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Treatment and Possible Causes of Dyshidrotic Eczema

John was a Navy hospital corpsman. He worked the general sick bay, managed a carrier O.R., and treated heat rash, eczema, and dyshidrosis.

A severe form of eczema on the forearms.

A severe form of eczema on the forearms.

My Experience With Dyshidrotic Eczema

I have dealt with outbreaks of dyshidrotic eczema on both the hands and feet for years. I have learned that dealing with the problem early is the most effective way to resolve the issue.

My hands are often sweaty. Some people just have sweaty hands—but for some people, like me, this is actually related to dyshidrotic eczema. In addition, my feet are extremely sweaty. I usually change socks at least twice a day. As you will learn, keeping the feet dry, wearing cotton socks, wearing leather shoes that breathe, and treating the feet medicinally as soon as you notice the tiny vesicles (blisters) is the best way to maintain control. The hands are somewhat easier to treat since they are not covered all the time. Keeping the hands clean and dry of perspiration (avoid paper towels for drying), using moisturizing cream for minor itching, and using doctor prescribed corticosteroids during an outbreak will provide you with a good maintenance routine.

What Is Dyshidrotic Eczema?

One form of eczema that appears in different levels of seriousness is known as dyshidrotic eczema (also known as Dyshidrosis, Dyshidrotic Eczema, and Pompholyx). This particular dermatitis is characterized by very small, pinhead size blisters known as vesicles. These blisters most often occur on the sides of fingers and toes, and on the palms of hands and soles of feet. Since the blister occurrence is most often at the hands and feet, dyshidrotic eczema is sometimes referred to as hand eczema or foot eczema. The blisters are often referred to as "tapioca-like." Extreme itching is present at the site of this skin eczema. Scratching makes the skin aggravated and sore, and it leads to more eruptions, redness, cracks, and bleeding. If the cause of this eczema is unknown, trying an astringent soak may give some relief.

The duration of this kind of eczema can range from a few days to lasting (or recurring) over a long period of time. Dyshidrotic eczema usually resolves itself. Normally it does not result in serious problems. The degree of disease can be from a mild case with a smaller concentration of blisters to a severe case with tiny blisters and severe itching densely covering the commonly affected areas. In time, without treatment, severe cases can result in cracks, open sores, bleeding, and crusting from serum. Serum is a component of blood that contains antibodies.

Getting the Help You Need

All eczema can cause psychological pain and social distress, and, as a result, it is a condition that is often self-treated because of embarrassment. When a patient finally visits a doctor, a skin condition (eczema) with typical characteristics can be diagnosed. It is sometimes the case that a physician treats based on an assumption of what is causing the eczema, and then a return trip is required. But once the right eczema treatment is begun, the response can be quick with relief of itching, disappearance of red inflamed skin, and healing of cracks that may have been bleeding.

Medical Treatments

The most important thing to help the body begin to heal itself is to stop the itching so the patient does not continue to scratch. There is a group of medicines called corticosteroids that help the body's immune system to slow down the reaction causing the eczema at the skin. Corticosteroids are man-made medications that resemble cortisone, a hormone produced by the body. They are used to treat inflammation and help to relieve pain and stiffness.

These corticosteroid medications, many of which are creams, are frequently prescribed for dyshidrotic eczema. This potency chart shows brand-name topical steroid medications along with the generic version.

Corticosteroid Medications:

  • Class 1 - Super Potent - Clobetasol (Timovate)
  • Class 2 - Potent - Lidex Cream/Gel/Ointment, 0.05% - Fluocinonide
  • Class 3 - Upper mid-strength - Lidex-E Cream, 0.05%
  • Class 4 - Mid-strength - Kenalog Cream/Spray, 0.1% - Triamcinolone acetonide
  • Class 5 - Lower mid-strength - Westcort Cream, 0.2% - Hydrocortisone valerate
  • Class 6 - Mild Synalar - Cream/Solution, 0.01% - Fluocinolone acetonide
  • Class 7 - Least Potent - Cortaid Cream/Spray/Ointment - Hydrocortisone

Physicians also frequently prescribe antihistamines, like Benadryl, to reduce the itching. Occasionally, for serious outbreaks, Prednisone, an oral steroid, is prescribed. The use of corticosteroids (prescription only), combined with medication to control itching, is the most frequent route physicians take to treat eczema.

How to Apply Topical Treatments

When cleaning the site of the dyshidrosis, you should use as little soap and water as possible, yet still clean the area thoroughly. Dove soap is frequently recommended in the literature. The affected area should be patted dry. Then a topical steroid, prescribed by a doctor after consultation, is applied to the skin.

What Causes a Dyshidrotic Episode?

There are several theories about what triggers the dyshidrotic episodes. Some believe that metals such as nickel and chromium can be the culprits, usually after exposure to cement or machinery. These folks recommend an "eczema diet" to help control outbreaks. Others believe that fungal infections and bacterial infections can be the instigators. Some believe that stress has a large role in these blistery occurrences, while just as many patients feel that stress had nothing to do with it. Another theory is that exposure to water for a long period of time can cause the eruptions. There is evidence that people who work as dishwashers and kitchen employees, whose skin is frequently exposed to water, often show symptoms. Heat exposure and seasonal allergies may also bring dyshidrotic eczema on.

Because of the connection between wet or damp conditions and dyshidrosis, it is recommended that the hands and feet not be in contact with man-made materials. These materials tend to harbor the moisture. It is advised that the hands be covered with cotton gloves after administering topical creams. Feet should be covered with natural (breathable) materials, such as cotton. Leather shoes are often recommended.

Home Treatments for Eczema

Here are some home remedies for the treatment of eczema:

  • Vitamin E oil
  • Chamomile tea
  • Virgin pressed coconut oil
  • Aloe Vera gel
  • Gentian tincture
  • Whole organic cucumber
  • Ground horsetail plant or herbs
  • Tea containing calendula, a marigold flower, and 5 drops of lavender essential oil
  • Paste of organic carrots
  • Ground juniper berry and sage
  • White vinegar soak (the vinegar changes the pH balance of the skin, effectively stopping any fungal growth on the skin).
  • An oat milk soak will relieve the pain and sooth the itching.
  • Hydrogen peroxide - Using a 3% hydrogen peroxide can heal persistent blisters; however, it is advisable to use it only once a week. Dab the peroxide with a cotton ball on the affected areas to alleviate the symptoms.

More important tips:

  • Avoid scratching the rash.
  • Limit your skin's exposure to water.
  • Moisturize with a hand cream after washing your hands.
  • Take measures to protect your hands from irritants, such as perfumed lotions or dish-washing soap.
  • Remove nickel from your diet, as nickel is a known trigger for this condition Foods like chocolate, oatmeal, shellfish, almonds, and canned vegetables are high in nickel.


Dyshidrotic eczema is a malady that affects people around the globe. The reason for all of the blisters and itching, and the very best treatment and cure have yet to be discovered. If you are experiencing the symptoms of dyshidrotic eczema, you ought to consult a doctor and get immediate treatment.

This content is accurate and true to the best of the author’s knowledge and does not substitute for diagnosis, prognosis, treatment, prescription, and/or dietary advice from a licensed health professional. Drugs, supplements, and natural remedies may have dangerous side effects. If pregnant or nursing, consult with a qualified provider on an individual basis. Seek immediate help if you are experiencing a medical emergency.

© 2010 John R Wilsdon


John R Wilsdon (author) from Superior, Arizona on July 15, 2018:


Mix equal amount of Apple Cider Vinegar and water. (Note: For sensitive skin, dilute the ¼ cup of ACV with 3 cups of water.) For topical application.

Add 2 cups of Apple Cider Vinegar (ACV) to warm bath water.

Vinegar on July 15, 2018:

How much vinegar/water?

John R Wilsdon (author) from Superior, Arizona on October 12, 2017:

Jack Heron - Thanks for reporting. Nickel in jewelry is often and instigator of contact dermatitis. Of course, those things are shared by many folks. No telling what might be on them, including cleaners. I might suggest gloves next time. Hope your symptoms subside soon. Thanks again.

Jack Heron on October 12, 2017:

I just had my very first episode of this - itchy lumps on my palms. They appeared shortly after I went to the gym (my first trip to the gym in quite a long time)

Could it be possible that holding the iron weights and metal bars created this (nickel and chronium connection)? Plus the hit my immune system took from working out hard?

John R Wilsdon (author) from Superior, Arizona on August 29, 2012:

I understand your concern over your 6 year old's dilemma, but since you are inquiring about a child, I must emphasize that you must seek a dermatologists recs. Having said that, I found a forum entry that may help give you direction. I am not trying to shirk your question, but I am not a doctor (I have provided nursing care for myself) and I would not want the liability of your child's health on my shoulders. Since I know how annoying the problem is, I would refer you to this link. If it helps, great, but I do hope professional medical care will help your child in the future. Good luck, and thanks for the comment.

Racquel Ferrer on August 28, 2012:

Is primrose suitable for a 6 years old with dyshidrosis ? Can it me applied directly in the affected area ?

Kirsten on June 07, 2012:

I have suffered with Dyshidrotic Eczema since I was five or six, not long after I was treated (for something else) with a year of antibiotics. I am 41 now, and have not had it predominantly as an adult. This year however I have had it for 5 months continually, day after day getting new blisters with a lot of swelling making it impossible some days to do anything. I have recently begun using alkalized water/pH-balanced water and the results have been immediate. I would recommend it to anyone who suffers with this. You can buy filters for your shower head, counter top filters for drinking/cooking and also little sticks to use for up to a year in your water/tea travel bottle/cup. I'm also looking into a pH balanced diet, and what I am reading is blowing my mind. (The pH Miracle is the book). Good luck and give it a try.

John R Wilsdon (author) from Superior, Arizona on March 10, 2012:

Hello ang

Vinegar, applied for 15 minutes four times daily in a weak solution can help decrease the itching.

anj on March 06, 2012:

how often with the vinegar? and for how long to soak?

John R Wilsdon (author) from Superior, Arizona on November 26, 2011:

Hello RB

I am so glad you took the time to report your success. If it helps one person to read about primrose it's great.

Good luck with continued success, and do let us know how things worked out.

RB on November 26, 2011:

I started getting these blisters about 2 weeks ago. Ironically, I am very interested in herbal remedies and a few days before had read about evening primrose oil (and it's effects on eczema). After extensive internet research (obviously, the best way - haha - to diagnose oneself when you can't afford a doctor), my symptoms matched Dyshidrotic eczema. I took 1,000mg pills 3X a day. After the blisters cleared, my skin cracked and had a whitish cast (really disturbing... and I was afraid it was infected, but I suspect it was from excess moisture). In anycase, it is day 10 into it and aside from neosporine a few times a day and the Evening primrose pills, I haven't done anything, but have seen a huge improvement. I will repost again in a day or so, but I really think it's the evening primrose that is helping.

dr. jitendra sharma india on September 28, 2011:

Thanx all of you. It is very informative.

John R Wilsdon (author) from Superior, Arizona on October 06, 2010:

I'm glad you have an alternative now. Thanks for letting me know.

Lita C. Malicdem from Philippines on October 06, 2010:

I had suffered badly from dermatitis as allergic reaction to leather footwear. The itchiness is really biting. I treated it with topical ointment. I don't know that vinegar soak can relieve the itchiness. I don't want this eczema to come again. Now I have this naturopathic treatment just in case. Thanks for sharing this.

gajanis from Pakistan on August 09, 2010:

very informative....keep it up.