What causes those itchy blisters on fingers and toes in summer. How to identify dyshidrotic eczema symptoms. What are the most effective treatments for managing flare-ups. Can dietary changes help prevent outbreaks.

What is Dyshidrotic Eczema and How Does it Manifest?

Dyshidrotic eczema, also known as pompholyx eczema, is a skin condition characterized by the appearance of small, itchy blisters on the hands and feet. These blisters, often referred to as “summer finger bumps,” can be extremely uncomfortable and may cause a burning or prickling sensation in the affected areas.

The condition derives its name from the Ancient Greek word “pompholyx,” meaning “bubble,” due to the distinctive appearance of the blisters. These tiny, deep-seated blisters often resemble tapioca pudding and typically appear on the sides of fingers, palms, toes, and soles of the feet.

Key Characteristics of Dyshidrotic Eczema

• Water-filled blisters on fingers, toes, palms, and soles
• Intense itching and burning sensation
• Sudden onset of symptoms
• Flare-ups lasting several weeks
• Recurring episodes in most cases

Is dyshidrotic eczema a chronic condition? In many cases, yes. While some individuals may experience only one flare-up, most people with dyshidrotic eczema face recurring episodes. These flare-ups can occur as frequently as once a month or as infrequently as once a year.

Recognizing the Symptoms of Dyshidrotic Eczema

Identifying dyshidrotic eczema is crucial for proper management and treatment. The condition presents with a range of distinctive symptoms that set it apart from other skin conditions.

Common Symptoms of Dyshidrotic Eczema

1. Extreme itching
2. Burning or prickling sensation
3. Heat sensation in palms or soles
4. Sudden appearance of small blisters
5. Painful drying and cracking of skin
6. Swelling and changes around nails

How do the blisters progress? Initially, the blisters are small but may grow larger over time. They can weep fluid and cause discoloration of the surrounding skin. It’s important to note that these blisters are localized to the hands and feet and do not appear elsewhere on the body.

What Causes Dyshidrotic Eczema and Who is at Risk?

While the exact cause of dyshidrotic eczema remains unknown, several factors have been identified as potential triggers for flare-ups. Understanding these triggers can help individuals manage their condition more effectively.

Common Triggers for Dyshidrotic Eczema

• Stress
• Metal allergies or sensitivities (especially nickel)
• Seasonal allergies
• Excessive sweating
• Hot and humid weather

Who is more likely to develop dyshidrotic eczema? The condition is more prevalent in individuals under 40 years of age and tends to affect females more frequently than males. Additionally, people with a family history of atopic eczema or those who already have another type of eczema are at higher risk.

Other Risk Factors for Dyshidrotic Eczema

• Having asthma or seasonal allergies
• Working with metals or cement
• Being a mechanic
• Having frequently sweaty or wet hands and feet

Diagnosing and Treating Dyshidrotic Eczema

If you suspect you have dyshidrotic eczema, it’s essential to consult a dermatologist or healthcare provider for a proper diagnosis. The diagnostic process typically involves a physical examination of the affected areas and a review of your medical and family history.

How is dyshidrotic eczema diagnosed? In addition to a physical examination, your doctor may recommend allergy testing to identify specific triggers that could be exacerbating your condition. This comprehensive approach helps in developing an effective treatment plan tailored to your needs.

Treatment Options for Dyshidrotic Eczema

While there is no cure for dyshidrotic eczema, various treatment options can help manage symptoms and reduce the frequency of flare-ups. Your healthcare provider may recommend a combination of the following treatments:

• Medical moisturizers
• Wet soaking with potassium permanganate
• Topical steroids
• Topical calcineurin inhibitors (e.g., tacrolimus ointment)
• Oral antibiotics (for bacterial infections)
• Oral immunosuppressant drugs
• Botox injections
• Phototherapy

What is the most effective treatment for dyshidrotic eczema? The effectiveness of treatments can vary from person to person. Your dermatologist will work with you to find the most suitable combination of therapies based on the severity of your symptoms and your individual response to treatment.

Managing Dyshidrotic Eczema at Home: Tips and Strategies

In addition to medical treatments, there are several strategies you can employ at home to manage flare-ups and provide relief from the discomfort associated with dyshidrotic eczema.

Effective Home Remedies for Dyshidrotic Eczema

• Use lukewarm water for washing to avoid irritating the skin
• Opt for emollient soaps or cleansers instead of regular soap
• Avoid direct contact with skin-irritating products
• Take antihistamines with sedative effects to aid sleep
• Carefully drain large, painful blisters using a sterile needle
• Apply creams or ointments and bandage the affected areas

How can stress management help with dyshidrotic eczema? Stress is a known trigger for flare-ups, so incorporating stress-reduction techniques into your daily routine can be beneficial. Consider practices such as meditation, deep breathing exercises, or regular physical activity to help manage stress levels.

The Role of Diet in Managing Dyshidrotic Eczema

While the connection between diet and dyshidrotic eczema is not fully understood, some individuals may find that certain foods trigger or exacerbate their symptoms. Identifying and avoiding these dietary triggers can be an effective strategy in preventing flare-ups.

Potential Dietary Considerations for Dyshidrotic Eczema

• Avoiding foods high in nickel (for those with nickel allergies)
• Identifying and eliminating personal food triggers
• Maintaining a balanced, nutrient-rich diet to support overall skin health

Can a low-nickel diet help manage dyshidrotic eczema? For individuals with a nickel allergy, which has been linked to dyshidrotic eczema in some cases, reducing the intake of nickel-rich foods may help prevent or reduce the severity of flare-ups. However, it’s important to consult with a healthcare provider or nutritionist before making significant changes to your diet.

Living with Dyshidrotic Eczema: Long-term Management and Outlook

While dyshidrotic eczema can be a challenging condition to live with, proper management and adherence to treatment plans can significantly improve quality of life. Understanding your triggers, maintaining a consistent skincare routine, and working closely with your healthcare provider are key to long-term management.

Strategies for Long-term Management of Dyshidrotic Eczema

• Consistent use of prescribed medications and treatments
• Regular moisturizing to maintain skin hydration
• Avoiding known triggers, including allergens and irritants
• Protecting hands and feet from excessive moisture and friction
• Managing stress through relaxation techniques and lifestyle changes

What is the long-term outlook for individuals with dyshidrotic eczema? While the condition is chronic for many people, proper management can lead to extended periods of remission and improved overall skin health. Some individuals may find that their symptoms become less severe or less frequent over time, especially with consistent treatment and lifestyle modifications.

By staying informed about your condition, working closely with healthcare providers, and being proactive in your skincare routine, you can effectively manage dyshidrotic eczema and minimize its impact on your daily life. Remember that each person’s experience with the condition is unique, and what works best for you may require some trial and error to discover.

What to know about summer finger bumps

Dyshidrotic eczema is a type of eczema that produces skin blisters on the feet and hands. These small blisters are sometimes known as “summer finger bumps.”

Doctors may also refer to dyshidrotic eczema as dyshidrosis, pompholyx, foot-and-hand eczema, vesicular eczema, or palmoplantar eczema.

The blisters or bumps that form can be uncomfortable, itchy, and painful. People may feel a burning or prickly sensation in their skin. The blisters are not permanent.

Dyshidrotic eczema involves flare-ups that last several weeks. Although some people may only experience one flare, people usually have repeated flare-ups that may occur from once every month to once every year.

Below, we look at the symptoms, causes, risk factors, and treatment options for dyshidrotic eczema, as well as how diet may impact this condition.

Doctors sometimes call dyshidrotic eczema “pompholyx eczema.”

Pompholyx is the word for “bubble” in Ancient Greek. The condition can produce intensely itchy blisters on the skin that can also be painful or have a burning sensation. These blisters are tiny and deep-seated and may have a similar appearance to tapioca pudding.

Water-filled blisters can appear on the sides of the fingers and may extend to the palms of the hands. They can also appear on the toes and soles of the feet.

People with this type of eczema may also have other types of eczema elsewhere on the body.

Dyshidrotic eczema may occur as a one-time episode. However, it often occurs as a chronic condition that involves repeated flare-ups.

Symptoms of dyshidrotic eczema include:

• extreme itching
• burning sensation
• a sensation of heat in the palms or soles
• prickling sensation
• the sudden appearance of small blisters, often on the sides of the fingers
• painful drying and cracking of the skin
• swelling and changes to the skin around the nail

The blisters start small and then may grow bigger. They may weep fluid and produce discoloration. They do not appear in other places on the body.

If a person has small, water-filled blisters elsewhere, it may be another form of eczema or another skin condition.

The bumpy blisters on the sides of the fingers may develop as a result of excessive sweating or heat exposure. This is why people sometimes refer to them as “summer finger bumps.”

There is no definitive known cause for dyshidrotic eczema. However, some factors that may trigger flare-ups include:

• stress
• metal allergies or sensitivities, such as a nickel allergy
• other types of allergies, such as seasonal allergies
• sweating
• hot, humid weather

According to the National Eczema Society, half of those with dyshidrotic eczema also have atopic eczema or a family history of the skin condition.

Dyshidrotic eczema is more common in people under 40 years of age. It is also more common in females.

According to the American Academy of Dermatology, other risk factors include:

• having another type of eczema
• having seasonal allergies or asthma
• having an allergy to certain metals
• having feet or hands that frequently sweat or become wet
• having a family history of dyshidrotic eczema
• working with metals
• being a mechanic
• working with cement

A person with symptoms of dyshidrotic eczema should see a doctor or dermatologist for a diagnosis.

The doctor will examine the person’s skin and take a medical and family history to determine a diagnosis and treatment plan.

A doctor may also recommend allergy testing to check for specific triggers that may be exacerbating the eczema.

There is no cure for dyshidrotic eczema. However, there are ways to manage the condition. A doctor may prescribe:

• medical moisturizer
• wet soaking with potassium permanganate to help with oozing blisters
• topical steroids to reduce inflammation
• a topical calcineurin inhibitor such as tacrolimus ointment (Protopic)
• oral antibiotics to combat bacterial infection
• oral immunosuppressant drugs
• Botox injections
• phototherapy

Dealing with a flare-up of dyshidrotic eczema can be difficult. The condition is often very itchy and can be painful and bothersome.

The National Eczema Society suggests some strategies for at-home relief, including:

• washing with lukewarm water because very hot or cold water may irritate the skin
• using an emollient soap or cleanser instead of regular soap
• avoiding direct contact with skin-irritating ingredients or products such as detergents and cleansing agents
• taking antihistamines with a sedative effect that will help with sleep rather than actively treat itchiness
• draining large, painful blisters with a sterile needle
• bandaging or wrapping the skin after applying creams or ointments

Stress management can also help prevent flare-ups.

Dietary triggers may contribute to flare-ups for some people. Avoiding these foods can help prevent symptoms.

As a nickel allergy may have a link to dyshidrotic eczema, it is possible that avoiding foods high in nickel may help prevent flare-ups. These foods include:

• soy products, such as soy sauce and tofu
• licorice
• cocoa powder
• clams
• cashews
• figs

An infection may develop as the blisters grow larger and the condition compromises the skin barrier.

Some people may also have fungal infections at the same time as they experience dyshidrotic eczema flare-ups.

If a person with dyshidrotic eczema develops a skin infection, they should see a doctor for evaluation so they can receive treatment.

Some symptoms of a skin infection include:

• discoloration
• swelling
• oozing pus
• pain
• warmth

Preventing flares involves avoiding known triggers such as allergens or temperature changes. Other strategies for preventing dyshidrotic eczema and its symptoms include:

• applying moisturizer to prevent dryness and cracking
• wearing gloves, socks, or tights made with cotton, silk, or bamboo to allow the skin to breathe
• removing rings before washing the hands, applying moisturizer, or sleeping to avoid skin irritation

It can be challenging to live with dyshidrotic eczema because it affects the hands and feet.

Some people with the condition may not be able to work during flare-ups. They may also have trouble walking if they develop painful blisters on their feet.

However, it is possible to manage this type of eczema. People with dyshidrotic eczema should talk with a doctor to find an appropriate treatment option.

Dyshidrotic eczema can cause small fluid-filled bumps or blisters to appear on the feet or hands.

Various factors can trigger a flare-up of dyshidrotic eczema. These may include dietary and environmental allergens, stress, weather conditions, and sweat.

A doctor can help people with dyshidrotic eczema find an appropriate treatment option.

A combination of treatment and prevention strategies can help a person manage the symptoms of dyshidrotic eczema.

Read this article in Spanish.

Heat rash (prickly heat) – NHS

Heat rash is uncomfortable, but usually harmless. It usually gets better on its own after a few days.

Check if you have heat rash

The symptoms of heat rash are:

• small, raised spots
• an itchy, prickly feeling
• mild swelling

The rash often looks red, but this may be less obvious on brown or black skin.

The symptoms of heat rash are often the same in adults and children.

It can appear anywhere on the body and spread, but it cannot be passed on to other people.

Heat rash appears as raised spots that are 2mm to 4mm across. Some spots may be filled with fluid.

Credit:

CID – ISM / SCIENCE PHOTO LIBRARY https://www.sciencephoto.com/media/1036411/view

If you’re not sure if your child has heat rash

Look at other rashes in children.

How you can treat or prevent heat rash yourself

The main thing to do is keep your skin cool so you do not sweat and irritate the rash.

To keep your skin cool

• wear loose cotton clothing
• use lightweight bedding
• take cool baths or showers
• drink plenty of fluid to avoid dehydration

To calm the itching or prickly feeling

• apply something cold, such as a damp cloth or ice pack (wrapped in a tea towel) for up to 20 minutes
• tap or pat the rash instead of scratching it
• do not use perfumed shower gels or creams

A pharmacist can help with heat rash

Speak to a pharmacist about heat rash. They can give advice and suggest the best treatment to use.

A pharmacist might recommend:

• calamine lotion
• antihistamine tablets
• hydrocortisone cream – though not for children under 10 or pregnant women as they need to get advice from a doctor before using this treatment

Non-urgent advice: See a GP if:

• the rash does not improve after a few days
• your baby has a rash and you’re worried

Causes of heat rash

Heat rash is usually caused by excessive sweating.

Sweat glands get blocked and the trapped sweat leads to a rash developing a few days later.

Babies often get heat rash because they cannot control their temperature as well as adults and children can.

Page last reviewed: 15 February 2021
Next review due: 15 February 2024

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