Dyshidrosis

What is Dyshidrosis?

Dyshidrosis is a skin condition where blisters develop on the soles of the feet and on the palms of the hands. It is also called dyshidrotic eczema.

It is found more in infants and children. In mild cases, this may be hard to see because the skin on the soles, palms, and sides of fingers tend to be thick. This condition lasts for about 3-4 weeks.

Symptoms of Dyshidrosis

This skin condition is characterized by some features such as:

• Presence of blisters on soles of feet and palms of hands.
• These blisters can also occur on fingers, toes and the hands.
• The blisters are usually itchy
• They may be filled with fluid
• Some of the larger blisters can be painful
• Skin can become flaky and get cracked
• The blisters are usually found in clusters

Complications of Dyshidrosis

The main discomfort from this condition is itching and pain. When the blisters flare up, it becomes difficult to use the hands and feet. Therefore, basic activities like walking become difficult.  After 3 weeks, the skin in the affected area turns dry and the skin starts to crack. If this is aggravated further, the skin turns thick. The blisters can also get infected with intense scratching.

Causes of Dyshidrosis

The exact cause of dyshidrosis is unknown. However, it has been linked to many conditions:

• Presence of seasonal allergies like hay fever and other skin conditions like atopic dermatitis.
• High levels of emotional stress and physical strain.
• Frequent exposure of hands and feet to moist or damp conditions.
• Exposure to certain metals like chromium, cobalt or nickel.
• Having sensitive skin that is easily aggravated
• Exposure to environmental factors like extreme weather conditions, temperature fluctuations, and humidity.

Diagnosis of Dyshidrosis

It is important to get a doctor to examine the blisters carefully for accurate diagnosis. A small portion of the blister may be scraped off and taken to a laboratory for testing it. This is done to check if the condition is benign and not cancerous and not a fungal infection like Athlete’s foot. Apart from this, the doctor may also recommend skin allergy tests.

Prevention of Dyshidrosis

There are certain measures that can be taken to prevent the occurrence of the condition or to prevent it from spreading. They are:

• Keeping the skin well moisturized by applying emollients, petroleum jelly or non scented moisturizers.
• Avoiding harsh soaps and shower gels or any cosmetics with alcohol.
• Avoid frequent hand washing.
• Avoid taking a bath or showers with hot water.
• Stay hydrated by drinking a lot of water.
• Avoid clothing that is rough and scratchy and wears light cotton instead.
• Avoid rubbing your skin with a towel harshly. Gently pat your skin instead to dry it.
• If lesions are already formed, try not to scratch them to prevent their spread.
• Keep your fingernails short and clean to avoid scratching and spread of infections.
• Remove any agents around you that could cause allergies.

Treatment for Dyshidrosis

The treatment for dyshidrosis is mainly aimed at relieving symptoms of itching and pain. When administered and taken properly, the skin condition completely goes away. The different treatment modes are:

1. Corticosteroid Treatment – for mild spreads with less itching, corticosteroid creams or ointments are used. These are applied to the skin after a moist compress has been applied. This is done so that the cream or ointment penetrates the skin better and promotes faster healing.  If the spread is more severe with intense itching, corticosteroid pills or injections are used.
2. Antihistamines – Antihistamines like Claritin are usually taken to relieve the inflammation caused by the blisters flaring up. They reduce redness and itching.
3. Phototherapy – this is the use of UV radiation to treat the blisters. The affected area is exposed to light under supervision by a medical professional. Certain drugs will also be used to make the skin more receptive to the UV rays. This treatment has been shown to be effective in many cases.
4. Dressings – Wet and cold compresses can be applied to the infected areas before using an ointment. If the area is infected, a moist bandage or dressing can be wrapped around the infected part to stop it from spreading.
5. Moisturizers – It is important to keep the skin well moisturized and supple. Petroleum jelly, mineral oil, oil-based creams and lotions, and emollients can be used for this purpose. Gels and cosmetics with agents that irritate the skin should be avoided as they can aggravate the blisters.
6. Immune-suppressing ointments – These medicines slow down the rapid functioning of the immune system and are taken by those who don’t want to be on steroids. Medications such as Protopic and Elidel are used. However, there may be some side effects associated with this. Also, as the immune system is being suppressed, the tendency to fall ill with colds and fevers will be more. Children and pregnant women should avoid this.
7. Alternative therapies – Some alternative therapies have been shown to be useful in treating dyshidrosis. This includes stress management through meditation, use of organic oils, acupuncture etc.
8. Botulinum toxin injections – These injections are taken for those with severe dyshidrosis. They stop the sweating on the soles of feet and palms of hands which otherwise irritate the blisters.

Prognosis of Dyshidrosis

With treatment, this condition disappears within 3-4 weeks. There are usually no complications and if the blisters were not scratched, then there will be no marks or scars.

Dyshidrosis Pictures

Dyshidrosis is a skin condition where blisters develop on the soles of feet and palms of hands. Its exact cause is unknown. The skin forms blisters which itch and can cause pain. Hence walking and holding items becomes a difficulty. But this is a treatable condition and with the application of topical medications and phototherapy and keeping the skin well moisturized, this condition disappears and the skin is smooth again.

References:

healthline.com/health/dyshidrotic-eczema

mayoclinic.org/diseases-conditions/dyshidrosis/symptoms-causes/dxc-20202259

emedicine.medscape.com/article/1122527-overview

nationaleczema.org/eczema/types-of-eczema/dyshidrotic-eczema/

aad.org/public/diseases/eczema/dyshidrotic-eczema

healdove.com/disease-illness/Treatment-of-Dyshidrotic-Eczema-and-Possible-Causes

skintifique.me/contents/us/dyshidrosis/

drugs.com/mcd/dyshidrosis

firstderm.com/dyshidrotic-eczema-dyshidrosis/

everydayhealth.com/dyshidrotic-eczema/guide