What Is Dyshidrotic Eczema?

 

Dyshidrotic eczema is an intensely itchy & painful skin condition that causes blisters on the palms, fingers, &soles of the feet. 

It can be mild or severe. It can also affect your sleep.

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Symptoms

Dyshidrotic eczema is an extremely itchy rash that typically develops on the sides of someone's fingers and palms or sometimes on their feet. This eczema flares up when certain irritants (or triggers) are introduced into the skin. It's a common condition affecting people in all age groups, but it's most commonly seen in young adults between 20 and 40.

These symptoms can be uncomfortable, but dyshidrotic eczema often disappears within 3 to 4 weeks. 

Your dermatologist may also recommend a topical lotion that can moisturize the affected areas.

These emollients can be purchased over the counter and help relieve the itching associated with this rash.

Dermatologists can also prescribe topical steroids that can be absorbed into the skin, easing the itching and inflammation of your skin. However, it is important to moisturize your skin while using these products because topical steroids can dry the skin out.

The main goal of treating dyshidrotic eczema is to decrease the number of flare-ups. This can be achieved by changing the things that trigger your eczema, such as avoiding certain personal care products that contain nickel or other metals.

Avoid washing your hands with hot water or soaps that irritate the skin, such as soaps with fragrances or dyes. Washing with lukewarm water instead is also an effective way to soothe your skin and reduce the itching associated with this rash.

Your dermatologist may also suggest taking a vitamin E supplement to reduce the itching and redness of your skin. Vitamin E will also help your skin maintain its natural moisture barrier, reducing the chance of drying out during a flare-up.

Diagnosis

Various factors may trigger allergies, stress, and weather conditions.

Your doctor will also use a special tool called the dyshidrosis area and severity index (DASI) to help determine the severity of symptoms.

In addition, your doctor will examine your fingers, hands, and feet to see if you have any other health issues causing the itchy skin. If they find anything, they can treat it to relieve your symptoms.

If your doctor thinks you have dyshidrotic eczema, they will likely prescribe a medication to reduce itching and inflammation. These medications can include topical steroids, creams, and ointments.

Another treatment option is phototherapy, which uses ultraviolet light waves from a special lamp. It can effectively treat severe cases of dyshidrosis and may help with dry skin.

Other treatments can include system-wide nonsteroidal immunosuppressive drugs, such as methotrexate tablets (Rheumatrex), mycophenolate tablets (CellCept), or sarilumab injections. These medications can cause side effects like kidney problems and liver damage.

You must find a medication that works best for you to treat your itchy skin. 

The most common medication for dyshidrotic eczema is a topical steroid cream or ointment. This medication can reduce your itching and inflammation, but be careful not to use too much, or you can experience unwanted side effects, such as topical steroid withdrawal.

In addition, you will need to use a moisturizer regularly to improve the appearance and health of your skin. 

Treatments

These ointments can help reduce itching and moisten skin to cut down on scratching.

Some doctors also recommend corticosteroid pills or injections. These may help reduce itching, but long-term use can cause side effects like skin infections.

If your eczema worsens or you experience itchy blisters that don't clear up, talk with a dermatologist (a doctor specializing in your skin). They can diagnose and treat dyshidrotic eczema.

They will look at your hands and feet to see the blisters and ask about your symptoms and triggers. They will also do a skin test to check for allergies.

In severe cases, the blisters can merge and form bullae (large blisters larger than a thumbnail), which can be very itchy.

If this doesn't work, your doctor may suggest a topical antibiotic lotion.

You can also use antihistamines or calamine lotion to reduce itching. Avoid irritants triggering your flare-ups, such as scented soaps and lotions, harsh cleansers, or dyed fabrics.

The best treatment for dyshidrotic eczema is to keep your skin moisturized. This helps cut down on itching and protects against infection, which is more likely when the skin is dry and cracked.

Sometimes, your dermatologist will recommend a special light therapy that uses ultraviolet light to relieve itching and inflammation. 

Other treatments your doctor may recommend include taking antihistamines to help ease itching and avoiding irritants that can aggravate your eczema. Your doctor may also suggest a low-cobalt diet if you have a nickel allergy causing your eczema to flare.

Dyshidrotic eczema can often go away independently after you learn to avoid triggers. Keeping your skin moisturized, keeping your fingernails short, and applying ointments and other skin products regularly can all help keep the rash from returning.

Prevention

It's more common in people younger than 40, although anyone can get it.

When the skin heals, it usually looks scaly and dry. In severe cases, blisters may bleed. Symptoms are similar to atopic dermatitis, and your dermatologist can diagnose dyshidrotic eczema with a skin exam and medical history.

Your immune system overreacts to minor irritants and allergens in your body when you have dyshidrotic eczema. 

The best way to prevent a dyshidrotic eczema flare is to avoid any potential triggers that you know cause flare-ups. Examples include using soap or detergents that sting your skin or coming into contact with nickel and cobalt in your job or hobbies.

Keeping your fingernails short is also a good idea, which can help prevent them from breaking and scratching your skin. It would help to moisturize your hands and feet with a hand or foot cream at least once daily.

Your doctor may recommend topical ointments, corticosteroids, and creams you rub on your skin. Oral antihistamines, including fexofenadine (Allegra(r)) or cetirizine (Zyrtec(r)), can help as well.

Another option is a light-sensitive plant substance called psoralen, which helps heal your skin and ease itching. Your doctor may also prescribe a topical or oral drug called PUVA, which uses ultraviolet radiation to treat your eczema.

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Your doctor will also consider your lifestyle, such as the foods you eat and how much you exercise. 

Other ways to prevent a flare include ensuring your skin is always well-hydrated and avoiding hot or humid weather. 

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