Learn what dyshidrotic eczema is, symptoms, possible causes, and how to manage it.
Dyshidrotic eczema is a type of eczema that causes painful blisters on the hands and feet. It usually affects young adults ages 20-40, but could affect a child or adult at any age. Today, we’ll cover what dyshidrotic eczema is, symptoms, possible causes, and how to manage it.
What is dyshidrotic eczema?
Dyshidrotic eczema is a type of eczema that only affects the hands and feet. It’s also called dyshidrotic dermatitis, pompholyx eczema, or vesicular eczema.
Most commonly, dyshidrotic eczema causes extremely itchy and watery blisters to develop on someone’s palms, the sides of their fingers, and the soles of their feet. When someone’s skin is exposed to certain irritants, or triggers, their eczema flares up and the blisters start to form.
Why does dyshidrotic eczema affect just the hands and feet? As the UK’s National Eczema Society explains, this is likely because “the skin in these areas is more prone to exposure to potential sources of irritation and aggravation.”
Anyone can develop dyshidrotic eczema, regardless of their age. Children sometimes develop dyshidrotic eczema. But it’s most common in young adults ages 20-40 --- and particularly, young women in this age range.
How is dyshidrotic eczema diagnosed?
Dyshidrotic eczema is diagnosed by a dermatologist. The dermatologist will check someone's medical history, including their family history of eczema and their history of reactions to possible triggers. They will also run a skin test.
Symptoms of dyshidrotic eczema
Dyshidrotic eczema causes the development of very itchy, and very painful blisters called vesicles, which later grow larger and become “weepy.” It also causes prickly, itching, burning sensations in the palms and/or soles.
(In some cases, the blisters develop first followed by the burning sensation, while in some cases, the burning sensation is felt before the vesicles form.)
Dyshidrotic eczema blisters usually last between two and four weeks before they start to dry. As the blisters, and the skin around them, start to dry out, the skin becomes tender and can turn red. Often, the skin peels at this point, and sometimes, the drying out creates very painful skin cracks called fissures.
Occasionally, the vesicles can become infected, causing swelling, more pain, and pustules (inflamed, pus-filled sores) to emerge.
What causes dyshidrotic eczema?
We don’t yet know what causes dyshidrotic eczema. But we do know possible triggers that could cause dyshidrotic eczema to flare up (get worse):
- Certain metals (nickel, chromium, cobalt)
- Hot or humid weather
- Irritants like soaps and detergents
- Excessive exposure of the hands to water
- Certain seasonal allergies (hay fever)
Dyshidrotic eczema vs. atopic dermatitis
Dyshidrotic eczema is different from atopic dermatitis, even though both are types of chronic eczema (lasting eczema) that flare up when the skin is exposed to certain triggers.
While dyshidrotic eczema causes itchy, watery blisters on the hands and feet, atopic dermatitis causes a scaly, itchy rash that could appear anywhere on the body (but most often on the face, elbows, knees, and joints of the arms and legs). And in babies and young children, atopic dermatitis is much more common than dyshidrotic eczema.
But someone can have dyshidrotic eczema on their hands and feet, along with other types of eczema (such as atopic dermatitis) on other parts of their body. In fact, the UK’s National Eczema Society reports that 50% of people with dyshidrotic eczema either have atopic dermatitis as well, or have a family history of atopic dermatitis.
Managing and treating dyshidrotic eczema
How to manage and help relieve your child's dyshidrotic eczema? Follow these tips:
- Gently wash your child's affected areas with lukewarm water and a mild, fragrance-free and dye-free cleanser. Then, carefully pat the areas dry. Apply a moisturizer within three minutes of the wash.
- Moisturize your child's skin regularly. Use a moisturizer that contains ceramides. This will help repair your child's damaged skin barrier.
- Apply cool compresses to the affected areas of your child's skin a few times a day, as directed by your child’s dermatologist.
- Ask your child's dermatologist about a prescription topical steroid. Dyshidrotic eczema flares will often improve after several days of topical steroid applications (combined with cool compresses and moisturizer).
- Limit contact with metal and other irritants that seem to cause dyshidrotic eczema. If your child does come in contact with an irritant, try to gently wash the affected hand or foot as soon as you can.
- Make sure any socks, tights and gloves your child wears are 100% cotton or silk. These materials allow the skin to breathe, and are less irritating. Avoid synthetic glove and sock materials like nylon.
- If your child’s dyshidrotic eczema affects their feet, avoid buying shoes that are plastic or rubber. Also, avoid buying any other shoes that are likely to cause your child’s feet to sweat.
- Consider covering your child’s affected hands and feet with cotton gloves and socks right after applying moisturizer, to help the moisturizer absorb most effectively. The gloves may also help cut down on scratching, which could make your child’s eczema worse and possibly lead to infection.
- Keep your child’s fingernails short to discourage scratching.
- Ask your dermatologist if bandaging your child’s hands or feet after moisturizing, or starting wet wrap therapy on the hands and feet, would be beneficial.
- If your child develops pus-filled blisters, has swelling or crusting in their affected areas, or is in pain, visit your dermatologist. They may have an infection, which will require antibiotics to treat.
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