What Is Dyshidrotic Eczema?
Dyshidrotic eczema is a sudden rash of small, itchy blisters on your palms and along the sides of your fingers. This skin condition can also make blisters pop up on the soles of your feet or on your toes.
Your doctor might call it by another name, including dyshidrosis, foot-and-hand eczema, pompholyx, vesicular eczema, or palmoplantar eczema.
There’s no cure, so these blisters will come and go over time. But you can manage them with medicine, moisturizers, and good hygiene. They might start to taper off once you get into middle age. And if you have a mild case, it could go away on its own.
Dyshidrotic Eczema Symptoms
The small, itchy blisters are the most noticeable sign of dyshidrotic eczema. These usually pop up in clusters. 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
The blisters often go away in 2 to 3 weeks. But the skin underneath can be red and tender for a while.
Dyshidrotic eczema can be mild or severe. If you have a severe case that affects your feet, the blisters can make it hard to walk. Blisters on your hands can make it hard to do things like cook, type, or wash dishes.
Sometimes, the blisters can get infected, especially if you scratch them a lot. Signs that you have an infection include:
Pain
Swelling
Crusting
Pus in the blisters
Dyshidrotic Eczema Causes
Doctors aren’t sure what causes dyshidrotic eczema. It mostly affects adults ages 20 to 40, and it's twice as common in women as in men. You're more likely to get it if you have allergies like hay fever, a family history of dyshidrotic eczema, or other forms of eczema.
Several things can set off dyshidrotic eczema, including:
Contact with metals like nickel, cobalt, or chromium salts on your job, or from things like costume jewelry
Sweaty or wet hands and feet
Warm, humid weather
HIV infection
Certain treatments for a weak immune system (immunoglobulin)
Seasonal allergies
About half of all people with dyshidrotic eczema also have other types of eczema such as contact and atopic dermatitis. This condition isn't contagious. You can't catch it from touching someone who has it.
Dyshidrotic Eczema Diagnosis
No lab test can confirm that you have dyshidrotic eczema, but if you notice blisters on your hands and feet, see a dermatologist (a doctor who specializes in your skin). They’ll look at your hands and feet, as well as your nails. Your doctor could also suggest tests to rule out other conditions with similar symptoms like athlete’s foot.
You also might need to see an allergy doctor (allergist). Patch tests can show if you have an allergy to nickel or another metal. During these tests, your doctor will put patches with a small amount of different metals or other things on your skin to see whether you react to them.
Dyshidrotic Eczema Treatment
Your doctor can prescribe an ointment or cream with a steroid in it to bring down swelling and help get rid of the blisters. Your skin will take in the medicine better if you put a wet compress on it after you use the cream. If you have a severe flare-up, you might need to take a steroid drug, like prednisone, in a pill.
An antihistamine like diphenhydramine (Benadryl) or loratadine (Alavert, Claritin) can help with the itch, too. Or you might hold a cold, wet compress on the blisters for 15 minutes at a time several times a day.
If these treatments don't work well for you, you might try one of these:
Light therapy. This uses ultraviolet (UV) light to clear up your skin. You might first get a sensitizing medication to help your skin respond better to the light.
Botulinum toxin. These shots stop your hands and feet from sweating, which can trigger the blisters.
Medicines that slow your immune system. Tacrolimus (Protopic) ointment or pimecrolimus (Elidel) cream can calm the swelling and irritation. These drugs can be options if you don't want to take steroids.
Draining the blisters. Your dermatologist can drain fluid from the blisters. Don't try to do this yourself. You could make the eczema worse.
To control the blisters at home:
Wash your hands and feet every day. Use lukewarm water and a 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 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 still wet to seal 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 stay away from things that trigger them.
Don't scratch the blisters. You'll make them worse.
If you're sensitive to nickel or cobalt, your dermatologist might tell you not to eat foods that are high in these metals. Nickel is in foods like chocolate, broccoli, legumes, and nuts. Cobalt is in shellfish, liver, nuts, beets, cabbage, and chocolate.