Dyshidrotic eczema causes small, itchy blisters on the skin. They usually begin as small bumps, before developing into fluid-filled lesions. It mainly affects the hands, particularly the palms and the edges of the fingers.
Dyshidrotic eczema can affect anyone, but it is more common among females and younger adults aged 20–40. Another name for it is pompholyx.
The cause of dyshidrotic eczema is unknown, but it is more common in people who have other types of eczema. It also tends to run in families, suggesting that a person’s genes may play a role.
This article provides an overview of dyshidrotic eczema of the hands, including its symptoms, causes, and treatments.
Dyshidrotic eczema is a type of eczema that affects the hands and the feet.
It causes itchy, fluid-filled blisters that can can turn into larger, weeping lesions. The lesions have a characteristic “tapioca pudding” appearance. Once the skin dries, it peels and flakes.
Additional symptms can include:
- itchiness
- pain
- swelling
- redness in lighter skin tones, or purple to dark brown in darker skin tones
- cracks or fissures in the skin
Dyshidrotic can also affect the skin around the fingernails. If it does, it can affect nail growth, causing pitting or ridges.
The exact causes of dyshidrotic eczema are unknown. However, there are
- having eczema in other areas of the body
- fungal infections on the hands or feet
- having allergies, such as hay fever
- hypersensitivity to certain foods, chemicals, or metals (such as nickel)
- hormonal changes
- certain medications
- stress
Dermatologists can often diagnose dyshidrotic eczema by taking a medical history and examining the skin. They may ask the person when their symptoms began, if they have other types of eczema, or any family members with dyshidrotic eczema.
If a person’s symptoms do not improve after
- a workup for bacterial, fungal, and viral infections
- skin patch testing
- skin biopsy
Dyshidrotic eczema may go away, in some cases, but it depends on what the cause is.
For example, if someone is sensitive to a certain laundry detergent, stopping the use of it may mean their symptoms go away and never come back. Similarly, if they have a fungal infection, treating this may improve the symptoms.
Although avoiding triggers is helpful, a person may find it challenging to determine what their triggers are, or to entirely avoid them. For example, if heat makes the itching worse, but the person lives in a hot climate, they may not be able to control the symptoms without medical treatment.
The main treatments for dyshidrotic eczema are:
- Corticosteroid creams: These topical medications reduce inflammation, ease irritation, and promote healing.
- Anti-itch medications: Antihistamine pills or lotions can reduce itching and discomfort.
- Moisturizer or a barrier repair cream: A thick, emollient cream can reduce skin dryness.
Knowing and avoiding triggers can also help people manage their symptoms. Identifying triggers may involve keeping a symptom diary to track any patterns in flare-ups.
A person can also try avoiding some common triggers to see if it helps. For example, they could:
- temporarily stop wearing hand jewelry
- avoid any fragranced skin products
- try a fragrance-free laundry detergent
- wear rubber gloves when cleaning or handling chemicals
People can also adapt how they care for their skin so that it reduces symptoms and allows treatment to be as effective as possible. For example, when washing the hands:
- remove rings and other hand jewelry first, so that water does not linger on the skin
- use a mild, pH-balanced cleanser, wherever possible
- use warm, rather than hot, water when washing or bathing
- pat the skin dry with a clean towel, rather than rubbing
After washing the hands, always apply an eczema-friendly moisturizer. Keep the fingernails trimmed short, and if itchiness occurs at night, people may find it helpful to wear cotton gloves to bed after moisturising.
People should contact a doctor or dermatologist if they think they may have dyshidrotic eczema. The symptoms can resemble those of other conditions, so a health professional can help with making a firm diagnosis. This will also allow a person to begin using the most effective treatments.
If treatments do not help, it is also important to follow-up with a doctor. They may recommend a different approach, or further testing.
Dyshidrotic eczema on the hands can be uncomfortable. If the symptoms become too difficult to manage, it is best to seek medical advice.
Dyshidrotic eczema causes itchy, fluid-filled blisters on the hands. The lesions may be red or darker than the surrounding skin, and can cause itchiness and pain if severe.
The exact causes of dyshidrotic eczema are not clear, but there are several risk factors, such as sensitivities, allergies, fungal infections, and a family history of the condition.
Medical treatment can involves topical corticosteroids to reduce inflammation and help the skin heal. People can also care for their hands at home by protecting the skin from triggers, avoiding harsh products, and moisturizing regularly.