Also known as dyshidrotic eczema or pompholyx, dyshidrosis is an uncommon skin condition in which very small, fluid-filled blisters appear on the palms of your hands and the sides of your fingers. The soles of your feet can be affected too.
The blisters are usually small and typically appear in clusters. In more severe cases, the small blisters may merge together to form larger blisters. Skin affected can be very itchy or even painful. Once the blisters dry and flake off, which occurs in about two to four weeks, the underlying skin may be red and tender.The blisters tend to recur, sometimes before your skin heals completely from the previous blisters.As the blisters dry up, they’ll turn into skin cracks that may be painful. If you have been scratching the affected areas, you may also notice that your skin seems thicker or feels spongy. Dyshidrosis tends to recur fairly regularly for months or years.
The cause of dyshidrosis is unknown. However, it can be associated with a similar skin disorder called atopic dermatitis, as well as with allergic conditions, such as hay fever. Eruptions may be seasonal in people with nasal allergies. Risk factors include:
- – Stress – It appears to be more common during times of stress.
- – Exposure to certain metals – These include chromium, cobalt and nickel, usually in an industrial setting.
- – Sensitive skin – People who develop a rash after contact with certain irritants are more likely to experience it.
- – Atopic eczema – Some people with atopic eczema may develop dyshidrotic eczema.
You may be more likely to develop dyshidrotic eczema if your hands or feet are often moist or in water.
Tests and Diagnosis
In most cases, your doctor can diagnose dyshidrosis based on a physical exam. No lab test can specifically confirm a diagnosis, but your doctor may suggest tests to rule out other skin problems with symptoms. Skin allergies and sensitivities can be revealed by exposing patches of your skin to various substances.
Treatments and Drugs
Depending on the severity of your signs and symptoms, treatment options may include:
- – Corticosteroids – High-potency corticosteroid creams and ointments can help speed up the disappearance of the blisters. Wrapping the treated area in plastic wrap can improve absorption. Moist compresses also may be applied after the application of a corticosteroid to enhance the absorption of the medication. In severe cases, your doctor may prescribe corticosteroid pills, such as prednisone. Long-term use of steroids can cause serious side effects though.
- – Phototherapy – If other treatments aren’t effective, your doctor may recommend a special kind of light therapy, that combines exposure to ultraviolet light with drugs, that help make your skin more receptive to the effects of this type of light.
- – Immune-suppressing ointments – Medications such as tacrolimus (Protopic), and pimecrolimus (Elidel), may be helpful for people who want to limit their exposure to steroids. However, these drugs can increase the risk of skin infections.
- – Coal tar preparations – For severe cases.
- – Botulinum toxin injections – Some doctors may consider recommending these injections to treat severe cases. However, this is a relatively new treatment option that has not yet gained general acceptance.
If you’re having a mild outbreak of dyshidrotic eczema, your doctor may prescribe mild antihistamines to help decrease your symptoms. Wet compresses can also help reduce the discomfort associated with itchy skin.
Your doctor may also suggest using the following twice a day to relieve itching:
- – petroleum jelly
- – heavy creams
- – mineral oil
- – steroid or corticosteroid ointments.
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.
Home treatment might include:
- – Compresses – Wet, cool compresses to help reduce itching.
- – Antihistamines – Over-the-counter antihistamine medications can help relieve itching.
- – Witch hazel – Soaking the affected areas in witch hazel may speed healing.
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, 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.
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