Dyshidrotic eczema, also known as Dyshidrosis, is a skin condition with small, fluid-filled blisters on the palms and sides of the fingers, soles of the feet, on the toes, or all of the above.
The name ‘Dyshidrotic’ means “bad sweating,” leading some to consider it to be caused by abnormal sweating. The condition does worsen when the weather gets warm and itching gets worse at night. When the condition appears on the hands, it is often referred to as pompholyx, or by the common terms ‘housewife’s eczema’ or ‘dishpan hands’.
Dyshidrotic eczema is very itchy, with lots of fluid-filled blisters. At first the blisters appear as tiny, deep, clear blisters that can soon join to form a rash the size of a fingernail. The blisters can start oozing or weeping – they persist for about three weeks and cause intense itching. In later stages, the blisters dry and crack and grooves (fissures) may form, which can be painful. Secondary bacterial infection is a common complication with Dyshidrotic eczema.
While this condition is not contagious, recurrence is common, and for many, the condition can be chronic. This itchy, blistering type of eczema is twice as common in women, than men.
Causes of Dyshidrotic Eczema
The cause of this eczema is not fully understood. In some cases there has been past incidence of allergic contact dermatitis, especially to nickel. Often, no specific allergen is found. Dyshidrotic eczema can develop in someone who:
- Is under stress
- Has allergies, such as hay fever
- Works with water or in a moist environment
- Works with cement or other work that exposes their hands to chromium, cobalt, nickel
- Has a job that exposes the hands to irritating chemicals.
Dyshidrotic eczema affecting the hands occurs most frequently in those whose hands are in constant contact with water, such as food preparers, nurses, or florists.
Those whose feet and toes are affected, often work in moist or wet environments, or wear tight, closed shoes or boots for long periods of time. This creates a warm, moist condition, providing an ideal situation in which the Dyshidrotic eczema can flourish in the feet.
Treating Dyshidrotic Eczema
Treating Dyshidrotic eczema can be difficult. Once you have an episode of Dyshidrotic Eczema, the risk of having another one increases greatly. For some people, the condition can become chronic. The lack of an easy remedy from conventional medicine has made some patients desperate to look for alternative treatments. Your success rate will depend largely on how you change your day-to-day habits, and the effort you put into avoiding products, chemicals and irritants that can trigger a the condition.
Don’t scratch! Since this can be an intensely itchy skin condition, scratching can be difficult to control, even hard to stop. But scratching will only make it worse. Excessive scratching may lead to thickened, irritated skin, which not only takes longer to heal, it becomes more difficult to treat.
Protect yourself – pompholyx (Dyshidrotic eczema affecting the hands) is triggered by contact with irritants such as soapy water, detergents and solvents. Wear protective gloves with a cotton lining (you may be allergic to latex or rubber) and avoid contact with these irritants as much as possible.
Avoid frequent bathing and hand washing (if hands are affected). The goal is to keep skin dry – avoid moisture or moist environments.
Ointments or heavy creams should be used at least twice a day, or any time you wash your hands. Heavy ointments such as Vaseline are best. Mineral oil or vegetable shortening are also very helpful, but can be messy. Jojoba oil (100% natural) is excellent. Creams are better than lotions. Many lotions contain water – your goal is to avoid water. The best treatment for hand eczema is a greasy one with a few, simple, ingredients works to retain skin’s natural moisture, and provides a protective barrier to help keep irritants out.
Steroid ointments or creams may be prescribed by a doctor for severe cases or in cases where the itching and spread of the condition is difficult to control.
Other medical treatments for severe cases may include:
- Steroid pills
- Coal tar preparations
- Phototherapy (ultraviolet light therapy)
Things to Avoid
According to the International Eczema-Psoriasis Foundation, there is a wide range of ingredients and preservatives that can cause skin irritation or trigger a reaction in someone predisposed to eczema. It’s best to avoid them if possible. The names are not easy to decipher or even read, let alone pronounce, but eventually will become skilled at recognizing some of the harmful ingredients in lotions, shampoos, cosmetics and other toiletries that you should avoid. They are:
- methyldibromoglutaronitrile/phenoxyethanol methylchloroisothiazolinone/methylisothiazolinone
- botanicals (can cause allergic reactions, even if they are natural)
- propylene glycol
- Formaldehyde (Formalin, Formol, Methanal, Veracur, etc.)
- formaldehyde releasers
- 2-bromo-2-nitropropane-1,3-diol (Bronopol)
- diazolidinyl urea (Germaben II or Germal II)
- imidazolidinyl urea
- retinol or vitamin A
- citric or fruit acids
Avoid waterless or antibacterial cleansers these are made up of solvents, alcohol, and other irritating ingredients that will make the condition worse.
Pay attention to your diet – A small percentage of people with the condition are sensitive to foods containing metal salts, specifically chromium, cobalt, and nickel.
International Eczema-Psoriasis Foundation – Dyshidrotic Eczema; Eczema Treatment
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