How Is Dyshidrotic Eczema Treated
Knowing your triggers and maintaining a regular skincare routine can help prevent and manage dyshidrotic eczema flares. Helpful steps can include:
- Wash the affected skin with a mild cleanser and gently pat dry.
- Apply a heavy cream with ingredients like ceramides to help repair the skin barrier.
- Remove rings and other jewelry when you wash your hands so water doesnt linger on you skin.
- Wash then moisturize hands or feet immediately after coming into contact with a potential trigger.
- Use stress management techniques.
- Keep fingernails short to help prevent scratching from breaking the skin.
Dermatologists can usually diagnose dyshidrotic eczema with a skin exam and medical history. Many cases improve quickly with a short course of topical corticosteroids combined with soaking or applying cool compresses to affected areas a few times a day to help dry out blisters. Because this form of eczema is sometimes linked to a fungal infection on the hands or feet, your dermatologist may prescribe an anti-fungal medication if needed.
Areas of dyshidrotic eczema are also at risk for bacterial skin infections, which can delay or prevent healing. If you develop swelling, crusting, pain or pus-filled blisters, visit your dermatologist to check for bacterial infection, which requires treatment with oral antibiotics.
What Are The Complications Of Vesicular Hand/foot Dermatitis
Infected vesicular hand dermatitis
- Soothing emollient lotions and creams
- Potent antiperspirants applied to palms and soles at night
- Protective gloves should be worn for wet or dirty work
- Well-fitting footwear, with 2 pairs of socks to absorb sweat and reduce friction.
- Note that cream cleansers are not antimicrobial soap and water or a sanitiser is needed for washing hands in order to destroy pathogens such as the SARS-CoV-2 virus responsible for COVID-19.
People with vesicular hand dermatitis found to be allergic to nickel must try to avoid touching nickel items.
Dyshidrotic Eczema Can Affect Your Quality Of Life
When you have blisters on your feet, wearing shoes can feel painful. Some people who get blisters on their feet say its too painful to walk until the blisters clear.
Flare-ups that lead to blisters on the hands can cause other problems. During flare-ups, the pain can limit what you can do with your hands. An auto mechanic or florist may be unable to perform certain jobs.
Some people are more likely than others to develop dyshidrotic eczema. To find out if you have an increased risk, go to, Dyshidrotic eczema: Causes.
Images used with permission of DermNet NZ: 2,3,4,6,7, 8
ReferencesAmini S, Burdick AE, et al. James WD. Dyshidrotic eczema . Medscape. Last updated 4/22/2020. Last accessed 9/30/2020.
Geria AN, Alexis AF. Atopic dermatitis and other eczemas. In: Taylor and Kellys Dermatology for Skin of Color. . McGraw Hill, USA, 2016:171.
McGovern TW. Dermatitis . In: Fitzpatrick JE, et al. Dermatology Secrets. Hanley & Belfus, Inc., USA, 1996:47-48.
Petering H, Christine Breuer C, et al. Comparison of localized high-dose UVA1 irradiation versus topical cream psoralen-UVA for treatment of chronic vesicular dyshidrotic eczema. J Am Acad Dermatol 2003 50:68-72.
Reider N, Fritsch PO. Other eczematous eruptions. In: Bolognia JL, et al. Dermatology. . Mosby Elsevier, China, 2018: 237-8.
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What To Do At Home
To help prevent hand eczema:
- Wear rubber or latex gloves to protect hands from harsh soaps and detergents when washing the dishes or cleaning.
- Use lukewarm water and a small amount of mild soap when washing your hands.
- Apply prescribed medicated creams and ointments after washing. Then apply a moisturizer.
- Use a fragrance-free, gentle moisturizer during the day. Some examples are: Dove®, Aveeno®, CeraVe®, Cetaphil®, Eucerin® and Aquaphor®.
- Wear warm cotton gloves outside in cold weather to prevent dry, chapped skin.
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Emollients For Treating Eczema
Emollient creams add moisture to the skin. Apply moisturisers each day to clean, dry skin. It is especially important to moisturise after showering and bathing, and when living or working in an air-conditioned or heated environment. You may need to try several different brands until you find the emollient that works best for you. Ask your doctor, dermatologist or pharmacist for advice.
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What Is Vesicular Hand Dermatitis
Vesicular hand dermatitis is a form of hand eczema characterised by vesicles or bullae . A similar condition can affect the feet .
The most common variant of vesicular hand dermatitis is also called vesicular endogenous eczema, dyshidrotic eczema, and pompholyx cheiropompholyx affects the hands and pedopompholyx affects the feet.
Vesicular hand/foot dermatitis
Stress Bumps On Fingers: Eczema Hives Or Something Else
Medically Reviewed By: Melinda Santa
Hands are important tools in most peoples’ arsenal. You use your hands to gesture, work, eat, clean yourself, and function daily. It takes a lot to impair your hands typically, but they can be taken out of commission by breaks, fractures, burns, blisters, and similar conditions – some of which can be brought about by stress.
How Does Stress Affect Your Body?
Stress affects your body in numerous ways. A single stress response can trigger an immediate reaction involving taut muscles, sweating, a racing heart, and rapid breathing. This response is an important one: it allows your body to react quickly and effectively to a threat. Stress responses can help you run from predators or defend yourself in an attack due to a heightened sensitivity to your surroundings and improved reaction speed.
Stress And Your Skin
Inflammatory responses are also common in the skin when stress leaps up. Existing conditions like psoriasis and eczema can be worsened by the presence of stress, causing the spread of the conditions or increased symptoms, such as itching and irritation. Stress can also cause hives, which are typically reserved for allergic responses, and a specific type of eczema, both characterized by itchy, red, and inflamed bumps on the skin.
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What If Home Treatment Isnt Enough For Dyshidrosis
Sometimes doctors recommend prescription-strength creams, like clobetasol. These treatments can reduce pain and itching.
In more severe cases, skin care routines and medications like antihistamines are not enough to control symptoms. If other treatments do not work, your doctor may recommend further treatment options, including:
- Systemwide corticosteroids: Sometimes, topical corticosteroids are not enough to relieve symptoms. Your doctor may prescribe an oral or injectable corticosteroid, such as prednisone .
- System wide non-steroidal immune suppression: Long term use of oral steroids is not recommended. Medications such as methotrexate or mycophenolate mofetil may be used in treating chronic disease.
- Exposing your skin to UV light may improve symptoms. You may receive phototherapy treatments at your doctors office or at a hospital.
Can Dyshidrosis Be Prevented
Dyshidrosis is a chronic, or lifelong, medical condition. While it may not be possible to prevent dyshidrosis, you can take action to reduce your likelihood of further flare-ups.
Prevention methods include a good skin care routine and medications such as antihistamines to manage symptoms. Further therapies, like phototherapy, can help as needed.
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Skin Changes Can Develop Over Time
Whether you get new blisters monthly, yearly, or somewhere in between, repeated flare-ups can cause changes to your skin and nails.
These changes include:
Dry, thick skin that itches all the time
When this happens, the skin can become inflamed, as shown here. Sometimes, the skin between your fingers or toes develops a soft, spongy texture.
The skin may feel scaly and have deep, painful cracks.
People who have long-standing dyshidrotic eczema can develop the nail changes shown here. The nails can develop pits and ridges, grow thick, and show discoloration.
What Are The Symptoms Of Dyshidrotic Eczema
Flares happen only on the hands and feet and usually begin with a rash of painful, deep-seated blisters called vesicles, although sometimes itching and burning sensations begin first. As blisters heal, the skin dries and often reddens and peels. This leaves it tender and dry and sometimes creates painful fissures or cracks. Skin can also become infected.
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Atopic Eczema On The Feet
Atopic eczema is a hereditary condition with alternating periods of eczema flare-ups and remission. It is linked to skin which is hypersensitive to its environment. Although genetic, the disease can be triggered or aggravated by various environmental factors.
This type of eczema rarely affects the feet . The treatment is the same for all types of atopic eczema: soothe itching with a topical corticosteroid and repair the skin with emollients.
Why Does Eczema Appear On The Hands
There can be a variety of reasons why eczema appears on the hands. For example, the hands can be affected by irritant or allergic contact dermatitis or both at the same time.
Coming into contact with irritants such as dust, detergents, cleaning agents, airborne sprays or even just frequent hand-washing can cause irritant hand eczema . The skin on the palms of the hands is much thicker than elsewhere on the body and is normally able to withstand a great deal of wear and tear. But in people who regularly immerse their hands in detergents or solvents, the protective barrier of the skin breaks down, and eczema may develop. People who have this form of hand eczema often have a history of eczema in childhood.
Allergic hand eczema arises as a result of an allergic reaction to a particular substance in the environment. It is possible to be allergic to a number of different substances, but common causes of contact sensitivity include nickel, fragrances, preservative chemicals, rubber and various plants, amongst other things. Once a persons immune system has identified a substance as harmful, they will react to the substance every time their skin is exposed to it, and this reaction becomes more severe on every exposure to the allergen.
When an allergic reaction of this kind is suspected, your GP should refer you to a dermatologist, who will normally perform patch tests to try to identify the allergic cause.
Infective Causes Of Blistering
Herpes simplex and herpes zoster
Herpes simplex and herpes zoster cause painful blisters. Both start as a red macule, which soon becomes raised and forms a vesicle. Pain preceding the appearance of the skin lesions is a very important clue to this diagnosis.
Herpes simplex causes small, closely grouped vesicles on a red base and these can be located anywhere on the body, not just the most common sites .
Herpes zoster lesions are more linear and restricted to one side of the body following a dermatome. In immunosuppressed people or patients on chemotherapy, this condition can involve several dermatomes.
Herpes simplex can be treated with either topical or oral aciclovir. Frequent recurrences may need an extended course of oral aciclovir. In immunosuppressed patients, herpes simplex can become generalised and may be life-threatening. In this situation, hospital admission and IV antivirals will be necessary.
Treating herpes zoster with antivirals has been shown to reduce the acute pain, virus shedding, rash and the incidence and severity of post-herpetic neuralgia.2
Eczema herpeticum is a condition with a somewhat misleading name, as it suggests there has to be eczema, but any skin problem that breaches the skin barrier can be complicated by herpes simplex . Often mistaken for impetigo, it consists of small, very even, punched-out blisters, which look as if someone has tried to take shallow punch biopsies.
What Is Dyshidrotic Eczema
Dyshidrotic eczema causes small, intensely itchy blisters on the palms of hands, soles of feet and edges of the fingers and toes. While the actual cause of dyshidrotic eczema isnt known, it is more common in people who have another form of eczema and tends to run in families, suggesting a genetic component.
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What Causes Eczema Blisters: Diagnosis Symptoms And Treatment
Dyshidrotic eczema causes horrifically painful blisters that itch excessively on the hands and feet. You are probably wondering what causes eczema blisters. Many things cause the blisters on feet and on fingers. We will explore the disorders causes and treatment in this article. Please continue reading to learn more.
How Long Does It Last
In many cases, pompholyx will clear up on its own within a few weeks. The treatments below may help relieve your symptoms in the meantime.
Sometimes pompholyx may just occur once and never come back, but it often comes and goes over several months or years. Any of the triggers mentioned above can cause it to flare up again.
Occasionally, pompholyx can be more continuous and difficult to treat.
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Dyshidrotic Eczema In Children
Conversely, dyshidrotic eczema can also affect children, but its rare.
The first symptoms of a dyshidrotic eczema flare may be a burning, itching sensation without any visual clues.
Tiny, itchy blisters might then develop, most likely on your:
In severe cases, the blisters can expand to the back of hands, limbs, and feet.
These tiny blisters can grow together and form larger areas that are very itchy, red, and raised. If the skin becomes infected, the blisters can become painful and ooze pus.
Typically, dyshidrotic eczema heals on its own in 3 to 4 weeks, but as the blisters heal, they can cause your skin to become very dry and peel. Individuals with a darker skin tone may develop dark spots where the blisters have healed.
Managing And Treating Dyshidrotic Eczema
How to manage and help relieve your child’s dyshidrotic eczema? Follow these tips:
All health-related content on this website is for informational purposes only and does not create a doctor-patient relationship. Always seek the advice of your own pediatrician in connection with any questions regarding your babys health.
These statements have not been evaluated by the Food and Drug Administration. Products are not intended to diagnose, treat, cure or prevent any disease.
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Who Gets Dyshidrotic Eczema And Why
This common form of eczema, also called pompholyx , foot-and-hand eczema, palmoplantar eczema and vesicular eczema, is found more frequently in women than in men.
Dyshidrotic eczema is most common in younger adults, typically between the ages of 20 and 40. People can have a single flare-up of dyshidrotic eczema, but its more common for it to come and go over long periods of time.
Metals, particularly nickel, are a common trigger. Stress can also cause a flare. The condition is also linked to seasonal allergies like hay fever, and to hot, humid weather. Sweaty palms can trigger the rash, as can doing a job such as hairstyling or healthcare that entails frequently getting the hands wet.
Complications Of Dyshidrotic Eczema
The main complication of dyshidrotic eczema is usually the discomfort from itching and the pain from the blisters.
This discomfort can sometimes become so severe during a flare that youre limited in how much you use your hands, or even walk. Theres also the possibility of getting an infection in these areas from over-scratching.
In addition, your sleep may be disrupted if the itching or pain is severe.
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Who Is At Risk For Developing Dyshidrotic Eczema
There are a variety of factors that may dictate who develops dyshidrotic eczema.
If you are going to develop it, itll most likely begin between 20 and 40 years of age. Genetics may also play a role in dyshidrotic eczema. If you have one or more blood relatives with it, theres a higher chance you could also have it.
A few other factors that may contribute to its development are:
- youre already living with another type of eczema
- youve worked, or currently work, as a mechanic or metalworker
- you have a history of working with cement
- you already deal with seasonal allergies
- youre living with asthma
- you have occasional bouts of allergic sinusitis
What Do The Ecz
Although dyshidrotic eczema involves limited areas of the body, it can have a big impact on patients, said Dr. Gil Yosipovitch, MD, professor and director of the Miami Itch Center at the Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery at the University of Miami Miller School of Medicine in Florida.
Unlike some forms of eczema, you dont usually cover it with clothes, so its visible to others. It can affect social interactions you may not want to shake hands, for example.
Its very common to see emotional stress induce or exacerbate this type of eczema, he added. A college student may be in the midst of exams, for example, and suddenly develop blistering at the fingertips.
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