What is Dyshidrotic Eczema
Dyshidrotic eczema (pompholyx) is a type of eczema that causes very itchy (pruritic), fluid-filled blisters (vesicles) to form on the hands and feet.
It can affect people of any age, but is more common before the age of 40. There is no cure, but treatment and certain lifestyle changes can help relieve symptoms.
What are the causes?
The cause of this condition is not known.
What increases the risk?
You are more likely to develop this condition if:
- You wash your hands frequently.
- You have a personal history or family history of eczema, allergies, asthma, or hay fever.
- You are allergic to metals such as nickel or cobalt.
- You work with cement.
- You smoke.
What are the signs or symptoms?
Symptoms of this condition may affect the hands, feet, or both. Symptoms may come and go (recur), and may include:
- Severe itching, which may happen before blisters appear.
- Blisters.
These may form suddenly.
- In the early stages, blisters may form near the fingertips.
- In severe cases, blisters may grow to large blister masses (bullae).
- Blisters resolve in 2–3 weeks without bursting. This is followed by a dry phase in which itching eases.
- Pain and swelling.
- Cracks or long, narrow openings (fissures) in the skin.
- Severe dryness.
- Ridges on the nails.
How is this diagnosed?
This condition may be diagnosed based on:
- A physical exam.
- Your symptoms.
- Your medical history.
- Skin scrapings to rule out a fungal infection.
- Testing a swab of fluid for bacteria (culture).
- Removing and checking a small piece of skin (biopsy) in order to test for infection or to rule out other conditions.
- Skin patch tests. These tests involve taking patches that contain possible allergens and placing them on your back. Your health care provider will wait a few days and then check to see if an allergic reaction occurred. These tests may be done if your health care provider suspects allergic reactions, or to rule out other types of eczema.
You may be referred to a health care provider who specializes in the skin (dermatologist) to help diagnose and treat this condition.
How is this treated?
There is no cure for this condition, but treatment can help relieve symptoms. Depending on how many blisters you have and how severe they are, your health care provider may suggest:
- Avoiding
allergens, irritants, or triggers that worsen symptoms. This may involve
lifestyle changes such as:
- Using different lotions or soaps.
- Avoiding hot weather or places that will cause you to sweat a lot.
- Managing stress with coping techniques such as relaxation and exercise, and asking for help when you need it.
- Diet changes as recommended by your health care provider.
- Using a clean, damp towel (cool compress) to relieve symptoms.
- Soaking in a bath that contains a type of salt that relieves irritation (aluminum acetate soaks).
- Medicine taken by mouth to reduce itching (oral antihistamines).
- Medicine applied to the skin to reduce swelling and irritation (topical corticosteroids).
- Medicine that reduces the activity of the body’s disease-fighting system (immunosuppressants) to treat inflammation. This may be given in severe cases.
- Antibiotic medicines to treat bacterial infection.
- Light therapy (phototherapy). This involves shining ultraviolet (UV) light on affected skin in order to reduce itchiness and inflammation.
Follow these instructions at home:
Bathing and skin care
- Wash skin gently. After bathing or washing your hands, pat your skin dry. Avoid rubbing your skin.
- Remove all jewelry before bathing. If the skin under the jewelry stays wet, blisters may form or get worse.
- Apply
cool compresses as told by your health care provider:
- Soak a clean towel in cool water.
- Wring out excess water until towel is damp.
- Place the towel over affected skin. Leave the towel on for 20 minutes at a time, 2–3 times a day.
- Use mild soaps, cleansers, and lotions that do not contain dyes, perfumes, or other irritants.
Keep your skin hydrated. To do this:
- Avoid very hot water. Take lukewarm baths or showers.
- Apply moisturizer within three minutes of bathing. This locks in moisture.
Medicines
- Take and apply over-the-counter and prescription medicines only as told by your health care provider.
- If you were prescribed antibiotic medicine, take or apply it as told by your health care provider. Do notstop using the antibiotic even if you start to feel better.
General instructions
- Identify and avoid triggers and allergens.
- Keep fingernails short to avoid breaking open the skin while scratching.
- Use waterproof gloves to protect your hands when doing work that keeps your hands wet for a long time.
- Wear socks to keep your feet dry.
- Do notuse any products that contain nicotine or tobacco, such as cigarettes and e-cigarettes. If you need help quitting, ask your health care provider.
- Keep all follow-up visits as told by your health care provider. This is important.
Contact a health care provider if:
- You have symptoms that do not go away.
- You
have signs of infection, such as:
- Crusting, pus, or a bad smell.
- More redness, swelling, or pain.
- Increased warmth in the affected area.
Summary
- Dyshidrotic eczema (pompholyx) is a type of eczema that causes very itchy (pruritic), fluid-filled blisters (vesicles) to form on the hands and feet.
- The cause of this condition is not known.
- There is no cure for this condition, but treatment can help relieve symptoms. Treatment depends on how many blisters you have and how severe they are.
- Use mild soaps, cleansers, and lotions that do not contain dyes, perfumes, or other irritants. Keep your skin hydrated.
