From the Research
Dyshidrotic eczema is a skin condition characterized by small, intensely itchy blisters on the edges of the fingers, toes, palms, and soles of the feet, and its treatment typically involves topical corticosteroids, moisturizing, and avoiding triggers.
Definition and Treatment
Dyshidrotic eczema, also known as pompholyx or vesicular palmoplantar eczema, is a type of eczema that affects the hands and feet. The exact cause of dyshidrotic eczema is unknown, but it is believed to be related to a combination of genetic predisposition, environmental triggers, and immune system dysfunction that leads to inflammation in the skin, particularly affecting the sweat glands in hands and feet 1.
Treatment Options
Treatment for dyshidrotic eczema typically involves:
- Topical corticosteroids, such as betamethasone or triamcinolone, applied twice daily for 2-3 weeks to reduce inflammation and itching 2
- Moisturizing regularly with fragrance-free emollients to maintain skin barrier function
- Avoiding known triggers, such as nickel, cobalt, chromium, certain foods, stress, and excessive hand washing
- Soaking affected areas in cool water with colloidal oatmeal to provide temporary relief
Severe Cases
For severe cases, a short course of oral prednisone (starting at 40mg daily and tapering over 2 weeks) may be necessary 1. Persistent cases may require prescription of tacrolimus ointment (0.1%) or pimecrolimus cream (1%) as steroid-sparing agents. Severe chronic cases may require phototherapy or oral immunosuppressants like cyclosporine.
Important Considerations
It is essential to note that the use of topical corticosteroids should be limited to the shortest duration necessary to achieve relief, as long-term use can lead to skin thinning and other adverse effects 2. Additionally, the use of antibiotics is not recommended for mild clinically infected eczema, as they do not provide a significant benefit and may contribute to antibiotic resistance 3.