Dyshidrosis: Symptoms, Causes & Treatment Options

Medical review: Dr. Clarisse Bezerra
Family Doctor
August 2022
  1. Symptoms
  2. Diagnosis
  3. Dyshidrosis treatments
  4. Causes

Dyshidrosis, also known as dyshidrotic eczema, is a skin condition that causes small, fluid-filled blisters to appear on the palms off the hands, on the sides of the fingers and on the soles of the feet. These blisters usually cause intense itching and can last for up to 3 weeks.

Although the exact cause os dyshidrosis is not known, it is typically associated with skin allergies, excessive palm or foot sweat, increased physical activity or excess stress.

Dyshidrotic eczema is not contagious, and therefore there is no risk of transmission after direct contact with someone who has it. All cases should be assessed by a dermatologist, who will likely recommend a skin care routine or medication. Phototherapy or botox may also be appropriate in some cases.

Common symptoms

The main symptom of dyshidrosis is the formation of small fluid-filled blisters. In more serious cases, these blisters go deep into the skin and become larger.

The most common symptoms of dyshidrosis are:

  • Small blisters found on the sides of the fingers, the palms of the hands or the soles of the feet
  • Intense itching and peeling of the blisters
  • Pain to the blisters and surrounding area
  • Excessive sweating in the affected areas
  • Dry or cracked skin once the blisters are gone

Generally, the blisters dry up and peel about 3 weeks after they appear.

How diagnosis is confirmed

Diagnosis for dyshidrosis is confirmed following an assessment by the dermatologist. He or she will evaluate the symptoms you have (like redness, peeling or itching), as well the amount of blisters you have and where they have spread to. 

Generally, lab tests are not needed to diagnose dyshidrotic eczema. However, the doctor may order testing to rule out other health problems (e.g. sending a scraping of the skin for testing of fungus, allergy testing, etc.).

Dyshidrosis treatments

The dermatologist will likely indicate the following types of treatment:

1. Skin care routine

A regular skin care routine can help to prevent the blisters from forming, as well as prevent any worsening or infection. This routine can include:

  • Applying cold compresses 2 to 4 times per day for up to 15 minutes, or soaking feet in cold water, to reduce discomfort or itching.
  • Using warm water to wash your hands.
  • Applying moisturizer as directed by your doctor, as they can help to build-up of a protective barrier layer on your skin. Moisturizers should be used frequently throughout the day to help with dry skin.
  • Avoid contact with any substances that can irritate or cause allergy to your skin.

If your symptoms do not improve with these interventions, the doctor may opt to prescribe medications,

2. Use of medication

Medication is usually prescribed in more serious cases, or when a skin care routine was insufficient in treating dyshidrotic eczema. Medications that are commonly prescribed include:

  • Oral allergy medication, like diphenhydramine or loratadine, to help alleviate itching and redness in the affected skin
  • Corticosteroid creams, like mometasone or betamethasone, which are applied as a thin layer to the affected skin. These can help to reduce inflammation and dry-up the blisters, which help the skin to heal faster. Treatment with corticosteroid creams is usually done for up 6 weeks, unless otherwise directed by the doctor (depending on the severity).
  • Immunosuppressant creams, like tacrolimus ir pimecrolimus, which are prescribed when patients have a corticosteroid allergy, or when corticosteroid creams were not effective in improving symptoms.
  • Oral corticosteroids, like prednisone, which are prescribed when the above-mentioned creams are not effective

To compliment treatment, you can also try soaking the skin or applying wet compresses soaked in potassium permanganate or weak boric acid (2%). These can be done 2 to 3 times per day, until blisters start to improve. In addition, you should cleanse the affected skin with soap and water to ensure it is clean, and apply moisturizer 2 to 3 times per day. This protects the skin from other irritants, like cleaning products.

If more serious cases of dyshidrosis do not respond to the above treatment, the doctor may prescribe other medication like azathioprine, methotrexate, mycophenolate mofetil, cyclosprine or etanercept.

3. Light therapy

Light therapy, or phototherapy, is a type of treatment completed under the supervision of a doctor. UV rays are applied directly to skin affected by dyshidrosis. This is usually recommended when other treatments were not effective.

UV light can be used in conjunction with oral or topical psoralen. This combination treatment is often called PUVA (psoralen with UV-A) and it consists of applying the psoralen on the skin and then exposing the skin to UV rays 2 hours later. 

4. Botox

In more serious cases, Botulinum toxin, or botox, injections may be recommended to decrease activity in the sweat glands, which contribute to dyshidrotic eczema.

5. A natural home remedy

A good way to treat and relieve the symptoms of dyshidrosis is to apply calendula, or field marigold, compresses to the affected skin. This should be used to complement the treatment indicated by your dermatologist. Field marigolds contain medicinal properties that help to heal skin and reduce irritation, which will help with itching and drying-up of the blisters.

Ingredients

  • 2 tablespoons of field marigold flower petals
  • 200 mL (or about 6.5oz) of hot water

How to prepare

Place the flower petals in a pot of boiling water and allow them to sit for 10 minutes. Then, strain the infusion through a mesh sieve and soak your clean gauze in the liquid. Apply these compresses directly to affected skin for 5 to 10 minutes.

Possible causes

The exact cause of dyshidrosis is not known, however, it is most commonly seen in the summer. The following factors may contribute to its emergence:

  • Family history of dyshidrotic eczema
  • Increased stress of physical activity
  • Allergies (e.g. to hay fever)
  • Atopic or contact dermatitis
  • Frequently washing your hands
  • Working in a job that requires frequent contact with water or with products that can cause skin irritation
  • Exposure or skin allergy to certain metals like cobalt, chromium or nickel
  • Administration of IV immunoglobulin

In addition, some studies have shown that excessive sweating in the hands and feet (also known as hyperhidrosis) is linked to the development of dyshidrosis.

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Atualizado por Tua Saude editing team, em August de 2022. Medical review por Dr. Clarisse Bezerra - Family Doctor, em November de 2021.

References

  • TAKCI, Z.; et al. Dyshidrotic eczema and seborrheic dermatitis-like eczematous eruption following intravenous immunoglobulin therapy. Dermatol Ther. 33. 6; e14147, 2020
  • CALLE SARMIENTO, P. M.; CHANGO AZANZA, J. J. Dyshidrotic Eczema: A Common Cause of Palmar Dermatitis. Cureus. 12. 10; e10839, 2020
Show more references
  • SOCIEDADE BRASILEIRA DE DERMATOLOGIA. Disidrose. Available on: <https://www.sbd.org.br/dermatologia/pele/doencas-e-problemas/disidrose/48/>. Access in 17 Apr 2020
  • MINELLI, Lorivaldo. Disidrose: aspectos clínicos, etiopatogênicos e terapêuticos. An Bras Dermatol.. Vol.83. 2.ed; 107-115, 2008
Medical review:
Dr. Clarisse Bezerra
Family Doctor
Dr. Bezerra possesses a medical degree and specializes in family medicine. She is licensed to practice under CRM-CE licence #16976.