17728 Dyshidrotic Eczema

Overview

Dyshidrotic eczema is a type of eczema that causes small, itchy blisters to form on the palms of your hands, the sides of your fingers, and the soles of your feet. It is also called pompholyx. The blisters can be very uncomfortable and may break open, crust over, and leave cracked, peeling skin. It is not contagious, so you cannot pass it to anyone else.

Dyshidrotic eczema is fairly common. Many people who have other forms of eczema may develop it at some point.

It most often affects adults between the ages of 20 and 40, and it is slightly more common in women. It can also develop in children, though it is less common.

Symptoms

Common symptoms

• Small, deep blisters on the palms, sides of fingers, or soles of feet
• Itching, burning, or a prickly feeling before and during the blisters
• Redness and scaling around the blisters
• Blisters that merge and become larger, then dry out and peel
• Cracked, dry, or thickened skin after the blisters heal

Symptoms in children

• Children get the same blisters as adults, usually on their hands and feet.
• Children may scratch a lot, which can make the skin raw or lead to an infection.
• Children may be fussy or have trouble sleeping because of the itch.

Symptoms in older adults

• Older adults may notice more dryness and cracking than blisters.
• The skin on the hands and feet may become very thick and tight.
• Healing may take longer, and there is a higher risk of skin infection if cracks open.

Causes

Main causes

• The exact cause is unknown, but it is a type of eczema linked to inflammation in the skin.
• Sweating or heat can trigger blisters to form.
• Stress or emotional upset can make a flare worse.
• Contact with skin irritants such as soaps, detergents, or water can irritate the skin.
• Some people react to metals like nickel or to fungal infections elsewhere on the body.

Risk factors

• A personal or family history of eczema, asthma, or hay fever
• Working with wet hands, chemicals, or cement
• Living or working in a hot or humid environment
• High levels of stress
• Smoking

When to see a doctor

See a doctor urgently if:

• Your hands or feet become extremely painful or swollen
• You see signs of a skin infection, such as yellow crusts, pus, or red streaks
• You develop a fever alongside a flare-up

Book a routine appointment if:

• Blisters last longer than a few weeks or keep coming back
• The itching disrupts your sleep or daily activities
• Over-the-counter moisturizers and gentle care are not helping

Diagnosis

A doctor can usually diagnose dyshidrotic eczema by looking at the blisters on your hands and feet and asking about your symptoms, lifestyle, and any eczema or allergies in your family.

Tests that may be done

• No special test is needed in most cases.
• Sometimes a doctor may gently scrape a bit of skin to rule out a fungal infection.
• If allergies are suspected, a dermatologist may offer patch testing to see if certain metals or chemicals cause your blisters.

What to expect at your appointment

The doctor will examine the affected skin, ask about when the blisters started and what makes them better or worse. They may ask about your job, hobbies, and stress levels. If the diagnosis is clear, they can talk with you about treatment. If not, they may refer you to a skin specialist (dermatologist).

Treatment

Treatment focuses on relieving the itch, drying out blisters, and calming the skin’s inflammation. You will also learn how to avoid things that trigger your flare-ups. Many people see a big improvement with proper treatment.

Self-care at home

• Soak your hands or feet in cool water with a mild emollient (a moisturizing product) to dry out blisters before your skincare routine.
• Use plain moisturizers or emollient creams every day, especially after washing.
• Wear cotton gloves or socks to protect the skin.
• Avoid harsh soaps, bubble baths, and washing-up liquid; use soap substitutes.
• Wear rubber or vinyl gloves with cotton liners when your hands are in water or chemicals.
• Keep your hands and feet cool and dry, and change sweaty socks and shoes regularly.

Medical treatments

Your doctor may suggest a topical corticosteroid cream or ointment to reduce inflammation and itching. For severe flare-ups, they might prescribe stronger prescription creams, oral medications, or phototherapy (light therapy) under specialist supervision. Any medications you are prescribed should be used exactly as directed, and you can ask your doctor or pharmacist about how they work. If there is a fungal infection or bacterial infection, your doctor may also recommend treatment for that.

Living with this condition

Living with dyshidrotic eczema means paying attention to your skin every day. Use gentle cleansers, moisturize often, and try to keep your hands and feet dry but not cracked. At work, use gloves if your hands are exposed to water or chemicals. At home, wear cotton socks and avoid tight shoes that make your feet sweat.

Lifestyle tips

• Wash your hands with lukewarm water and fragrance-free soap, then dry gently and apply moisturizer.
• Take short, lukewarm showers and pat your skin dry — do not rub.
• Use an emollient wash instead of regular soap.
• Wear comfortable, breathable socks and shoes, and change them daily.
• Find healthy ways to manage stress, such as walking, breathing exercises, or talking to a friend.

Diet and exercise

Regular exercise is good for stress and overall health, but shower soon after to wash off sweat and reapply moisturizer. There is no single diet proven to cure dyshidrotic eczema, but some people find that avoiding foods high in nickel (like whole grains, beans, and nuts) helps if they have a nickel sensitivity. Talk to your doctor or dietitian before cutting out foods.

Mental health and emotional wellbeing

This skin condition can feel embarrassing, and the constant itch and pain can affect your mood and sleep. It is normal to feel frustrated or stressed. Remember that eczema is a medical condition, not something you caused. If it is affecting your mental health, talk to your healthcare provider — they can help you find support.

Prevention

Dyshidrotic eczema cannot always be completely prevented, but you can reduce how often it flares by identifying your personal triggers and taking precautions with hand and foot care. Avoiding known irritants and managing stress can make a big difference.

Complications

If left untreated

• Blisters can crack open and become infected with bacteria, causing cellulitis (a deeper skin infection).
• Repeated flares can make the skin thick, painful, and hard to move.
• If blisters affect the nail area, you may develop nail changes such as ridges or pitting.

Long-term outlook

Although dyshidrotic eczema can recur, most people respond well to treatment and learn to control their flare-ups. With good skin care, avoiding triggers, and regular check-ins with your doctor, you can keep symptoms to a minimum and protect your skin. The outlook is generally very good, and many people find that their eczema becomes less active over time.

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