Dyshidrotic Eczema

Understanding Dyshidrotic Eczema

One of the less common types of eczema, Dyshidrotic eczema is also known as Pompholyx.  Dyshidrotic means, “bad sweating’ which was thought to be the cause of this condition. Pompholyx, derived from the Greek word cheiropompholyx, which means “hand and bubble”. It is also known vesicular palmoplantar dermatitis or housewife’s eczema.

The condition occurs mostly on the palms, soles and the sides of fingers and toes and often worsens in warm weather. It is extremely itchy and appears as tiny, opaque blisters or bumps called vesicles. With the itching and scratching, thickening and cracks begin which seems to worsen at night and/or in warm, humid weather, causing the cycle to spiral.

The fluid filled blisters start up as tiny beads, which eventually join to form a rash and begin to weep or ooze. Although the Dyshidrotic eczema is not contagious, it often recurs and for many sufferers it is a chronic condition.

Dyshidrotic Eczema Causes

Mild Dyshidrotic eczema on back of knees

In the past, the belief was that the cause of Dyshidrotic eczema was due to sweating but nowadays, the suggestion is that it may be due to a genetic predisposition as most patients with Dyshidrotic eczema also present with Atopic eczema.

Studies show that Dischidrotic eczema affects those living in warmer climates and occurs more frequently in the spring and summer months. It is more prevalent in people in their middle ages but is seen in patients as young as four years.

Dyshidrotic eczema seems to start when a person is exposed to chemical substances such as nickel or cobalt or sometimes by others, which may be ingested. Emotional stress or trauma exacerbates the condition and so too does extreme weather or temperature changes. In some cases, it has been noted that the excessive consumption of coffee and smoking can also aggravate the condition. The fungal infection tinea pedis is said to bring on an episode ofDyshidrotic eczema, however, the treatment for tinea pedishas cured the eczema as well.

Dyshidrotic Eczema Symptoms

Common symptoms of Dyshidrotic eczema:

• Very small blisters, about 1mm or less in diameter, which appear on the toes, palms, soles and tips and sides of the fingers
• The blisters or vesicles are opaque and deep-seated, they may be flush with the skin or slightly elevated and do not easily break. The small blisters eventually join to form larger vesicles.
• The blisters may itch, burn or cause pain or produce no symptoms at all, however, they could worsen after contact with irritants, chemicals or soaps.
• The fluid, which accumulates inside the blisters, is thought to be sweat. However, it is serum, which accumulates in the irritated skin cells.
• Scratching the vesicles breaks them, releasing the serum. This causes the skin to crust and then crack. The cracking is painful and unsightly, often-taking weeks or months to heal.

Severe Dyshidrotic eczema on hands

Dyshidrotic Eczema Treatment

Treating Dyshidrotic eczema can be difficult for both the patient and physician; however, there are a few tips to follow to ease the discomfort and pain of Dyshidrotic eczema.

It may be helpful to dry out the blisters by soaking the area in a mild antiseptic. Hydrogen Peroxide or Potassium Permanganate diluted (1 in 10 000) are good antiseptics to try. Topical steroid creams may be applied, however, in severe cases oral steroids may be necessary. Ointments with Zinc Oxide have proved helpful as well and oral anti-pruritics like Atarax and Benadryl can assist with the itching.

UV ray treatment has also been recommended by some doctors and in the case of emotional stress or trauma causing the flare-up, counselling may be in order.

With cases of nickel allergy or sensitivity, diet low in nickel should be advised as this may improve the condition or at least lessen the symptoms. Foods high in nickel include oatmeal, chocolate, canned food, e.g. pineapple, tomatoes, and vitamins that contain nickel. Excessive exposure to environmental sources of nickel should also be curbed, e.g. the use of stainless steel pots and silverware.

Helpful Tips and Advice

Some useful tips to follow to prevent Dyshidrotic eczema:

• Take care of the skin, especially on the hands and feet if you are prone to Dyshidrotic eczema
• Allow the feet to air frequently
• Wear cotton socks
• Use gloves when exposing your hands to chemicals or harsh detergents or detergents and soaps which are less harsh or chemical free
• Avoiding the feet or hands becoming too dry or allowing them to sweat excessively
• Ensure that any jewellery worn is nickel free
• Bathe with a mild soap and lukewarm water, ensuring that the soap is rinsed off thoroughly
• Avoid unnecessary exposure to soapy water or excessively long baths or showers
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