MT Ghozali is a researcher and lecturer of pharmaceutical sciences with extensive experience in patient education.
What Is Dyshidrotic Eczema? A Brief Overview
Dyshidrotic eczema, or dyshidrosis or pompholyx, is a type of skin disease that causes the development of small, tense, and itchy water-filled blisters that pop up on your palm, fingers, toes, and soles.
Of all hand eczema, dyshidrotic eczema accounts for 5-20%. This skin disease highly affects your personal and professional life and makes it a nuisance to deal with it due to pain and continuous itchiness.
The flare-ups of dyshidrotic eczema disease more commonly occur at a young age (between 20 to 30) and may last up to two to four weeks, depending upon the treatment and good personal hygiene.
The severity of dyshidrotic eczema may range from mild to severe, and in some instances, it can become chronic or debilitating if not treated properly. Moreover, dyshidrotic eczema often recurs, and repeated flares cause skin thickening.
How to Treat Dyshidrotic Eczema?
Since there is no particular cure for this skin disease, dermatologists or skin specialists have recommended certain alternative medical treatments, including a home skincare routine and medication that have been applied and are currently being used to treat dyshidrotic eczema.
Depending upon the clinical course of dyshidrotic eczema, let's review the most recommended treatment options one by one!
When Should I See a Doctor?
Consult your doctor if:
- you think you have the symptoms.
- you have a skin infection.
- your symptoms affect daily activities.
- your symptoms don't go away after self-treatment.
How Do You Get Rid of Dyshidrotic Eczema? At-Home Skincare Routine
Everyone's body and skin texture are unique. Sometimes your body responds well to an at-home skincare treatment, and sometimes it goes out of control and is not treatable at home anymore. Still, mild dyshidrotic eczema is treatable at home if you follow the proper skincare routine.
You can follow the National Eczema Society guidelines to treat minor blisters at home as suggested below.
- Use only lukewarm water while washing your hands and feet and dry it thoroughly because moisture causes more blisters and would make the condition worse.
- To reduce dyshidrotic eczema's symptoms like itching and irritation, you can soak your hands and feet in cool water for at least 5 minutes.
- You can also apply a cool compressor routinely throughout the day to ease discomfort caused by the blisters.
- Drain the large blisters with the help of a sterilized needle and cover the treated area properly to avoid infection. This helps in pain reduction.
- Apply ointments as recommended by your dermatologist to get rid of the blisters.
- Avoid rough and non-breathable fabrics, harsh soap, and allergens (metals or allergic food components) that trigger the blisters.
- Use topical steroids prescribed by your doctor to reduce inflammation, redness, soreness, and irritation. The topical steroids typically slow down the inflammatory response in your body, and as a result, your skin becomes drier.
- Use emollients (medical moistures) to prevent the skin from drying as the blister heals. Because once the blister dried up and healed, it left the cracked and dry skin behind, which became more painful.
- If the fluid is leaking from the blisters, soak your skin in a potassium permanganate solution to avoid infections.
- However, if the blisters get infected, consult your dermatologist immediately and get antibiotic treatment.
The symptoms of mild dyshidrotic eczema usually disappear following the general skincare guidelines instructed by your dermatologist.
The recommended first-line treatment for dyshidrotic eczema includes cold compress and high-strength topical steroids.
Meanwhile, the second line of treatment for acute flares is short courses of oral steroids.
For topical therapy, your doctor or dermatologist may prescribe corticosteroids.
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Treatment of Severe Dyshidrotic Eczema
If the dyshidrotic eczema condition becomes severe and blisters spread throughout the body, then the dermatologist prescribes a short course of oral medications or other treatment therapies, which include:
Phototherapy Ultraviolet (UV) light is one of the FDA-approved treatment options used to treat moderate to severe dyshidrotic eczema. Healthcare professionals use a specific number of wavelengths for a short amount of time to treat dyshidrotic eczema.
For treating dyshidrotic eczema, UVA of 315-400 nm and UVB of 280-315 nm are used due to their skin improvement and inflammation reduction effects.
Skincare specialists or technicians use UV light lamps to treat blisters and carefully control the amount of time and intensity of light you will spend under the UV lamps during the treatment procedure and ensure that it targets all the affected areas of your body.
As per National Eczema Society guidelines, phototherapy is given only 2-3 times per week for at least several seconds to a few minutes. The phototherapy is customized according to the degree of the eczema rashes that need to be targeted. The skin condition gradually improves, and the itching symptom reduces after several weeks of regular treatment.
It is important to attend sessions regularly to optimize the chances of treatment success.
Botulinum Toxin A (BTXA)
Botulinum toxin A (BTXA), commonly known as "Botox," is an FDA-approved medical procedure used to treat dyshidrotic hand eczema. Botox injections not only have an antipruritic (treat itching) effect but also reduce excessive sweating in dyshidrotic eczema patients.
Excessive sweating promotes flare-ups of dyshidrotic eczema; conversely, reducing excessive sweating can prevent the severity of this skin condition and its recurrence.
Moreover, a successful clinical trial conducted on eight adult patients with severe dyshidrotic hand eczema revealed that Botox injections have improved the outcomes and reduced the relapses in patients suffering from severe dyshidrotic hand eczema.
Oral Steroid Medications
Oral steroids medicines are given to patients with severe dyshidrotic eczema. These steroids help to reduce inflammation. In this case, your doctor or dermatologist may prescribe prednisone – a strong prescription drug, cortisone, or methylprednisolone.
A warning word: Oral steroid medications may help ease symptoms; however, they are not intended for regular use.
In some cases, when the potent topical steroids fail to treat severe dyshidrotic hand eczema, doctors recommend patients to take immunosuppressant drugs such as Alitretinoin capsules regularly for 12 to 24 weeks.
It is a licensed oral treatment and works as an inflammation reducer as well as damps down the inflammatory response of the immune system.
A warning word: If you have health problems, such as high blood pressure, urinary retention, heart disease, glaucoma, kidney or liver disease, or special conditions, such as pregnancy or breastfeeding, consult your doctor or pharmacist before use!
Antihistamines are also recommended by healthcare providers when you have severe dyshidrotic eczema and a home skin care treatment no longer benefits you. It is recommended to be taken orally with water. Antihistamines reduce itching and skin irritation in the affected area and prevent the condition from worsening.
Examples of commercial over-the-counter antihistamines for the symptoms include diphenhydramine (Benadryl) and loratadine (Claritin).
A List of Treatment Options for Dyshidrotic Eczema
|Types of treatment||Procedures||Effects|
Given only 2-3 times per week for at least several seconds to a few minutes or According to the doctors' recommedation.
Used to treat moderate to severe cases of dyshidrotic eczema.
Botulinum toxin A (BTXA)
According to the doctors' recommedation
Used to treat dyshidrotic hand eczema
Oral steroid medications
Take regularly for 12 to 24 weeks or according to the doctors' recommedation
Used to reduce inflammation due to dyshidrotic eczema.
According to the doctors' recommedation
Used to treat severe dyshidrotic hand eczema.
According to the doctors' recommedation.
Used to treat severe dyshidrotic eczema.
This content is for informational purposes only and does not substitute for formal and individualized diagnosis, prognosis, treatment, prescription, and/or dietary advice from a licensed medical professional. Do not stop or alter your current course of treatment. If pregnant or nursing, consult with a qualified provider on an individual basis. Seek immediate help if you are experiencing a medical emergency.
© 2022 Dr apt MT Ghozali