four times a day, can help reduce the discomfort associated with itchy skin. Your doctor may recommend that you apply an ointment or rich moisturizer after you use compresses. A moisturizer may also help with the dryness, and therefore reduce some itching as well. These moisturizers may include:
- petroleum jelly, such as Vaseline
- heavy creams, such as Lubriderm or Eucerin
- mineral oil
- soaking with witch hazel
Changing your diet may help if medications don’t seem to be keeping up with flare-ups. Since it is believed that a nickel or cobalt allergy can cause eczema, removing foods that contain these may help. Some have said that adding vitamin A to your diet will help, but be sure to ask your doctor before doing so.
Treatment for feet
Dyshidrosis can also occur on the soles of your feet, although it’s not as common as on your fingers or the palms of your hands. The treatment for your feet is similar to the treatment for other areas. To avoid making your pain and itching worse, try not to scratch or break your blisters. Although it’s important to wash your hands regularly, you may want to avoid extensive contact with water, such as frequent hand-washing. You should also avoid using products that can irritate your skin, such as perfumed lotions and dishwashing soap.
Complications of dyshidrotic eczema
The main complication from dyshidrotic eczema is usually the discomfort from itching and the pain from the blisters. This can sometimes become so severe during a flare that you are limited in how much you use your hands or even walk. There is also the possibility of getting an infection in these areas. In addition, your sleep may be disrupted if the itching or pain are severe.
Prevention and control of outbreaks
Unfortunately, there is no proven way to prevent or control outbreaks of dyshidrotic eczema. The best advice is to help strengthen your skin by applying moisturizers daily, avoiding triggers such as perfumed soaps or harsh cleansers, and staying hydrated.
What can be expected in the long term?
Dyshidrotic eczema will usually disappear in a few weeks without complications. If you don’t scratch the affected skin, it may not leave any noticeable marks or scars. If you scratch the affected area, you may experience more discomfort or your outbreak may take longer to heal. You could also develop a bacterial infection as a result of scratching and breaking your blisters. Although your outbreak of dyshidrotic eczema may heal completely, it can also recur. Because the cause of dyshidrotic eczema isn’t known, doctors have yet to find ways to prevent or cure the condition.