20 years ago Dyshidrotic Eczema was thought to be the result of an endocrine disorder. A malfunction of the sweat glands where sweat is trapped beneath thick skin resulting in painful blisters on the hands and feet.
It is now more commonly accepted by healthcare providers that dyshidrotic eczema is caused by an allergic response to something in the environment. The most common allergens are believed to be nickel, balsam and cobalt. Nickel is found in costume jewelry while balsam and cobalt are used in manufacturing.
Deep seated blistering rash
Dyshidrotic eczema is not a pleasant condition. It presents itself as an unbearably itchy, deep seated, blistering rash on the palms of the hands, sides of fingers and soles of the feet. There is localised swelling, excessive sweating and considerable discomfort. Although it can affect any age, it is most common in men 20 – 50 years old. There also appears to be a genetic component to the disorder.
A person is more prone to develop dyshidrotic eczema if they suffer from asthma, sinusitis, hayfever or anxiety. Certain skin infections or recent immunoglobulin therapy may also predispose you to the condition. It is also believed that a fungal infection elsewhere in the body may result in an outbreak of dyshidrotic eczema.
Aspirin, cigarette smoking, joint implants (i.e. total hip replacement) and oral contraceptives have also been linked to dyshidrotic eczema however further studies need to be carried out to determine how relevant they are to the development of the condition.
Taking steps to prevent dyshidrotic eczema from developing is easier than treating the condition once it has developed. A good skin care regime where the hands and feet are kept clean using a mild soap that is rinsed off well and preventing the skin from becoming overly dry by using a good moisturiser will help.
It is also advisable to avoid jewellery and other objects made of nickel, wear heavy duty gloves when handling chemicals and avoid unnecessary exposure to soapy water or extremes of temperature. Avoiding excessive sweating by wearing cotton socks and allowing the feet to air frequently will also help.
What to do if you develop Dyshidrotic Eczema
A physical examination and medical history by your doctor is required to properly diagnose dyshidrotic eczema. Blood tests may also be undertaken to eliminate other causes for the rash. Once an outbreak occurs it is important to keep the skin cool and dry as heat, sweat and moisture will aggravate the symptoms.
Your doctor will discuss a variety of treatment options with you including antihistamines to decrease itching, chelation therapy to reduce the effect of nickel, drainage of the fluid filled lesions, immunosupressant medications or PUVA treatment.
If the lesions become infected oral or topical antibiotics will be required. Topical corticosteroid creams are often the first line of treatment to control the itching and inflammation. In severe cases oral steroids may be required.
Dyshidrotic eczema usually heals completely with effective treatment but may reoccur. Controlling stress and limiting risk factors will help to reduce the risk of future flare ups.