Medical News Today: What is dyshidrotic eczema?

Dyshidrotic eczema is a common form of eczema. The condition causes a person to develop small, itchy blisters on the fingers, toes, palms, and soles of the feet.

This type of eczema is also called vesicular eczema, dyshidrosis, foot-and-hand eczema, and palmoplantar eczema.

In this article, we will look at the symptoms of dyshidrotic eczema, along with its causes and treatment.

Symptoms

image of persons hand with dyshidrotic eczema <br>Image credit: Eugene Alvin Villar, 2008</br>
Blisters on the palms of the hands are a key symptom of dyshidrotic eczema.
Image credit: Eugene Alvin Villar, 2008

Dyshidrotic eczema causes small blisters to appear on a person’s hands or feet. These blisters are often itchy and can be painful.

Symptoms of dyshidrotic eczema include:

  • small blisters on the palms or side of the fingers
  • small blisters on the soles of the feet
  • an itching or burning feeling around the blisters
  • sweating around the blisters

The blisters caused by dyshidrotic eczema tend to go away within 2 to 3 weeks. After this, the skin may become red, cracked, tight, or dry.

Because the blisters can result in open areas of 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
  • pain
  • areas of crusting skin
  • areas of swollen skin

A person should always see their doctor if they think they have an infection in their skin.


Causes

Dyshidrotic eczema may be caused by:

The blisters can also be caused by an allergic reaction to certain metals, including nickel and cobalt. These metals are found in everyday objects, such as jewelry and mobile phones, and also in certain foods.

Risk factors

Woman at work holding eyes through stress. Possible risk factor for dyshidrotic eczema
Possible risk factors for dyshidrotic eczema include an increase in outdoor temperatures, a history of medical conditions, or severe stress.

Women are twice as likely as men to experience dyshidrotic eczema, according to the National Eczema Association. Those aged 20 to 40 are also more likely to have this condition.

Known risk factors for dyshidrotic eczema include:

  • a family history of dyshidrotic eczema
  • a history of certain medical conditions, including atopic dermatitis, contact dermatitis, and hay fever
  • an increase in outdoor temperatures during the spring or summer
  • periods of severe stress
  • jobs or hobbies that involve having wet hands or feet for long periods of time

A person receiving intravenous immunoglobulin therapy is also at a greater risk of developing dyshidrotic eczema. This therapy involves injecting specific antibodies into the veins to help a person fight a particular virus or bacteria.


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Diagnosis

To diagnose dyshidrotic eczema, a doctor will perform a physical examination of the skin. They may also ask questions about a person’s family history of eczema, their occupation, diet, and medications the person is taking.

Allergy testing may be recommended to determine if specific allergens are causing the eczema. This involves pricking the skin using needles that contain common allergens, including certain foods, pet dander, molds, and pollen.

By identifying potential triggers, a doctor may be able to make recommendations to help a person reduce the incidence of their eczema flare-ups.

Treatment

There is currently no single cure for dyshidrotic eczema, but there are many treatments that can help a person manage this condition.

Medical treatments for dyshidrotic eczema include:

  • Applying over-the-counter corticosteroid creams to reduce skin inflammation and irritation.
  • Taking antihistamines to reduce itching.
  • Applying anti-itch creams containing pramoxine, which are available over the counter.
  • Draining blisters. This should be performed by a doctor as it can increase the risk of harmful infections.
  • Taking oral steroids, such as prednisone, to reduce inflammation.
  • Using light treatments. Exposure to ultraviolet light may reduce incidences of dyshidrotic eczema.

Injections of Botox (botulinum toxin) can also be used to reduce excessive sweating, which can worsen dyshidrotic eczema. It is important to note that the U.S. Food and Drug Administration (FDA) have not specifically approved Botox for this use.


Home remedies

Examples of home remedies for dyshidrotic eczema include:

  • Applying cool compresses to dried-out blisters for 15 minutes may reduce itchiness. Following this, apply a lotion or medicated cream.
  • Applying moisturizing creams, especially after washing the hands or taking a bath.

Washing the skin frequently keeps the skin clean, reducing the likelihood of skin infections. Limiting showers to 10 minutes, avoiding very hot water, and applying moisturizer or cream after bathing will help to prevent the skin from drying out.

Diet

If this condition does not respond well to usual treatments, a doctor may recommend reducing or eliminating foods that contain cobalt or nickel. These are trace metals that can cause or worsen dyshidrotic eczema.

Examples of these foods include:

  • bean sprouts
  • canned meats, including tuna
  • cashews
  • chocolate and cocoa powder
  • kidney beans
  • nuts
  • seeds
  • soybeans and soy products

    If a person has other specific food allergies, this can also worsen dyshidrotic eczema symptoms.


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      Complications

      Dyshidrotic eczema can, in some cases, cause skin infections. These may require treatment using antibiotics.

      When this type of eczema is recurring, a person may notice thickened, tough skin on the areas where the blisters had occurred.

      Prevention

      woman moisturizing after shower, may help with dyshidrotic eczema
      Dyshidrotic eczema may be prevented by refraining from scratching, and applying moisturizer after showering.

      While there is no sure way of preventing an eczema outbreak, a good skincare routine can help to protect the skin from future flare-ups.

      Ways to prevent dyshidrotic eczema include:

      • Consistently applying moisturizer soon after getting out of the shower or bath. This can prevent moisture loss and excessive dryness.
      • Wearing soft, loose clothing made of natural fibers, such as cotton. Avoid overly scratchy or non-breathable materials, including wool.
      • Refraining from scratching or itching, as this can break the skin and worsen the condition.
      • Reducing exposure to allergens, such as pet dander and pollen. Washing pets with dander-reducing pet shampoos may reduce allergy-related flare-ups. These shampoos are available online.
      • Using a humidifier, especially when the air is cold and dry. This adds moisture to the air, which protects the skin from drying out.


      Outlook

      Dyshidrotic eczema symptoms can range from mild to severe. Some people have flare-ups every few years, while others experience severe, recurring bouts that can make it hard to use the hands or to walk.

      A person with dyshidrotic eczema should talk to their doctor about the many treatment options available. Using treatment and prevention methods should help to keep this condition under control, and to reduce the risk of skin infection.

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