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Dyshidrosis: How to treat this vesicular eczema of the hands and feet?

Dyshidrosis is a specific form of eczema localized on the hands and feet. It is a vesicular type of eczema that is accompanied by itching sensations. Discover how to treat dyshidrosis.

What is Dyshidrosis?

dyshidrotic eczema or vesicular eczema, dyshidrosis is a skin condition characterized by small blisters that form on the tips of the fingers, toes, palms of the hands, or soles of the feet. This specific form of eczema is often associated with seasonal allergies and can be more pronounced during the spring. It's important to note that dyshidrosis, like other types of eczema, is a benign and non-contagious disease that manifests in periodic flare-ups.

Dyshidrotic eczema presents with symptoms such as skin redness and severe itching . Blisters that resemble bubbles also appear, hence its name, blistering eczema. The skin also tends to flake and thicken significantly (lichenification). In addition, vesicles filled with a clear fluid form, and when they rupture, they leave behind oozing sores that are then covered with thick crusts. The most severe form of dyshidrosis is pompholyx. Pompholyx is referred to when the small blisters join together to form larger ones. In some cases, dyshidrosis can become infected during the oozing phase, often due to colonization by golden staphylococcus bacteria or the herpes virus.

What are the treatments for dyshidrosis?

Dyshidrosis is a recurrent condition. Therefore, it is advised to manage it from the first signs. The initial step should be to consult a dermatologist who can prescribe suitable medications. The primary treatment for dyshidrosis involves the application of a cortisone-based cream. This is a proven remedy against inflammatory reactions and typically results in improvement within 48 to 72 hours. If the dyshidrosis is stubborn, it is recommended to apply the cream under occlusion, that is, under cellophane or plastic gloves. Finally, in case of bothersome blisters, it is possible to puncture them after disinfecting the area, and then apply the corticosteroid cream.

It is rare for dermocorticoids not to have an effect. However, when this is the case, the dermatologist may prescribe topical immunomodulators that work by modulating the skin's immune response to reduce inflammation, redness, and itching caused by dyshidrosis. Sessions of phototherapy can also be performed. Indeed, UV rays act on dyshidrotic eczema by reducing the number of flare-ups. Finally, if the dyshidrosis is becoming infected, oral or topical antibiotics can be prescribed to combat bacterial proliferation.

How to prevent the recurrence of dyshidrosis?

There are certain measures to be taken to prevent the recurrence of dyshidrotic eczema. As an aggravating factor, sweat must be controlled. To limit its accumulation on the hands, it is recommended to regularly wash your hands with a mild soap. You can also take foot baths on evenings when you have felt sweat in your shoes.

Furthermore, the daily application of a emollient is recommended. Cream, milk, balm... The possible formulations are numerous. Emollients are rich and nourishing treatments that help to strengthen the skin barrier and prevent dehydration. With increased protection, the skin is then less prone to irritations and the penetration of allergens. Finally, if you are frequently exposed to irritating substances, due to your work for example, and you cannot reduce exposure times, we advise you to consistently wear gloves when handling them.

Sources

  • GOLDENBERG G. & al. Eczema. The Mount Sinai journal of medicine (2011).

  • AZANZA J. & al. Dyshidrotic Eczema: A Common Cause of Palmar Dermatitis. Cureus (2020).

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