Causes And Risk Factors Of Dyshidrotic Eczema
As with other forms of eczema, we do not understand what causes it or why it affects some more than others, but there do appear to be genetics involved, as it is more common in some families, says Lio. Frequent hand-washing, sweaty hands and feet, and contact with irritants or chemicals are all the most common . We see it in many healthcare workers, as you can imagine.
According to the AAD, dyshidrotic eczema is more likely to occur if you:
- Have sweaty or moist hands
When To Seek Medical Advice
See a GP if you have symptoms of atopic eczema. They’ll usually be able to diagnose atopic eczema by looking at your skin and asking questions, such as:
- whether the rash is itchy and where it appears
- when the symptoms first began
- whether it comes and goes over time
- whether there’s a history of atopic eczema in your family
- whether you have any other conditions, such as allergies or asthma
- whether something in your diet or lifestyle may be contributing to your symptoms
Typically, to be diagnosed with atopic eczema you should have had an itchy skin condition in the last 12 months and 3 or more of the following:
- visibly irritated red skin in the creases of your skin such as the insides of your elbows or behind your knees at the time of examination by a health professional
- a history of skin irritation occurring in the same areas mentioned above
- generally dry skin in the last 12 months
- a history of asthma or hay fever children under 4 must have an immediate relative, such as a parent, brother or sister, who has 1 of these conditions
- the condition started before the age of 2
How Do You Treat Skin Conditions That Look Like These Photos Of Eczema
Eczema can often be treated with over-the-counter remedies, including creams containing corticosteroids as well as natural remedies. In severe cases, prescription medications may be needed, such as oral or injected steroids, antibiotics, and immunomodulators. While prescription medications are often effective, they also carry the risk of some serious side effects.
If youre interested in a natural treatment for eczema, one that is available without a prescription, wed like to recommend Wild Naturals Eczema and Psoriasis Moisturizing Skin Cream. Notice in the above photos, how dry and rough and irritating eczema looks? This moisturizing skin cream soothes rough, irritated skin, locking in moisture, and relieving itching and discomfort. To learn more, just follow the link.
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Some Basic Things You Can Do At Work To Help Control Your Hand Eczema:
- Avoid allergens or irritating substances in products you use on the job like industrial hand cleansers or waterless, antibacterial cleansers that may trigger your hand eczema, or make it worse. These often contain ingredients like alcohol and solvents, that are very hard on your hands, especially during flare-ups.
- Protect your hands at work with a combination of heavy-duty vinyl or neoprene gloves and cotton glove liners. Regularly wash cotton liners and vinyl gloves if they arent disposable.
- Always carry your own hand cleanser, moisturizer and medication with you, wherever you go.
- Keep your clothes, protective gear, tools and work surfaces clean and free of residue from irritating substances.
- Treat wounds on your hands and bandage them in order to avoid irritation from allergens or chemical substances.
Your doctor may also prescribe a barrier repair cream, or topical steroid to help speed up healing.
Reasons Hand Eczema Flares Up
Hand eczema flare-ups are beyond annoying. It can cause redness, itching, cracks, blisters, and dryness to the point of peeling and flaking, but thats not all. During a bad flare-up of hand eczema, fingers can swell and hands can hurt. Without proper treatment, hand eczema can become chronic. A severe case could even make it hard to button your clothes or use a computer.
So, what causes flares? Here are five of the most common triggers and tips for avoiding them.
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How Can Parents Help
Help prevent or treat eczema by keeping your child’s skin from getting dry or itchy and avoiding triggers that cause flare-ups. Try these suggestions:
- Kids should take short baths or showers in warm water. Use mild unscented soaps or non-soap cleansers and pat the skin dry before putting on cream or ointment. Teens should use unscented makeup and oil-free facial moisturizers.
- Ask your doctor if it’s OK to use oatmeal soaking products in the bath to help control itching.
- Kids should wear soft clothes that “breathe,” such as those made from cotton. Wool or polyester may be too harsh or irritating.
- Keep your child’s fingernails short to prevent skin damage from scratching. Try having your child wear comfortable, light gloves to bed if scratching at night is a problem.
- Kids should avoid becoming overheated, which can lead to flare-ups.
- Kids should drink plenty of water, which adds moisture to the skin.
- Get rid of known allergens in your household and help your child avoid others, like pollen, mold, and tobacco smoke.
- Stress can make eczema worse. Help your child find ways to deal with stress .
Excessive Exposure To Irritants And Water
Another possible cause of itchy wrists with or without a rash is excessive exposure to common irritants especially soaps and detergents. Scented and antibacterial soaps as well as soap powders are common culprits but shampoos and washing up liquids can also be to blame.
These irritants cause direct damage to the skin, leading to a condition known as irritant contact dermatitis. The itching is often accompanied by dry skin in the affected areas of skin. Washing very vigorously can compound the problem by inducing mechanical damage to the skin.
To stop the itching, try moisturizing the area with a good quality lotion or cream.
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Avoid Tasks That Make The Pain Worse
Try to avoid tasks that are causing the pain or making it worse. This may be anything that has a repetitive nature, such as using a screwdriver, painting or lifting heavy objects. You might be able to change the way you do some tasks to take the strain off your hands and wrists. Some conditions affecting the hand and wrist wont get better until you stop doing certain tasks.
Causes Of Itchy Wrists
The causes of an itchy skin in most parts of the body are similar. Therefore, itchy wrists may occur due to the same reasons as itchy skin elsewhere on the body. In many cases, an itchy wrist may be accompanied by itching on the skin beyond the wrist as well. However, in some cases, itchy wrists may be caused due to some unique factors that are pertinent only to the skin on the wrist. In such cases, itching is typically restricted to the wrist area.
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What Is Dyshidrotic Eczema Symptoms Causes Diagnosis Treatment And Prevention
Dyshidrotic eczema is a type of dermatitis that affects the hands and feet. It is also known as dyshidrosis, dyshidrotic dermatitis, foot-and-hand eczema, pompholyx, and vesicular eczema, according to the American Academy of Dermatology Association .
It is characterized by tiny blisters or vesicles, usually between the digits, and it can be extremely itchy, says Peter Lio, MD, a dermatologist who is a clinical assistant professor in the department of dermatology and pediatrics at Northwestern University’s Feinberg School of Medicine in Chicago, as well as a board member and scientific advisory committee member for the National Eczema Association . Certain triggers can also make it flare, such as contact with irritating chemicals like soaps or detergents or hand sanitizers, sweating, seasonal changes, and sometimes even just stress.
Other causes and triggers include allergic skin reactions, atopic dermatitis, fungal and bacterial infections, exposure to nickel or cobalt, and excessive exposure to water, according to Chesahna Kindred, MD, a dermatologist in Columbia, Maryland, who is an assistant professor at Howard University College of Medicine in Washington, DC.
Dyshidrotic eczema is also a side effect of intravenous immunoglobulin infusions , which are typically used to treat certain immune system diseases, according to the AAD. Exposure to cement is another risk factor.
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What Are The Treatments For Severe Hand Eczema
If your hand eczema is severe, discuss the possibility of a dermatology referral with your GP. The referral may be for diagnosing contact allergy or for treatment, which may include a short course of oral steroids or immunosuppressants . Alternatively, dermatology departments may recommend alitretinoin or phototherapy, as described below.
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Mental Health And Dyshidrotic Eczema
In addition to physical anguish, flare-ups of dyshidrotic eczema can lead to mental anguish. For those whose hands are affected, it is in a highly visible area that can’t be covered with clothing, so many patients feel ashamed or embarrassed about their skin, notes Lio. Also, severe cases can interfere with a person’s ability to work or carry out routine daily tasks involving hands or feet stressful situations brought on by a condition that itself is aggravated by stress.
Complications Of Dyshidrotic Eczema
The complications of this condition can be very painful and disruptive. Sometimes the hands are cracked, fissured, and bleeding, and it can cause lots of pain, says Lio. Some people can’t work due to the severity. I recently had a surgeon with such bad dyshidrotic eczema that he was on disability. I’m happy to say that we got him better and he is operating again.
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Rash On Wrist: Cause And Treatment
Rash on your wrists can be caused by many things. Perfumes and other fragrance containing products can very commonly irritate the skin on your wrists and lead to a rash. Jewelry, especiallyif it is made of cobalt or nickel, may also lead to a rash on your wrist. Certain diseases of the skin are also the possible culprit. Some common causes and their treatment are described below:
1. Lichen Planus
Lichen planus is a condition of the skin that is characterized by presence of small, reddish, shiny bumps. Sometimes, white streaks are present in between them. They can cause severe itching and can lead to blister formation. It is believed to be an autoimmune condition. The rash of lichen planus commonly erupts on the inner side of your wrist.
It is treated by using antihistamines and steroid creams. PUVA or psoralen ultraviolet A, light therapy or corticosteroid drugs may be used in severe cases of lichen planus. The condition usually disappears on its own within around two years.
Eczema, also referred to as contact dermatitis is a commonly occurring skin condition and another cause of wrist rash.
Eczema is initially seen as flaky, dry, elevated patches of skin. On scratching the patches become inflamed and raw. Oozing blisters may also form on these patches. The cause of contact dermatitis remains unknown. People who have a family history of eczema are more prone to have the condition. It is often accompanied by asthma and allergies of other types.
Clinical Patterns Of Hand Eczema
There are different patterns of hand eczema which differ only clinically, not histologically. Several clinical variants of hand dermatitis have been described, including hyperkeratotic , frictional, nummular, atopic, pompholyx , and chronic vesicular hand dermatitis. Hybrids of these patterns exist and some experts do not agree on classifications.
Many published classifications involve a combination of etiological factors and morphological features . However, no single classification of hand eczema is satisfactory.
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What Causes Atopic Hand Dermatitis
Atopic hand dermatitis is multifactorial with inherited and environmental factors contributing to skin barrier dysfunction and immune system dysregulation.
Skin barrier function in atopic dermatitis is impaired due to a deficiency in or defective function of filaggrin, increasing transepidermal water loss , and the risk of contact dermatitis and infection.
Atopic hand dermatitis has increased Th2 activation and production of IL-4, IL-13, IL-31, CCL17, CCL18 and CCL22.
Irritant contact dermatitis complicating atopic hand dermatitis
Clinical Examination And Supplementary Testing
The hands must be examined for signs of acute or chronic eczema. The patient may be tested using procedures such as epicutaneous testing, skin prick testing and/or blood IgE assays . In rare cases, a skin biopsy may be necessary to rule out other inflammatory skin diseases such as psoriasis. An asymmetric pruritic rash may raise clinical suspicion of dermatophytosis. Other common differential diagnoses include atopic eczema, scabies and palmoplantar pustulosis.
Epicutaneous testing is used to diagnose allergic contact eczema in cases of chronic or recurrent hand eczema. The testing is conducted by applying patches to the patient’s back bearing low concentrations of selected allergens. The patches must remain in place for 48 hours. The test material is selected based on the occupational and environmental anamnesis such that relevant contact allergens from both the home environment and the workplace are included. There are also test series available for various occupational exposures, such as a hairdressing series, an oil and cooling fluids series, a dental series, etc. Testing with the patient’s own materials is performed when indicated .
Skin prick testing and specific IgE assays are used in cases of suspected protein contact dermatitis. Skin prick testing can be performed using standardised extracts or via the prick-by-prick test method with fresh materials, such as fish, fruit or vegetables.
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Role Of Skin Barrier And Genetics
Another factor which is required for normal functioning of the epidermis is proper control of skin proteases activity. SPINK is a protein that inhibits serine protease action in the skin. The SPINK gene is absent in Netherton’s syndrome. In this syndrome, the patient has severe atopic dermatitis, scaling, and raised serum IgE level. Lack of SPINK results in uncontrolled serine protease elastase-2 activity. Increased protease activity negatively alters filaggrin and lipid processing thereby decreasing skin barrier function.
An impaired expression of antimicrobial peptides such as cathelicidin and defensins was detected in lesional skin in patients with atopic dermatitis.
Detergents cause stratum corneum damage by removal of the surface lipid layer and increase TEWL leading to irritant contact dermatitis.
Stratum corneum chymotryptic enzyme is a serine protease, which has a role in the desquamation of skin via the proteolysis of desmosomes in the stratum corneum. An elevated expression of hK7 or SCCE in the epidermis leads to increased proteolytic activity, pathological desquamation, and inflammation in many skin diseases such as Netherton syndrome, psoriasis, and atopic dermatitis.
Integrative And Complementary Approaches
There are many natural moisturizers that can be soothing, such as sunflower seed oil and coconut oil, says Lio. He adds that soaking in diluted apple cider vinegar or black tea can help to dry blisters. For milder cases, these can be enough to get people through, but usually if things are more severe, we often need more powerful treatments.
Research into the bathing remedies he mentions have had mixed results on people with related types of eczema.
A study published in January 2019 in the Journal of Dermatological Treatment studied 22 German people with facial eczema who received treatment with gauze compresses soaked in black tea, followed by cold cream, for six days. Though small, the study suggests this remedy led to significant decreases in itchiness and other symptoms, the researchers write.
On the other hand, another small study published in September 2019 in Pediatric Dermatology found that soaking skin in diluted apple cider vinegar up to the forearms led to irritation in 73 percent of the treated participants with atopic dermatitis and did not improve the condition of the skin barrier.
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What Are The Signs & Symptoms Of Eczema
The signs of eczema :
- are mainly dry, itchy skin. Because it is so itchy, it is often called “the itch that rashes.”
- include redness, scales, and bumps that can leak fluid and then crust over
- tend to come and go. When they get worse, it is called a flare-up.
- may be more noticeable at night
Symptoms can vary:
- Infants younger than 1 year old usually have the eczema rash on their cheeks, forehead, or scalp. It may spread to the knees, elbows, and trunk .
- Older kids and teens usually get the rash in the bends of the elbows, behind the knees, on the neck, or on the inner wrists and ankles. Their skin is often scalier and drier than when the eczema first began. It also can be thicker, darker, or scarred from all the scratching .
Bonus For The Numerology Fans
In numerology ECZEMA adds to 5+3+8+5+4+1 = 26/8. This is the same vibration as the word FAITH or THINK. Breaking 26/8 down gives insight into the spiritual cause of eczema, namely:
-An imbalance in the second chakra , which rules our emotions and hip/ lower belly area. When our second chakra is balanced, we find relationships easy. When its underactive, we suppress our intuition and go numb . When its overactive, we cant stand being alone and take everything personally. This chakra is healed through conflict resolution, finding pleasure in the small things and balancing giving and receiving. Its ultimate goal is peace and going with the flow.
-An imbalance in the sixth chakra , which rules our brain and vision . When our sixth chakra is balanced, we see the good and bad in every situation, feel on purpose, and keep an open mind. When our sixth chakra is underactive, we overanalyse things, worry a lot and are sceptical of spiritual matters. We follow others rather than create our own lives. When our sixth chakra is overactive, we have headaches, nightmares or become ungrounded/ spaced out. This chakra is healed through visualisation, study, self-care and time in nature. Its goal is love for self, the planet and all life.
With best wishes,
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