Treatment and Possible Causes of Dyshidrotic Eczema
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 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.
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.
- 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.
Only a physician can recommend and prescribe corticosteroid treatments for 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. (Source: Carolyn Lawrence, http://www.ehow.com/facts_5016923_natural-treatment-dyshidrosis-eczema.html)
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.
I use this when I have an outbreak that results in blisters and wet exudate on my feet. The drying effect reduces the sting and helps the seepage to stop. It along with steroid medications from the doctor get me through a bad outbreak.
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.
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© 2010 John R Wilsdon