Dyshidrotic Eczema

What is dyshidrotic eczema?

Dyshidrotic eczema is an ongoing (chronic) skin condition. It causes a burning, itching feeling. Severe dyshidrotic eczema may also cause a blistering rash. It can affect your palms, the sides of your fingers, and the soles of your feet. It’s most common in people in their 20s, 30s, and 40s, but can happen at any age.

Skin has several layers. The outermost layer is the epidermis. Under this is the dermis. The dermis contains blood vessels, nerve endings, hair roots, and sweat glands. With eczema, your skin becomes inflamed. Inflammatory cells of your immune system invade the epidermis. They irritate and destroy some of the tissues there. Eczema is common. It’s also known as atopic dermatitis.

Dyshidrotic eczema is a certain form of this skin inflammation. It can cause mild to severe symptoms. In some cases, it causes symptoms that go away in a few weeks with no treatment or with use of hand lotion. More often, it happens over many months or years.

What causes dyshidrotic eczema?

Researchers are still working to learn the causes. But some factors may increase your risk of having it, such as:

  • Having had atopic dermatitis in the past
  • Having allergies, such as allergic rhinitis
  • Being exposed to allergens or irritants, such as certain metals
  • Smoking
  • Having a fungal infection of the skin
  • Receiving UV radiation
  • Having overactive sweat glands

Certain things can trigger episodes, such as:

  • Stress
  • Very warm or cold weather
  • Very dry or humid air

What are the symptoms of dyshidrotic eczema?

Often, the first symptom is sudden itching on the palms, the sides of your fingers, or the soles of the feet. Next, small fluid-filled blisters (vesicles) may start to appear. These cause more intense itching and pain. These blisters may get bigger. In some people, these symptoms can cause a lot of problems with daily activities. The blisters often last for a few weeks before they dry up and flake away.

Dyshidrotic eczema is more likely to affect the hands than the feet. In most cases, the symptoms happen on both hands or both feet.

Some people have symptoms in frequent episodes. The episodes may happen every month or so for months or years. Over time, this may cause chronic hand dermatitis and lead to more symptoms, such as:

  • Reddened, hard skin
  • Scaling and peeling skin
  • Cracks in your skin
  • Color changes in your nails

How is dyshidrotic eczema diagnosed?

You may be diagnosed by a general healthcare provider or a dermatologist. A dermatologist is a healthcare provider who specializes in diseases of the skin.

Your healthcare provider will ask about your medical history and your symptoms. Tell him or her about contact you’ve had to possible irritants. You will also have a physical exam. Your healthcare provider will need to make sure your symptoms aren’t caused by other conditions. These may include allergic contact dermatitis, ringworm, herpes, or a rare autoimmune disease. You may also have tests such as:

  • Skin scraping or biopsy, to check for infection
  • Patch skin testing, to look for allergic causes
  • Blood tests, to check for an autoimmune cause

How is dyshidrotic eczema treated?

Treatments may include:

  • Moisturizing lotion or cream
  • Steroid ointment, to reduce inflammation
  • Calcineurin creams, which may also reduce inflammation
  • Oral steroid medicine, for more severe symptoms
  • Draining of very large blisters, to reduce pain
  • Treatment with psoralen and ultraviolet light (PUVA), for people with chronic, severe symptoms

You will need to use moisturizing lotion or cream every day. This helps to treat skin dryness as the blisters heal. If your symptoms don’t decrease, you may need more tests to help check for other possible causes of your symptoms.

What are possible complications of dyshidrotic eczema?

Dyshidrotic eczema can sometimes let bacteria, such as Staphylococcus, infect the skin. Your healthcare provider may swab your skin to test it for infection. An infection may be treated with antibiotic medicine.

How to manage dyshidrotic eczema

General skin care may also help you limit how often and severely your symptoms happen. Your healthcare provider may suggest:

  • Using lukewarm water instead of hot
  • Using soap-free cleansers
  • Making sure you dry your hands well
  • Applying cream or petroleum jelly to protect your hands after drying them
  • Wearing latex-free gloves when washing dishes
  • Wearing gloves if the weather is cold or wet
  • Avoiding contact with possible irritants, such as detergents, solvents, or hair products
  • Avoiding exposure to weather extremes, when possible

Reducing your stress may also help you limit your symptoms.

Key points about dyshidrotic eczema

  • Dyshidrotic eczema is a type of skin inflammation. It causes a burning, itching feeling, as well as a blistering rash.
  • It can affect your palms, the sides of your fingers, and the soles of your feet. In some people, these symptoms can be quite severe.
  • You may need tests to help diagnose your condition.
  • Steroid ointment and moisturizing lotion or cream some treatments for the condition.
  • General skin care may help you limit how often and severely your symptoms happen.

Next steps

Tips to help you get the most from a visit to your healthcare provider:

  • Know the reason for your visit and what you want to happen.
  • Before your visit, write down questions you want answered.
  • Bring someone with you to help you ask questions and remember what your provider tells you.
  • At the visit, write down the name of a new diagnosis, and any new medicines, treatments, or tests. Also write down any new instructions your provider gives you.
  • Know why a new medicine or treatment is prescribed, and how it will help you. Also know what the side effects are.
  • Ask if your condition can be treated in other ways.
  • Know why a test or procedure is recommended and what the results could mean.
  • Know what to expect if you do not take the medicine or have the test or procedure.
  • If you have a follow-up appointment, write down the date, time, and purpose for that visit.
  • Know how you can contact your provider if you have questions.
Online Medical Reviewer: Finke, Amy, RN, BSN
Online Medical Reviewer: Lehrer, Michael Stephen, MD
Last Review Date: 12/1/2016
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