Dyshidrotic eczema, or dyshidrosis, is a dry scaly skin condition that starts with blisters that develop on the soles of your feet and/or the palms of your hands. The blisters are usually itchy and may be filled with fluid and lasts for about two to four weeks. It may be related to other seasonal allergies or even stress.
The exact cause of dyshidrotic eczema is not known. Experts believe that the condition may be related to seasonal allergies, such as hay fever.
Doctors believe that you have a greater chance of developing the condition if you’re experiencing a high level of stress (either physical or emotional) or have other allergies. Some doctors think that dyshidrotic eczema may be a type of allergic reaction. You may be more likely to develop dyshidrotic eczema if your hands or feet are often moist or in water, or if your work exposes you to metal salts, such as cobalt, chromium and nickel.
Eczema, or atopic dermatitis, is more common in children and infants than in adults. About 10 to 20 percent have some form of eczema, however, half will outgrow atopic dermatitis or eczema by adulthood. Conversely, dyshidrotic eczema can affect children, but it’s usually seen in adults 20 to 40.
If you have dyshidrotic eczema, you may notice blisters forming on your fingers, toes, hands or feet. The blisters may be more common on the edges of these areas and will probably be full of fluid. Sometimes, large blisters will form, which can be particularly painful. The blisters will usually be very itchy and may cause your skin to be dry and scaly. Affected areas may become cracked or painful to the touch.
The blisters may last up to three weeks before they begin to dry. As the blisters dry up, they’ll turn into skin cracks that may be painful. After scratching the affected areas, you may notice that the skin seems thicker or even feels spongy.
Diagnosis and treatment
In many cases, your doctor will be able to diagnose dyshidrotic eczema by examining your skin carefully. Because the symptoms of dyshidrotic eczema can be similar to those of other skin conditions, your doctor may choose to run more tests to rule them out. The tests may include a skin biopsy, which involves removing a small patch of skin to send to the lab. The biopsy can rule out other possible causes of your blisters, such as a fungal infection. Your doctor may also order an allergy skin test if necessary.
There are a number of ways that the doctor can treat dyshidrotic eczema depending on how bad the condition is. It also may be necessary to try more than one treatment before finding the right one that works for you.
For mild outbreaks, medications such as corticosteroid cream or ointment that is applied directly to your skin can be used. For more severe outbreaks, you may need to get a topical steroid, steroid injection and or pill. If your skin becomes infected, then you may need to take some antibiotics or other medications to treat the infection. If you’re having a mild outbreak of dyshidrotic eczema, your doctor may recommend over the counter antihistamines such as Claritin or Benadryl to help decrease your symptoms and itching. Other medical treatments that can be used are UV light treatments, draining large blisters and immune-suppressing ointments, such as Protopic and Elidel.
Prevention and control
Unfortunately, there is no proven way to prevent or control outbreaks of dyshidrotic eczema. The best advice is to help strengthen your skin by applying moisturizers daily, avoiding triggers such as perfumed soaps or harsh cleansers and staying hydrated.
Soaking your hands and feet in cool water or applying wet, cold compresses for 15 minutes at a time, two to four times a day, can help reduce the discomfort associated with dry, itchy skin. You may also apply an ointment or rich moisturizer after you use the compresses. A moisturizer may also help with the dryness, and therefore reduce some itching as well. These moisturizers may include petroleum jelly, such as Vaseline, heavy creams, such as Lubriderm or Eucerin, shea butter or even soak with witch hazel.
To avoid making your pain and itching worse, try not to scratch, pick or break your blisters. Although it’s important to wash your hands regularly, you may want to avoid extensive contact with water, such as frequent hand-washing. You should also avoid using products that can irritate your skin, such as perfumed lotions and dishwashing soap.
Changing your diet may help prevent skin flare-ups. It is believed that a nickel or cobalt allergy can also cause eczema, so removing foods that contain these may help. Some also recommend adding vitamin A to your diet. Using anti-inflammatory foods may also help.
The main complication from dyshidrotic eczema is usually the discomfort from itching and the pain from the blisters. This can sometimes become so severe during a flare that you are limited in how much you use your feet or even walk. There is also the possibility of getting an infection in these areas. In addition, your sleep may be disrupted if the itching or pain are severe.
Dyshidrotic eczema will usually disappear in a few weeks without complications. If you don’t scratch the affected skin, it may not leave any noticeable marks or scars. If you scratch the affected area, you may experience more discomfort or your outbreak may take longer to heal. You could also develop a bacterial infection from scratching or breaking the blisters. Although the outbreak of dyshidrotic eczema may heal completely, it can also recur. Because the cause of dyshidrotic eczema isn’t known, doctors have yet to find ways to prevent or cure the condition.
• For more information or to see a podiatrist visit Bahamas Foot Centre Rosetta Street, telephone 325-2996 or Bahamas Surgical Associates Centre, Albury Lane, telephone 394-5820 or email firstname.lastname@example.org or visit www.apma.org.