Dyshidrotic eczema, also called dyshidrosis or pompholyx, is a chronic skin disorder in which small, itchy bumps or blisters develop on the soles of the feet or palms, or back of the hands. It mainly affects adults aged 20 to 40 and is more common in women than men. People with allergies like hay fever, a family history of dyshidrotic eczema, or other types of eczema are more likely to get this condition. Dyshidrotic eczema is not contagious, and one can not catch it by touching someone who has it. However, dyshidrotic eczema can be a lifelong, debilitating disease.

What Causes Dyshidrotic Eczema?

The exact cause of dyshidrotic eczema is still not known. However, several triggering factors can set off dyshidrotic eczema, including:

Stress.
Contact with metals, particularly nickel, cobalt, or chromium salts.
Sweaty or wet hands and feet
Hot and humid weather.
Human immunodeficiency virus (HIV) infection.
Certain treatments for a weak immune system.
Seasonal allergies.
Specific ingredients in personal care products like soaps, shampoos, or moisturizers.
Smoking.
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Skin infections like athlete's foot.
History of atopic dermatitis in the past.
History of allergies such as allergic rhinitis in the past.
Having overactive sweat glands.

What Are the Common Symptoms of Dyshidrotic Eczema?

Dyshidrotic eczema clinically presents as follows:

The early symptoms of dyshidrotic eczema may be a burning, itching sensation without any visual clues.
Small, fluid-filled blisters may commonly develop on the edges of the fingers, the palms, and sometimes the soles of the feet, which may cause intense itching and burning sensation.
In severe cases, the small blisters may extend to the back of the hands and cluster to form larger ones.
If the skin becomes infected at this stage, the blisters can become painful and ooze pus.
Some people with dyshidrotic eczema have symptoms of infrequent episodes that may happen every month. However, over time, this may cause chronic hand dermatitis that may lead to newer symptoms such as reddened and hard skin, cracked skin, sweat near the blisters, and color changes in the nails.
The blisters usually last a few weeks before they dry up and flake away.

What Are the Risk Factors of Dyshidrotic Eczema?

Risk factors for dyshidrosis include:

Stress: Dyshidrotic eczema appears more common during emotional or physical stress.
Exposure to Certain Metals: Prolonged exposure to metals like cobalt and nickel can increase the likelihood of developing the condition.
Sensitive Skin: People who get a rash after contact with certain irritants and allergens are more likely to develop dyshidrotic eczema.
Atopic Dermatitis: People affected with atopic dermatitis may be more likely to develop dyshidrotic eczema.

What Are the Potential Complications of Dyshidrotic Eczema?

It may be an itchy inconvenience for most people with this condition, while severe pain and itching may affect their daily lives. In addition, dyshidrotic eczema may have complications such as:

There may be discomfort from itching and pain from the blisters. This discomfort can sometimes become so severe that it may cause difficulty walking and doing other daily activities.
There may be a possibility of developing an infection in the affected areas from over-scratching.
People may have disrupted sleep due to intense itching and pain.

How Is Dyshidrotic Eczema Diagnosed?

If a person has been dealing with red, itchy skin for more than a week, in that case, it is good to seek a doctor or dermatologist, as many skin conditions can cause blisters, including allergic contact dermatitis ringworm, and herpes. In most cases, the doctor diagnoses dyshidrosis based on a physical examination. No laboratory test can specifically confirm a diagnosis of dyshidrotic eczema, but the doctor may suggest certain tests to rule out other skin conditions with similar symptoms.

Skin Scraping or Biopsy: This test checks for infection or other rash causes.
Patch Skin Testing: This test identifies the causes of allergy.
Blood Tests: These tests help check for autoimmune causes.

What Are the Different Treatment Options for Dyshidrotic Eczema?

Treatment options for dyshidrotic eczema usually depend on the severity of the signs and symptoms and may include:

Corticosteroids: Corticosteroid creams and ointments may reduce inflammation and speed the disappearance of blisters. After applying a corticosteroid, wrapping the treated area in plastic wrap or moist compresses can enhance absorption. The doctor may prescribe corticosteroid pills in severe cases, such as Prednisone.
Phototherapy: If other treatments are ineffective, the doctor may recommend a special light therapy that uses ultraviolet (UV) light to clear the skin. The doctor may also give medicine with light therapy to help make the skin more receptive to the effects of light therapy.
Immune-Suppressing Ointments: Medications such as Tacrolimus and Pimecrolimus can calm the irritation and be an alternative for people who want to reduce their exposure to steroids. However, immuno-suppressing ointments may increase the risk of skin infections.
Botulinum Toxin Injections: Some doctors may prescribe botulinum toxin injections to treat severe cases of dyshidrosis. These shots also stop the hands and feet from sweating, which is one of the triggers of dyshidrosis.
Moisturizing Lotion or Cream: This may help treat dry skin.

What Are the Different Ways to Prevent Dyshidrotic Eczema?

There is no proven way to completely prevent or control the outbreaks of this condition, as the cause of dyshidrosis is generally unknown. But one can keep the symptoms from barreling out of control by following some practical tips, including:

Manage stress.
Stay hydrated.
Avoid exposure to metals, such as cobalt and nickel.
Follow good skincare practices like applying moisturizers and mild cleansers and using lukewarm water to wash your hands.
Wear gloves.
Avoid plastic or rubber shoes as this footwear is likely to cause sweating.

Conclusion

Dyshidrotic eczema is a chronic skin condition that causes a burning and itching sensation. Typically, blisters associated with this condition disappear within a few weeks without complications. However, scratching the affected area may cause infection, and the outbreak may take longer to heal. Although the outbreak of dyshidrotic eczema may recover completely, it can also recur. Working with a dermatologist to develop a personalized treatment plan is best to keep this skin condition from disturbing daily life.