Dyshidrotic eczema

What is dyshidrotic eczema?

Pompholyx, dyshidrosis, or dyshidrotic eczema, is a skin condition that causes an eruption of blisters across your hands (usually the fingers), and the soles of your feet. The condition is sometimes referred to by different names, including recurrent vesicular hand dermatitis, cheiropompholyx, and acute palmoplantar eczema.^[1]

Symptoms usually start as a burning sensation on your skin, on areas where fluid-filled blisters appear afterwards. When the blisters fade, they can leave cracked patches of skin on your hands and feet that are often painful. The blisters can sometimes become infected — if this happens, you might need antibiotics.^[2]

Who gets dyshidrotic eczema?

Dyshidrotic eczema tends to affect both men and women, but it’s more common in young adults.^[3] An eruption of blisters on the hands and feet can occur as a one-time event, but sometimes the condition reoccurs over time.

If dyshidrotic eczema runs in your family, or if you have other forms of eczema which affect your hands or feet, like atopic dermatitis, you might be more likely to develop blister flare-ups.

How common is dyshidrotic eczema?

It’s hard to say specifically how common dyshidrotic eczema is. The factors that put you at risk for developing blisters on your hands and feet can depend on your triggers, which can often be personal and aren’t the same for everyone.

Despite a lack of concrete information about why dyshidrotic eczema occurs, around 5-20% of hand eczema is thought to be caused by the condition.^[3]

What causes dyshidrotic eczema?

The exact cause of dyshidrotic eczema isn’t known. However, there are some things which are thought to trigger symptoms. These can vary from person to person. Coming into contact with particular chemicals, like those found in soaps and detergents, can cause dyshidrotic eczema symptoms to flare up in some people. Allergies to metals like cobalt or nickel are also thought to be a potential cause of the blisters.^[1] For others, heat, sweat, or having constantly wet hands can aggravate symptoms.

In a study that looked at 120 patients with dyshidrotic eczema over a three-year period, allergic contact reactions were found to be the main cause of the symptoms. Hygiene and cosmetic products were responsible for the most cases, with reactions to metals the second highest cause.^[2]

What are the symptoms of dyshidrotic eczema?

Dyshidrotic eczema normally begins as itchy skin that causes a burning sensation or feels prickly. It then develops into small, watery blisters that appear on the hands (usually the fingers), and soles of the feet. The blisters can change in size over time, and are normally filled with fluid. If the blisters weep, they can become infected.

The blister eruptions typically last for around two to three weeks.^[3] When the blisters dry, the skin on the affected areas can become dry, red and sore. The dried blisters can become itchy, and create an urge to scratch which can make your skin bleed.

Dyshidrotic eczema is sometimes referred to as looking like ‘tapioca pudding,’ because of the bubble-like pattern of the blisters. Pompholyx, an Ancient Greek word meaning bubble, is another name for the condition for this same reason.

Can dyshidrotic eczema lead to other problems?

It’s unlikely dyshidrotic eczema will lead to any other conditions, but without the right treatment, the blisters can cause pain and discomfort over time. Because they occur on your hands and feet, the blisters are in regular contact with work surfaces and shoes, meaning they’re often at risk of friction and rubbing, which can make them worse. This can impact your ability to perform at work, and carry out everyday tasks.

If the blisters become infected and crusty, or start to ooze, a doctor will usually recommend using antibiotics to treat them.