Dyshidrosis

Overview

What is dyshidrosis?

Dyshidrosis is a skin condition that causes small blisters and dry, itchy skin. It usually develops on fingers, hands and feet. It is also known as dyshidrotic eczema (DE), acute palmoplantar eczema or pompholyx.

This type of eczema is a chronic (long-term) condition. With treatment, most people can control their symptoms. Dyshidrosis is not contagious (cannot pass from person to person).

Who is most at risk for getting dyshidrosis?

Anyone can develop dyshidrosis. The condition is most common in adults between ages 20 and 40. In occupational or clinical settings, dyshidrotic eczema accounts for 5 to 20 percent of all cases of hand dermatitis.

Women are more likely than men to develop dyshidrosis. This gender difference may be because women are exposed to certain skin irritants more often than men. These irritants include things like nickel or cobalt in jewelry.

You are at higher risk of developing dyshidrosis if:

  • Other members of your family have the condition.
  • You have a history of atopic or contact dermatitis.
  • You receive immunoglobulin infusions. Intravenous immunoglobulin (IVIG) is injections of antibodies for people with an immune deficiency.

Symptoms and Causes

What causes dyshidrosis?

The exact cause of dyshidrosis is not known. It may occur because of triggers including:

  • Increased stress
  • Allergies, including hay fever
  • Frequently moist or sweaty hands and feet
  • Exposure or contact allergy to certain substances, including cement, nickel, cobalt or chromium

What are the symptoms of dyshidrosis?

Dyshidrosis causes symptoms that come and go. These symptoms may last for several weeks at a time. The most common symptoms of dyshidrosis include:

  • Small, firm blisters on the sides of fingers, palms of hands, and soles of feet
  • Itchy, scaly skin at or around blisters
  • Pain at or around blisters
  • Sweating heavily around areas of skin affected by blisters
  • Dry, cracked skin that appears as blisters fade
  • Thickened skin where itchy, blistered skin appears

The skin on your fingers, hands, and feet may thicken if scratched frequently. Large blisters or large areas of blisters may become infected and can be painful.

Management and Treatment

How is dyshidrosis treated at home?

For many people, effective treatment of dyshidrosis starts with an at-home skin care routine. Home care might include:

  • Using warm water instead of hot water when washing your hands
  • Soaking your hands and feet in cool water to improve symptoms
  • Applying cool compresses 2 to 4 times each day, for up to 15 minutes each time, to reduce discomfort or itching
  • Applying moisturizers frequently each day to improve dry skin

Your doctor may recommend medications such as topical corticosteroids or oral antihistamines. These antihistamines include fexofenadine (Allegra®) or cetirizine (Zyrtec®). These medications help reduce inflammation and itching.

What if home treatment isn’t enough for dyshidrosis?

Sometimes doctors recommend prescription-strength creams, like clobetasol. These treatments can reduce pain and itching.

In more severe cases, skin care routines and medications like antihistamines are not enough to control symptoms. If other treatments do not work, your doctor may recommend further treatment options, including:

  • Systemwide corticosteroids: Sometimes, topical corticosteroids are not enough to relieve symptoms. Your doctor may prescribe an oral or injectable corticosteroid, such as prednisone (Deltasone®).
  • System wide non-steroidal immune suppression: Long term use of oral steroids is not recommended. Medications such as methotrexate or mycophenolate mofetil may be used in treating chronic disease.
  • Phototherapy: Exposing your skin to UV light may improve symptoms. You may receive phototherapy treatments at your doctor’s office or at a hospital.

What should I expect after dyshidrosis treatment?

This condition usually disappears with treatment, but it may come back later. You may need to follow a specific skin care routine at home or continue using medication to reduce symptoms.

Prevention

Can dyshidrosis be prevented?

Dyshidrosis is a chronic, or lifelong, medical condition. While it may not be possible to prevent dyshidrosis, you can take action to reduce your likelihood of further flare-ups.

Prevention methods include a good skin care routine and medications such as antihistamines to manage symptoms. Further therapies, like phototherapy, can help as needed.

Outlook / Prognosis

What is the prognosis (outlook) for people with dyshidrosis?

There is no cure for dyshidrosis. You may have infrequent flare-ups throughout your life. However, you may recover from mild dyshidrosis without treatment.

Last reviewed by a Cleveland Clinic medical professional on 03/03/2018.

References

  • Merck Manual Professional Version. Hand and Food Dermatitis. (http://www.merckmanuals.com/professional/dermatologic-disorders/dermatitis/hand-and-foot-dermatitis) Accessed 3/8/2018.
  • National Eczema Foundation. Dyshidrotic Eczema. (https://nationaleczema.org/eczema/types-of-eczema/dyshidrotic-eczema/) Accessed 3/8/2018.
  • American Academy of Dermatology. Dyshidrotic eczema. (https://www.aad.org/public/diseases/eczema/dyshidrotic-eczema) Accessed 3/8/2018.

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