Predisposition to eczema
About half of people with dyshidrotic eczema have an atopic predisposition, as in atopic eczema.
Inflammatory
Medically reviewed by Dr. A.M. van Coevorden, dermatologist, on
± 5 min read
Dyshidrotic eczemaItchy blisters on hands and feet
Dyshidrotic eczema is a form of eczema with small, itchy blisters on the palms, the sides of the fingers or the soles of the feet. The blisters dry up and peel, and the eczema often comes back in waves.
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- What is dyshidrotic eczema?
- What causes dyshidrotic eczema?
- Blisters on hands and feet: what does dyshidrotic eczema look like?
- How does the dermatologist make the diagnosis?
- Dyshidrotic eczema treatment: how it works
- Does dyshidrotic eczema go away?
- Dyshidrotic eczema: what you can do yourself
- When to see a dermatologist or GP?
- Frequently asked questions about dyshidrotic eczema
What is dyshidrotic eczema?
Dyshidrotic eczema is an inflammation of the skin with small, deep-seated blisters. They appear on the palms, the sides of the fingers, the soles of the feet or the sides of the toes. Doctors also call it acrovesicular eczema. When the blisters merge into large blisters, it is called pompholyx.
The name dyshidrotic refers to the sweat glands. That is misleading: the sweat glands are usually not the real cause. Dyshidrotic eczema is a form of hand eczema and sometimes also affects the feet.
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Dyshidrotic eczema is not contagious. You cannot pass it on to others, not even through the blisters.
What causes dyshidrotic eczema?
In many people there is no single clear cause. Several factors often act together: a predisposition to eczema, irritation from water and soap, a contact allergy or a fungal infection elsewhere on the body.
Contact allergy
In about three in ten people a contact allergy plays a role, often to nickel. Chromium, cobalt, fragrance, rubber and plants also occur.
Irritation
Frequent hand washing, soap, cleaning products and wet work damage the skin and trigger a flare.
Fungal infection
A fungal infection on the feet or in the groin can trigger a reaction on the hands. Treating the fungus then also helps the blisters.
Heat, sweating and stress
Warm weather, heavy sweating and stress often make the eczema worse.
Read more about contact eczema and atopic eczema.
Blisters on hands and feet: what does dyshidrotic eczema look like?
A flare often starts suddenly with groups of small, deep-seated, tense blisters. They sit on the palms, the sides of the fingers and sometimes the soles. The blisters itch or burn.
- Groups of small, clear blisters, often on both hands.
- Intense itching or a burning feeling.
- After a few days the blisters dry up. The skin peels and may crack.
- Sometimes the blisters merge into larger blisters.
A full cycle of blisters, drying and peeling usually takes three to four weeks. A new flare can follow.
Please note
Is the skin red, warm and painful, or do you have a fever? A bacterial infection may have developed. Contact a doctor the same day.
How does the dermatologist make the diagnosis?
The dermatologist usually recognises dyshidrotic eczema from its appearance: the typical blisters in the typical places. A biopsy is rarely needed.
Sometimes further tests are useful. If a fungal infection is suspected, a small skin sample or the roof of a blister is examined under the microscope. For severe or persistent dyshidrotic eczema, patch testing can identify a contact allergy.
With 247dermatologist you upload photos of your hands or feet and answer a few questions. A registered dermatologist assesses them within 12 to 48 hours.
Dyshidrotic eczema treatment: how it works
Treatment consists of protecting the skin, daily moisturising and an anti-inflammatory ointment during a flare. For persistent eczema there are more options.
Protect the skin
Avoid soap, cleaning products and wet work as much as possible. Wear gloves for wet or dirty work, preferably vinyl or nitrile with a cotton glove underneath.
Moisturise
Apply a neutral, rich cream or ointment at least twice a day. Also after washing your hands.
Anti-inflammatory ointment during a flare
The dermatologist usually prescribes a strong corticosteroid ointment. If that is not suitable, tacrolimus ointment can be an alternative.
Treat a fungus or allergy
Is there a fungal infection on the feet? It is treated with an antifungal. If a contact allergy is confirmed, you avoid the substance.
For persistent eczema
If ointments do not help enough, the dermatologist may consider light therapy or tablets, such as alitretinoin, ciclosporin or methotrexate.
Does dyshidrotic eczema go away?
Dyshidrotic eczema often comes back, sometimes in waves. A flare usually clears within a few weeks. Protecting and moisturising the skin and avoiding triggers make flares less frequent and less severe.
Dyshidrotic eczema: what you can do yourself
This helps with dyshidrotic eczema:
- Wash your hands as little as possible and with lukewarm water. Use no soap, or only occasionally.
- Apply a base ointment or rich cream several times a day.
- Wear gloves for wet work, cleaning and cooking.
- Take off rings: moisture and soap collect underneath.
- Keep your nails short and do not pop the blisters.
- Check your feet for fungus and have it treated.
When to see a dermatologist or GP?
See a doctor if:
- You still have symptoms after six weeks of using a base ointment.
- The blisters keep coming back or are spreading.
- The skin is red, warm and painful, or you have a fever.
- You suspect a contact allergy, for example from your work.
A dermatologist at 247dermatologist assesses your photos, tells you whether the picture fits dyshidrotic eczema and writes a prescription where needed. No referral needed.
Frequently asked questions about dyshidrotic eczema
Not sure whether this needs a look? Have a dermatologist assess it: you get an answer within 12 to 48 hours, no referral needed. In an emergency, contact your GP straight away or call 112.
Is dyshidrotic eczema contagious?
No. Dyshidrotic eczema is an inflammation of the skin, not an infection. You cannot pass it on.
Can I pop the blisters?
Better not. Popping increases the risk of infection. The blisters dry up on their own.
Is dyshidrotic eczema caused by stress?
Stress is not a cause in itself, but it can trigger or worsen a flare. Usually several factors act together.
Which ointment helps with dyshidrotic eczema?
A rich base ointment keeps the skin in good condition. During a flare a doctor usually prescribes a corticosteroid ointment. Which one suits you depends on the severity and the location.
Does a nickel-free diet help?
If you have a nickel allergy, avoiding contact with nickel is important. According to research a low-nickel diet has little effect.
What is the difference with athlete's foot?
Athlete's foot usually causes scaling and itching between the toes, dyshidrotic eczema causes blisters on the soles and palms. A fungus can trigger dyshidrotic eczema. The dermatologist can tell them apart.
Have a dermatologist look at your skin
Upload photos and answer a few questions. A BIG-registered dermatologist replies within 12 to 48 hours, no referral needed, from € 39.
If more is needed, the dermatologist refers you to a medical specialist.
Want to know what a dermatologist does, when you can see one and how quickly that can happen? Read more about the dermatologist.
Sources and more information
- Thuisarts.nl, Ik heb blaasjes-eczeem op mijn handen of voeten
- NVDV, patiëntenfolder Handeczeem
- Huidinfo.nl, Dyshidrotisch eczeem
- Huidziekten.nl, zakboek Acrovesiculeus eczeem
Source: Thuisarts.nl, Dutch Society of Dermatology and Venereology (NVDV), Huidinfo.nl and huidziekten.nl.
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