From the Research
Dyshidrotic eczema treatment should prioritize reducing inflammation and managing symptoms, with dupilumab being a promising option for recalcitrant cases, as shown in a 2018 study 1. When managing dyshidrotic eczema, it is essential to start with gentle skin care using fragrance-free moisturizers applied several times daily, especially after washing hands.
- For mild cases, use over-the-counter 1% hydrocortisone cream twice daily for up to two weeks.
- More severe cases require prescription-strength topical steroids like triamcinolone 0.1% or clobetasol 0.05% applied twice daily for 1-2 weeks, as discussed in a 1998 study 2. Cold compresses can help reduce itching and blisters.
- Avoid potential triggers including nickel, cobalt, chromium, certain foods, stress, and excessive hand washing. For severe cases that don't respond to topical treatments,
- oral antihistamines like cetirizine 10mg daily can help with itching,
- while oral steroids like prednisone (starting at 20-40mg daily with a taper over 2 weeks) may be needed for severe flares. Phototherapy and immunosuppressants like tacrolimus ointment are options for resistant cases. These treatments work by reducing inflammation, which is the underlying cause of the itchy, fluid-filled blisters characteristic of dyshidrotic eczema that typically appear on hands and feet, as noted in a 2006 study 3. However, it is crucial to consider the potential side effects of topical corticosteroids, such as clobetasol propionate, which can have cumulative depot effects and increase the risk of infection, as highlighted in a 2017 study 4. Therefore, dupilumab, with its novel mechanism of action and promising results in recalcitrant cases 1, may be a valuable addition to the treatment arsenal for dyshidrotic eczema.