Dyshidrotic eczema or pompholyx is a form characterized by small-sized blisters across the fingers, palms of the hands and oftentimes on the soles of the feet. This type of eczema can develop among individuals of all ages but most often among adults below 40 years old.
What are the indications?
Dyshidrotic eczema generally starts as significant itchiness and burning of the skin on the fingers and hands. The sides of the fingers and palms end up with small-sized itchy blisters that start to weep fluid.
In severe instances, the blisters are large enough and even spread to the back part of the feet, hands and limbs. In some cases, the skin can become infected. Once this occurs, the blisters become painful and start to drain pus or become covered with a yellowish crust.
The blisters typically heal in a few weeks. The affected skin tends to dry out and crack or peel as the healing process starts.
What are the causes?
The precise cause of dyshidrotic eczema is still unclear but can be triggered or aggravated by the following:
- Fungal skin infection – this can form on the hands or at a distant site from the blisters
- Reaction to substances that touched the skin – this includes detergents, metals (nickel), soap, household chemicals, shampoo, perfume or cosmetic products
- Sweating – the condition is common during the spring and summer season where the climate is warm and among those with hyperhidrosis
Generally, dyshidrotic eczema settles on its own in a few weeks. In some cases, the condition might only occur once and never to recur but it often comes and goes over a span of several months or years. Occasionally, the condition can be persistent and hard to treat.
Management of dyshidrotic eczema
It is important to avoid exposure to anything that can irritate the skin including shampoos, soaps and other household chemicals.
An emollient can be used as a substitute to soap and use cotton-lined gloves if at risk for exposure to other potentially irritating substances when doing housework or washing the hair. If there are blisters present, they should not be opened. Simply allow the blisters to heal on their own. If the blisters are large enough, the doctor will decide to drain them.
Management of the symptoms
The main treatment options that the doctor will suggest are the same as managing atopic eczema which includes:
- Steroid creams – works by decreasing the inflammation and irritation as well as promote healing of the skin
- Emollients – these are used regularly as a substitute to soap to prevent skin dryness
The doctor might prescribe a steroid cream to be used briefly to reduce the risk for the side effects. The individual is also advised to use cotton gloves at night time to allow penetration of the cream into the skin.
Other measures include:
- Immersing the hands in a diluted solution of potassium permanganate for 10-15 minutes at least 1-2 times a day for up to 5 days
- Antihistamines can be given to reduce the itchiness and allow the individual to sleep if the itchiness disrupts sleeping
Remember that these treatment options are available without requiring a prescription. If the skin shows signs of infection, antibiotics might be prescribed.