Dyshidrotic Eczema
Small, itchy blisters on the hands and feet
Quick Facts
- Type: Skin condition (a form of eczema)
- Where: Palms, sides of fingers, soles
- Hallmark: Small, deep, itchy blisters
- Course: Often flares and settles repeatedly
Overview
Dyshidrotic eczema is a type of eczema that produces clusters of small, deep-seated, very itchy blisters, mainly on the palms, the sides of the fingers, and the soles of the feet. The blisters are often described as looking like tiny tapioca pearls.
The condition tends to come in flares that last a few weeks, during which the blisters appear, eventually dry, and the skin may peel or crack. It is not contagious. While there is no permanent cure, most cases can be managed well by treating flares and avoiding triggers. It is more common in adults and can range from mild to quite uncomfortable.
Symptoms
Symptoms typically affect the hands and feet and may include:
- Small, firm, fluid-filled blisters on the palms, sides of the fingers, or soles
- Intense itching, sometimes with a burning sensation
- Redness and, in some cases, mild swelling
- As blisters dry, skin that becomes scaly, cracked, or peels
- Pain or tenderness, especially if the skin cracks or becomes infected
Signs of infection, such as increasing redness, warmth, swelling, pus, or worsening pain, should prompt medical attention.
Causes
The exact cause of dyshidrotic eczema is not fully understood, but it is linked to the same tendency toward sensitive, easily irritated skin seen in other forms of eczema. Flares are often set off by triggers, including:
- Stress
- Contact with metals such as nickel or cobalt
- Frequent wet hands or sweating, including sweaty palms and feet
- Exposure to irritants and certain chemicals
- Seasonal changes, particularly warmer months
People with a history of eczema, hay fever, or allergies may be more prone to it.
Risk Factors
- A personal or family history of eczema, hay fever, or allergies
- Frequent contact with water, soaps, or chemicals (such as in certain jobs)
- Sensitivity to metals like nickel
- High stress levels
- Excess sweating of the hands and feet
Diagnosis
A clinician can usually diagnose dyshidrotic eczema by examining the characteristic blisters on the hands and feet and reviewing the pattern of flares and possible triggers. Additional tests may include:
- Patch testing: To identify allergies, such as to nickel, that may be triggering flares.
- Skin scraping or culture: To rule out a fungal infection or check for bacterial infection when the diagnosis is unclear or the skin looks infected.
Treatment
Treatment aims to relieve itching, heal the skin, and reduce flares.
- Moisturizers: Frequent use of thick, fragrance-free moisturizers to repair and protect the skin barrier.
- Topical steroids: Prescription corticosteroid creams or ointments to calm inflammation and itching during flares.
- Cool compresses: To soothe itching and dry blisters.
- Avoiding triggers: Limiting contact with irritants, water, and known allergens, and managing stress and sweating.
- Other therapies: For severe or persistent cases, a dermatologist may recommend stronger treatments such as light therapy or other prescription medications.
Antihistamines may help with itching, and infected skin may need antibiotics.
Prevention
- Moisturize the hands and feet regularly, especially after washing
- Wash with gentle, fragrance-free cleansers and avoid harsh soaps
- Wear protective gloves for wet work and avoid known irritants and metals you react to
- Keep hands and feet dry and manage excess sweating
- Practice stress management techniques
When to See a Doctor
See a doctor or dermatologist if blisters are widespread, very itchy or painful, keep coming back, or do not improve with moisturizing and over-the-counter care. Seek prompt care if the skin shows signs of infection, such as increasing redness, warmth, swelling, pus, or worsening pain, or if you develop a fever, as infected eczema may need antibiotics.
Frequently Asked Questions
What triggers dyshidrotic eczema flares?
Common triggers include stress, contact with metals such as nickel, frequent wet hands or sweating, and exposure to irritants and chemicals. Seasonal changes, especially warmer weather, can also bring on flares. Identifying and avoiding your personal triggers helps reduce them.
Is dyshidrotic eczema contagious?
No. Dyshidrotic eczema is not contagious and cannot be spread to others through touch. It is a form of eczema related to sensitive, easily irritated skin, not an infection, although broken skin can occasionally become infected and need treatment.
How do I treat the itchy blisters?
Use frequent fragrance-free moisturizers, apply cool compresses, and use a prescription topical steroid during flares to calm inflammation and itching. Avoiding triggers and irritants helps prevent flares. For severe or persistent cases, a dermatologist can offer stronger treatments.
Will dyshidrotic eczema go away?
Individual flares usually settle within a few weeks, but the condition tends to recur over time, and there is no permanent cure. With good skin care, trigger avoidance, and treatment of flares, most people can keep it well controlled.
How can I tell if the blisters are infected?
Warning signs of infection include increasing redness, warmth, swelling, pus or yellow crusting, worsening pain, or fever. If you notice these, see a doctor promptly, as infected eczema may require antibiotics in addition to your usual eczema care.
References
- American Academy of Dermatology Association. Dyshidrotic Eczema.
- MedlinePlus, U.S. National Library of Medicine. Dyshidrotic eczema.
- National Eczema Association. Dyshidrotic Eczema.
- Mayo Clinic. Atopic dermatitis (eczema) — Symptoms and causes.