Dyshidrotic Eczema and Itchy Blisters

Small, itchy blisters on your palms and along the sides of your fingers could be signs of dyshidrotic eczema. This skin condition can also make blisters pop up on the soles of your feet or on your toes.

Your doctor might call it by another name, including dyshidrosis or foot-and-hand eczema.

These blisters will come and go over time because there is no cure. But you can manage them with medicine, moisturizers, and good hygiene. They might start to taper off once you get into middle age. And if you have a mild case, it could eventually go away on its own.

Dyshidrotic eczema mostly affects adults ages 20 to 40, and it's twice as common in women as men. You're more likely to get it if you have allergies like hay fever, a family history of dyshidrotic eczema, or other forms of eczema.

Symptoms

The small, itchy blisters are the most noticeable sign. These usually pop up in clusters, and you may itch or feel a burning pain before they appear. The skin around the blisters might sweat more than usual, and your nails might thicken and change colors, too.

The blisters often go away in 2 to 3 weeks. But the skin underneath can be red and tender for a while.

Dyshidrotic eczema can be mild or severe. If you have a severe case that affects your feet, the blisters can make it hard to walk. Blisters on your hands can make it hard to do things like cook, type, or wash dishes.

Sometimes the blisters can get infected, especially if you scratch them a lot. Signs that you have an infection include:

  • Pain
  • Swelling
  • Crusting
  • Pus in the blisters

 

Causes

Several things can set off dyshidrotic eczema, including:

  • Stress
  • Contact with metals like nickel, cobalt, or chromium salts on your job or from things like wearing costume jewelry
  • Sweaty or wet hands and feet
  • Warm, humid weather
  • HIV infection
  • Certain treatments for a weak immune system (immunoglobulin)

This condition isn't contagious. You can't catch it from touching someone who has it.

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Diagnosis

If you notice blisters on your hands and feet, see a dermatologist (a doctor who specializes in your skin). He'll look at your hands and feet, as well as your nails.

You also might need to see an allergy doctor (allergist). Patch tests can show if you have an allergy to nickel or another metal. During these tests, your doctor will put patches with a small amount of different metals or other things on your skin to see if you react to them.

Treatment

Your doctor can prescribe an ointment or cream with a steroid in it to bring down swelling and help get rid of the blisters. Your skin will take in the medicine better if you put a wet compress on it after you use the cream. If you have a severe flare-up, you might need to take a steroid drug, like prednisone, in a pill.

An antihistamine like diphenhydramine (Benadryl) or loratadine (Alavert, Claritin) can help with the itch, too. Or you might hold a cold, wet compress on the blisters for 15 minutes at a time several times a day.

If these treatments don't work well for you, you might try one of these:

  • Light therapy: This uses ultraviolet (UV) light to clear up your skin. You might get a medicine first to help your skin respond better to the light.
  • Botulinum toxin: These shots stop your hands and feet from sweating, which can trigger the blisters.
  • Medicines that slow down your immune system: Tacrolimus (Protopic) ointment or pimecrolimus (Elidel) cream can calm the swelling and irritation. These drugs can be options if you don't want to take steroids.
  • Draining the blisters: Your dermatologist can drain fluid from the blisters. Don't try to do this yourself. You could make the eczema worse.

To control the blisters at home:

  • Wash your hands and feet every day. Use lukewarm water and a mild, scent-free soap. Afterward, gently pat your skin dry.
  • Take your rings off before you wash your hands. Moisture can get trapped under your rings and cause more blisters.
  • Wear gloves with cotton liners whenever your hands are in water, like when you wash dishes.
  • Put a thick moisturizer on your hands and feet every time you shower or wash. Rub it on while your skin is still wet to seal in water. You also might use a cream that has dimethicone to protect your skin.
  • Turn on a humidifier in dry weather to keep your skin from cracking.
  • If allergies set off your eczema, try to stay away from things that trigger them.
  • Don't scratch the blisters -- you'll make them worse.

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If you're sensitive to nickel or cobalt, your dermatologist might tell you not to eat foods that are high in these metals. Nickel is in foods like chocolate, broccoli, legumes, and nuts. Cobalt is in shellfish, liver, nuts, beets, cabbage, and chocolate.

 

WebMD Medical Reference Reviewed by Stephanie S. Gardner, MD on February 26, 2017

Sources

SOURCES:

American Academy of Dermatology: "Dyshidrotic eczema."  

National Eczema Association: "Favorite earrings got you feeling irritated?"

Mayo Clinic: "Dyshidrosis: Symptoms and Causes," "Dyshidrosis: Treatment."

Medscape: "Dyshidrotic Eczema."

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