What Exactly Is Dyshidrotic Eczema and How is it Different?

Many people are familiar with atopic eczema but that's only one of several types. Dyshidrotic eczema is another common form of eczema. Some people can have both atopic and dyshidrotic eczema. 

What's the difference between atopic and dyshidrotic eczema? Dyshidrotic eczema appears as blisters and skin irritation on the hands and feet. Atopic eczema can appear on any part of the body.

What Is Dyshidrotic Eczema?

Your doctor may refer to this condition by several names. They include: foot-and-hand eczema, pompholyx eczema, vesicular eczema, and palmoplantar eczema. These are all interchangeable medical terms for the same type of eczema, which we'll simply call "dyshidrotic eczema" for the purpose of this article. 

Dyshidrotic eczema often presents as painful blisters on hands, fingers, inside the webs of fingers, soles of the foot and between the toes. Blisters might be itchy or painful and often the skin can become rough and crack as the blisters heal. Flare-ups may last several weeks.

This type of eczema is most common in women, though anyone can develop the condition. Many sufferers have their first outbreak between the ages of 20 and 40. Someone with atopic eczema or other types of eczema can also develop dyshidrotic eczema. Like other types of eczema, there is no cure. However, most cases of dyshidrotic eczema are manageable with knowledge of how to treat and precautions to take to limit flare-up severity.

The condition is not contagious. You should take special care during outbreaks because you're more prone to infection due to open sores on the skin.

Signs and Symptoms of Dyshidrotic Eczema

Dyshidrotic eczema presents slightly different than other forms of eczema because the blisters are unique to this form. You can have other forms of eczema on your hands and feet. The best way to determine the type of eczema or skin condition you have is by seeing your doctor for a proper diagnosis. Some people might have more than one type of eczema. Flare-ups from one kind of eczema can sometimes cause the other type to flare-up as well.

It's important for you to know the type of eczema because there may be separate causes and treatments that will work better for you, depending on the condition.

Some common symptoms of dyshidrotic eczema include:

• Deep blisters on palms, soles of feet, fingers, in between fingers, in between toes. 
• Itching or burning sensation where blisters are located.
• Weeping or sweating around blisters.
• Drying, flaking skin once blisters are healing.
• Swelling.
• Cracking, red, irritated skin as the condition heals.
• Pain at the site of blisters and as the skin heals.
• In some cases, the condition may appear on the delicate skin around the nails.

Blisters are unique to dyshidrotic eczema, though they can also be symptoms of other conditions. Itching, redness, and swelling are common symptoms of many types of eczema. A high percentage of those with dyshidrotic eczema will also have atopic eczema. Fungal infections, such as athletes foot, might be present as well as dyshidrotic eczema, and they should be treated with different types of therapy. 

A doctor's diagnosis is important to rule out other illnesses which might have similar characteristics to treat dyshidrotic eczema properly.

Risk Factors and Triggers

Any person of any age can develop dyshidrotic eczema, though it is more common in adult women between 20 and 40. This type of eczema is more prevalent in those with a family history of eczema of any type. People who have dermatitis or other forms of eczema are also more likely to develop dyshidrotic eczema. This condition is often more prevalent during allergy season and may have some connection with hay fever or allergies.

Other common triggers for dyshidrotic eczema include:

• Allergies. Seasonal allergies tend to bring out flare-ups for those who suffer from dyshidrotic eczema. Pollen is a known trigger.
• Stress. While it's difficult to eliminate stress entirely, high stress periods and serious emotional stress can bring out flare-ups.
• Metal. Nickel, chromate, and cobalt are the three types of metal most noted for causing dyshidrotic episodes. People with this condition may be extra sensitive to the properties of these types of metals which can be found in jewelry, dishes and silverware, everyday items, and even some types of food.
• Sweating on hands and feet. This might be an issue of working with gloves or warm footwear or simply overactive sweating which can be difficult to control. 
• Prolonged exposure to moisture. This is the same cause as sweating but it may be from having hands or feet submerged for too long, either working or swimming.

Treatments and Therapies for Dyshidrotic Eczema

There are several treatment options for dyshidrotic eczema, from prescription to over the counter therapies. A good first step is to note when you're experiencing outbreaks, which can help you to narrow down triggers that impact you. You may notice more flare-ups during allergy season or due to specific environmental factors. When possible, eliminating triggers can help you to keep flare-ups to a minimum.

Some treatment options include:

• Having Blisters Drained. Your doctor may drain blisters that are deep and painful to help speed healing. This should be performed by your physician in order to limit risk of infection.
• Allergy Medications. Allergy medication can help to reduce dyshidrotic eczema, as well as your other allergy symptoms.
• Steroid Cream or Oral Steroids. This treatment may be recommended to reduce severe swelling.
• Eczema Gloves and Socks. Gloves and socks can be worn to protect your hands and feet from environmental factors that can trigger outbreaks.
• Eczema Creams. Cream and ointment made for the treatment of eczema can help repair skin and sooth the area.

For this type of eczema, infection is the largest concern. Keep the area clean and dry and if you see signs of infection, contact your doctor as soon as possible.

For further reading, you can read Christine's journey on how she deals with dyshidrotic eczema here.