Overview

Dyshidrosis is a skin condition that causes small, fluid-filled blisters to form on the palms of the hands and sides of the fingers. Sometimes the bottoms of the feet are affected too.

The blisters that occur in dyshidrosis generally last around three weeks and cause intense itching. Once the blisters of dyshidrosis dry, your skin may appear scaly. The blisters typically recur, sometimes before your skin heals completely from the previous blisters.

Treatment for dyshidrosis most often includes creams or ointments that you rub on the affected skin. In severe cases, your doctor may suggest corticosteroid pills, such as prednisone, or injections. Dyshidrosis is also called dyshidrotic eczema and pompholyx.

Symptoms

The blisters associated with dyshidrosis occur most commonly on the sides of the fingers and the palms. Sometimes the soles of the feet also can be affected. The blisters are usually small — about the width of a standard pencil lead — and grouped in clusters, with an appearance similar to tapioca.

In more-severe cases, the small blisters may merge to form larger blisters. Skin affected by dyshidrosis can be painful and very itchy. Once the blisters dry and flake off, which occurs in about three weeks, the underlying skin may be red and tender.

Dyshidrosis tends to recur fairly regularly for months or years.

When to see a doctor

Call your doctor if you have a rash on your hands or feet that doesn't go away on its own.

Causes

The exact cause of dyshidrosis isn't known. It can be associated with a similar skin disorder called atopic dermatitis (eczema), as well as with allergic conditions, such as hay fever. Eruptions may be seasonal in people with nasal allergies.

Risk factors

Risk factors for dyshidrosis include:

  • Stress. Dyshidrosis appears to be more common during times of emotional or physical stress.
  • Exposure to certain metals. These include cobalt and nickel — usually in an industrial setting.
  • Sensitive skin. People who develop a rash after contact with certain irritants are more likely to experience dyshidrosis.
  • Atopic dermatitis. Some people with atopic dermatitis may develop dyshidrotic eczema.

Complications

For most people with dyshidrosis, it's just an itchy inconvenience. For others, the pain and itching may limit the use of their hands or feet. Intense scratching can increase the risk of a bacterial infection developing in the affected skin.

Prevention

Because the cause of dyshidrosis is generally unknown, there's no proven way to prevent this condition. You may help prevent the condition by managing stress and avoiding exposure to metal salts, such as cobalt and nickel.

Good skin care practices may help protect the skin as well. These include:

  • Using mild cleansers and lukewarm water to wash your hands and drying your hands well
  • Moisturizing regularly
  • Wearing gloves

April 05, 2019
References
  1. Wolff K, et al. Eczema/Dermatitis. In: Fitzpatrick's Color Atlas and Synopsis of Clinical Dermatology. 8th ed. New York, N.Y.: McGraw-Hill Education; 2017. https://www.accessmedicine.mhmedical.com. Accessed March 22, 2019.
  2. Adams DR, et al. Acute palmoplantar eczema (dyshidrotic eczema). http://www.uptodate.com/contents/search. Accessed March 22, 2019.
  3. Hand and foot dermatitis. Merck Manual Professional Version. https://www.merckmanuals.com/professional/dermatologic-disorders/dermatitis/hand-and-foot-dermatitis. Accessed March 22, 2019.
  4. Gibson LE (expert opinion). Mayo Clinic, Rochester, Minn. March 17, 2016.