Health

Everything You Need to Know About Dyshidrotic Eczema

April 09, 2022

Overview

A dyshidrotic eczema is a common form of eczema. In this skin condition, blisters develop on the palms of the hands, fingers, and feet soles. It is also called:

Dyshidrosis
Foot-and-hand eczema
Pompholyx
Palmoplantar eczema
Vesicular eczema

The blisters can appear as tiny bumps on fingers or grow together and cover larger areas on the hands and feet. These blisters are usually very itchy and sometimes filled with fluid. Blisters can last for about 3 to 4 weeks, and several factors can trigger them, like, an allergy, genetics, or stress.

There is no cure for dyshidrotic eczema, so these blisters will come and go over time. But you can manage them with medicine, moisturizers, and good hygiene. They might start to decrease once you get into middle age. And if you have a mild case, it could go away on its own without the treatment. Whereas in chronic cases, you might need treatment. Read the full article to know more about this skin condition's symptoms, causes, treatment, risk factors, and prevention.

Symptoms of Dyshidrotic Eczema

The first symptom of a dyshidrotic eczema flare may be a burning, itching sensation without any visual clues. Then tiny, itchy blisters might appear on a person's palms, sides of fingers, or feet. 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. The blisters can become painful and ooze pus if the skin becomes infected.

You may also have:

Itching or a burning pain before blisters appear.
Blisters on the edges of your fingers, toes, palms, and soles of your feet.
Red, cracked skin.
Sweaty skin around the blisters.
Nails that thicken and change colors.

Dyshidrotic eczema heals on its own in 3 to 4 weeks, but as the blisters heal, they can cause your skin to become red, cracked, tight, or dry. Individuals with a darker skin tone may develop dark spots where the blisters have healed.

Because the blisters appear on the open areas of the skin, a person with dyshidrotic eczema is at greater risk for skin infections, such as staph infections. Symptoms of a staph infection include:

Blisters that leak pus.
Areas of crusting skin.
Areas of swollen skin.

The person should immediately see the doctor if they experience staph infection symptoms.

Causes of Dyshidrotic Eczema

The exact cause of dyshidrotic eczema is unknown. Previously, it was thought to be caused by an issue with an individual's sweat ducts. But that statement was proven false. Adults ages 20 to 40 mostly get dyshidrotic eczema. But it is twice as common in women as in men.

You are more likely to get it if you have allergies like hay fever, a family history of dyshidrotic eczema, or other forms of eczema. People with dyshidrotic eczema are hypersensitive to something like:

High-stress levels.
Seasonal allergies.
Staying in water for too long.
Excessive sweating of the hands or feet.
Contact with metals like nickel, cobalt, or chromium salts on your job or from things like costume jewelry or cell phones.
A specific ingredient in a personal care product like soap or moisturizer.
Medication, especially birth control or aspirin
Smoking (tobacco).
A skin infection like Athlete's foot.
An intravenous immunoglobulin (IVIG) infusion.
Warm, humid weather.
HIV infection

Risk Factors of Dyshidrotic Eczema

There are a variety of factors that may indicate who develops dyshidrotic eczema. You are most likely at risk if you are between 20 and 40 years of age. Genetics may also play a crucial role in dyshidrotic eczema. Or if you have one or more blood relatives with dyshidrotic eczema. You are at a higher chance of getting the disease. A few other factors that may contribute to its development are:

You are already living with another type of eczema.
You are currently working or previously worked as a mechanic or metalworker (because of the contact with certain metals like nickel).
You have a history of working with cement (which can contain both cobalt and nickel).
You already deal with seasonal allergies.
You are living with asthma.
You have occasional bouts of allergic sinusitis.
You have a history of certain medical conditions, including atopic dermatitis, contact dermatitis, and hay fever.
You have exposure to increase temperatures during the spring or summer.
You have periods of severe stress.
You have jobs or hobbies that involve having wet hands or feet for a long time.
You are receiving intravenous immunoglobulin therapy. This therapy involves injecting specific antibodies into the veins to help a person fight a particular virus or bacteria.

Dyshidrotic Eczema In Children

Eczema, or atopic dermatitis, is more common in children and infants than in adults. About 10 to 20 percent of children may have some form of eczema. But many will outgrow atopic dermatitis or eczema by adulthood. Conversely, dyshidrotic eczema can also affect children, but it is rare.

Diagnosis of Dyshidrosis Eczema

No lab test can confirm that you have dyshidrotic eczema. But if you notice blisters on your hands and feet, see a dermatologist (a skin specialist doctor). To diagnose dyshidrotic eczema, your doctor will perform a physical examination of the skin. They will look at your hands, feet, and nails.

Your doctor could also suggest tests to exclude other conditions with similar symptoms, like Athlete's foot. They may also ask questions about your family history of eczema, occupation, diet, and medications you are taking. Your doctor is likely to ask you several questions, such as:

When did you first begin experiencing symptoms?
Have your symptoms been continuous or occasional?
How severe are your symptoms?
What, if anything, seems to improve your symptoms?
What, if anything, appears to worsen your symptoms?
Are you exposed to chemicals or metals at work or through a hobby?

The doctor may recommend allergy testing to determine if specific allergens are causing eczema. Patch tests may help show if you have an allergy to nickel or another metal. During these tests, your doctor will put patches with a small piece of different metals or other things on your skin to see whether you react to them.

Or the doctor performs a test that involves pricking the skin using needles that contain common allergens, including certain foods, pet dander, molds, and pollen. The doctor may identify potential triggers and make recommendations to help reduce the incidence of eczema flare-ups.

Treatment of Dyshidrotic Eczema

Currently, there is no single cure for dyshidrotic eczema. But many treatments can help a person manage this condition. Medical therapies for dyshidrotic eczema depend on the severity of signs and symptoms, which may include:

Corticosteroids

High-potency corticosteroid creams and ointments may help speed the disappearance of the blisters. Wrapping the treated area in plastic wrap can improve absorption. Moist compresses also may use after the application of a corticosteroid. It enhances the absorption of the medication. In severe cases, the doctor may prescribe corticosteroid pills (prednisone). Long-term use of steroids can cause serious side effects.

Phototherapy

If other treatments are not effective. Your doctor may recommend a unique light therapy that combines exposure to ultraviolet light with drugs. It helps make your skin more receptive to the effects of this type of light.

Immune-suppressing ointments

The doctor may prescribe immune-suppressing creams. It includes medications tacrolimus (Protopic) and pimecrolimus (Elidel). It may be helpful for people who want to limit their exposure to steroids. A side effect of these drugs is an increased risk of skin infections.

Botulinum toxin injections

Some doctors recommend botulinum toxin injections for chronic cases of dyshidrosis. It reduces excessive sweating, which causes dyshidrotic eczema worse. But the U.S. Food and Drug Administration (FDA) has not approved Botox for this use. The severity of your outbreak and other personal health factors determine which treatments your doctor might suggest. It also may be necessary to try more than one treatment before finding one that works.

Treatments for Mild Outbreaks

The doctor may prescribe pimecrolimus cream, tacrolimus ointment, or Eucrisa to treat atopic dermatitis. But they are also shown to be effective for dyshidrotic eczema. For mild flare-ups, your doctor may recommend:

A moisturizer that's very emollient to help relieve the dryness.
A prescription corticosteroid helps heal the blisters and reduces inflammation.
Anti-itch medication in the form of a pill or cream.

Treatments for More Severe Outbreaks

More severe outbreaks might require possible treatments like:

Antifungal medications if eczema seems tied to a fungal infection.
Steroid tablets or creams.
Immunosuppressant creams or ointments.
UV light therapy.
Botox (Botulinum toxin injections) if dyshidrotic eczema seems to be triggered by extreme sweating.

Home Remedies For Dyshidrotic Eczema

While home remedies may not be as effective as doctor-recommended medication, they can help ease symptoms.

Follow a skin routine: You can start with cold compresses, soothing the area every 15 minutes. You can also soak the affected areas for 15 minutes. Cool compresses to dried-out blisters for 15 minutes may reduce itchiness. The doctor may also recommend some good inflammation-lowering medicated soaks.
Reduce your stress: Find ways to relieve stress. Since stress can also trigger dyshidrotic eczema, go for techniques like meditation. It can help provide a dose of calm for your mind and body if you notice that your personal care products like a new soap bar, seem to cause blisters. Stop using it for a few weeks and see if the inflammation and itching die.
Moisturize your skin: Keep the affected area well moisturized at all times. Try to maintain your fingernails and keep them short enough not to break the skin if/when you scratch. It can help you prevent infections.

The other examples of home remedies for dyshidrotic eczema include:

Wash your hands and feet every day. Use lukewarm water and mild, scent-free soap. Afterward, gently pat your skin dry.
Take your rings off before you wash your hands. Moisture can get trapped under your rings and cause more blisters.
Wear gloves with cotton liners whenever your hands are in the water, like when you wash dishes.
Put a thick moisturizer on your hands and feet every time you shower or wash. Rub it on while your skin is wet to seal it in water. You also might use a cream that has dimethicone to protect your skin.
Turn on a humidifier in dry weather to keep your skin from cracking.
If allergies set off your eczema, try to avoid those things that trigger them.
Do not scratch the blisters. You will make them worse.

Washing the skin frequently keeps the skin clean, reducing the chances of skin infections. Limit your showers to 10 minutes, avoid boiling water, and apply moisturizer or cream after bathing helps prevent the skin from drying.

Diet For Dyshidrotic Eczema

There is no specific diet for dyshidrotic eczema. But certain foods may contain dyshidrotic eczema triggers. For example, cobalt and nickel, many healthy foods include these natural elements. These are trace metals that can cause or worsen dyshidrotic eczema. Examples of these foods include:

Bean sprouts.
Canned meats, including tuna.
Chocolate and Cocoa powder.
Kidney beans.
Soybeans and Soy products.
Brazil nuts.
Dried fruit.

Suppose the doctor suspects your dyshidrotic eczema flares due to nickel or cobalt allergy. In that case, they may recommend reducing or eliminating foods that contain cobalt or nickel. The easiest way your dermatologist will recommend following this specialized diet is through a point system.

The higher the amount of nickel or cobalt, the higher the points value for that food or beverage. You have to instruct to count your points. A person with other specific food allergies can also worsen dyshidrotic eczema symptoms.

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 you are limited to using your hands or walking. In addition, your sleep may be upset if the itching or pain is unbearable.

There is also the possibility of getting an infection in these areas from over-scratching. These may require treatment using antibiotics. Also, the recurring dyshidrotic eczema can cause the skin to thicken and be hard in the areas where the blisters had occurred.

Prevention of Dyshidrotic Eczema

There is no cure for dyshidrotic eczema also no sure way of preventing an eczema outbreak. But a good skincare routine can help to protect the skin from future flare-ups. The prevention of dyshidrotic eczema includes:

Avoid Some Chemicals

You can avoid some chemicals that can make eczema itchy. To keep your skin happy, you must do the following:

Wear cotton-lined gloves when cleaning.
Do not use air fresheners, perfume, or scented candles.
Stay away from smoke. If you smoke, now is a great time to kick the habit.

Do not use Hot Water

Use lukewarm or cool water for handwashing and showers. It keeps your skin stays calmer after handwashing and showers. After handwashing and showers, gently pat your skin and do not rub until it is just damp. Then, slather on thick lotion right away to lock in moisture. It can prevent moisture loss and excessive dryness. To avoid allergic reactions, you must check the ingredients on the label of your lotion.

The Sun, Sweat, and Sunscreen

You can be out in the sun, but do not get your skin hot and sweaty. If so, stay calm and seek out shade. Always wear sunscreen because sunburns inflame your skin and can lead to an eczema flare. If you are sensitive to sunscreens, you can use mineral versions, like zinc oxide or titanium dioxide. Sunscreens may also give gentle protection to your face.

Be Selective in Your Wearing Clothes

Wear soft and loose clothing made of natural fibers, such as cotton. Avoid overly scratchy or non-breathable materials, including wool, and mohair can be prickly. Wool Synthetic materials like polyester, nylon, and rayon can make you sweaty. Wash your new clothes before you wear them. You can get rid of dye or chemicals used to keep them wrinkle-free at the store. Never do your clothes dry-clean.

Detergents, Soaps, and Shampoos

Choose laundry detergent for babies or sensitive skin, like fragrance-free types for washing clothes. Do not use more than the amount suggested. If needed, rinse them twice. Skip fabric softeners and scented dryer sheets. For showers, pick a non-soap cleanser that is mild and fragrance-free. Shampoos are also available in clear, pH-neutral, fragrance-free versions.

Avoid Exposure to Allergies

Avoid pollen, pet dander, dust mites, and mold if you are allergic to pollen, pet dander, dust mites, and mold. Do dust and vacuum regularly, and wash bedding weekly in hot water. If possible, get rid of heavy drapes and carpeting. If certain chores irritate your skin, ask for help or hire someone. Also, reduce exposure to allergens, such as pet dander and pollen. Washing pets with dander-reducing pet shampoos may reduce allergy-related flare-ups. If you still have allergy issues, talk to your doctor about other ways to get relief.

Avoid Exposure to Dry Air

If your skin gets worse in the winter, moisturize your skin regularly. The heater in your home keeps you warm but can suck the moisture out of the air. You must use a humidifier if you live in a cold and dry place. Humidifier adds moisture to cold and dry air to help protect the skin from drying out. Clean it as directed at least once a week. Mold can thrive in humidifiers and make eczema worse for some people.

Exercise and Sweat

Working out can help you relieve stress. But sweat from exercise can aggravate the skin. Take breaks during workouts, don't over-dress, and sip water when you get hot. Do exercise indoors or during colder parts of the day.