Dyshidrosis: how to treat and prevent this very common skin condition

Dyshidrosis, or Dyshidrotic Eczema, is a chronic skin disease. It is a fairly common type of eczema (allergy) that affects the palms of the hands, fingers and soles of the feet. Its main characteristic is small bubbles of one to two millimeters in width and reddish base. But, in more severe cases, it can develop into cracks and fissures. In these situations, you need to be more careful, as the site is vulnerable to bacterial infections.

There is controversy whether the disease usually has a higher incidence in women or whether it affects both sexes equally. But what is clear is that the age group most susceptible to developing the disease is between 20 and 40 years of age. Blisters last for about three weeks, after which they usually disappear. However, as it is a chronic disease, it reappears after some time. Recurrent attacks can result in thickening of the skin (hyperkeratosis).

According to dermatologist Izabella Maia, the diagnosis of dyshidrosis is clinical: from a detailed clinical history, that is, a description of the development of the disease, it is possible to establish the causes and know if it really is dyshidrosis. The dermatologist also explains that some tests may be requested, such as direct mycological examination, in case of suspected fungal infection; the patch test, in cases related to contact dermatitis; and biopsy, when it is not possible to identify the causal agent.

The dermatologist also states that dyshidrosis can be confused with atopic dermatitis, allergic contact dermatitis, primary irritant contact dermatitis, nummular eczema, among other dermatological diseases, and it is possible to distinguish from a skin examination.

Dyshidrosis has no cure, but it can be controlled in a number of ways. Next, you know the causes, symptoms and treatments for the disease.

What are the causes of dyshidrosis?

Dyshidrosis is caused by an inflation in the skin that creates tiny blisters, which burst, leaving the skin looking scaly. About half of affected people tend to develop allergies, having other types of allergic manifestations in their history, such as dermatitis or even bronchitis.

According to Izabella Maia, the causes of dyshidrosis are not completely established. Despite this, it can be classified into two types: idiopathic or true dyshidrosis, when it is not possible to identify the origin of the disease; and dyshidrosisiform eruptions, when dyshidrosis arises related to another problem, such as atopic dermatitis, contact dermatitis, pharmacoderma (allergic reaction to drugs), and dermatophytids (allergic reactions to a fungus).

Among other triggers of the disease are physical or mental stress and very frequent hand washing. The disease is more frequent during the summer or in sudden changes in temperature, and seems to be related to the exaggerated production of sweat in the hands and feet, even though the liquid present inside the blisters is not sweat.

It is important to note that dyshidrosis is not a contagious disease: there is no danger of transmission, even if it comes into direct contact with the skin of another person.

What are the symptoms of dyshidrosis?

In dyshidrosis crises, the skin becomes inflamed. This causes the spaces created by inflammation between skin cells to fill with fluid. This is how the small blisters characteristic of the disease appear. Dermatologist Izabella Maia helped us put together a list of the main characteristics and symptoms of the disease:

• Blisters: small bumps that, when scratched, can evolve into larger blisters and eruption of the fluid inside them. They appear in groups, never alone. There are two types of blisters that are characteristic of dyshidrosis: small raised blisters and deeper, opaque blisters that are flush with the skin or slightly raised. This second type does not break easily.
• Itching: It is not always itchy, but it is possible for the blisters to itch and become painful. The itching can get worse with contact with irritating substances.
• Fissures (cracks): When you scratch the blisters, they can burst, releasing the liquid inside. As they heal, the skin may become thicker and drier, and may crack. Cracks can be quite painful and take weeks or months to heal.
• Burning or fever at the site, pain and/or swelling: these symptoms can appear if there is an infectious process at the site. In that case, see a doctor to treat the infection and get your symptoms under control again.
• Tingling: In some cases, bouts of dyshidrosis can be accompanied by swelling of the lymph nodes, which can cause a tingling sensation in the forearm.

How to treat?

There are several treatments for dyshidrosis, but the most common treatment is the application of topical medications, such as creams or lotions. They are used to combat the symptoms, since, as has been said, the disease has no cure.

According to the dermatologist consulted, only in more serious cases the use of oral medication is indicated. In addition, in the presence of secondary infection, the use of antibiotics is indicated, and in cases that are more resistant to conventional treatments, immunosuppressants and phototherapy can be used.

Topical treatment

The ointments and creams used to treat dyshidrosis are usually applied twice a day and have Vaseline, mineral oil or vegetable fat in their formula, to try to keep the skin hydrated. Some of the types of ointments used are:

• Cortisone-based creams and ointments: relieve symptoms of dyshidrosis and accelerate the healing process. For better absorption, the affected area can be wrapped in plastic wrap for a few minutes. But beware: prolonged use can wear and dry the skin, as well as making room for secondary infections.
• Urea-based creams: exfoliate and moisturize the skin, preventing the development of the disease and relieving symptoms.
• Immunosuppressive ointments: they prevent the appearance of blisters, but as they alter the immune system, they increase the chances of getting a skin infection.
• Potassium permanganate or aluminum acetate solution: “dries” and neutralizes blisters with a lot of fluid and has an antiseptic effect, but it must be used with caution: its application can be painful and residues left on the skin can cause burns.

In addition, it is important to use a good moisturizer, as dyshidrosis leaves the skin dry.

It is important to remember that, with the exception of moisturizer, all these medicines must be prescribed by your doctor, considering your specific case.

oral treatment

As already mentioned, oral treatment is indicated for slightly more severe cases of the disease. In these situations, the doctor may prescribe an antihistamine (antiallergic) to improve the itching and burning symptoms; a corticosteroid, to decrease the number and size of the blisters; or an antibacterial in chronic cases. The doctor will review each case to determine which drug is most appropriate.

food change

Dermatologist Izabella Maia explains that, in some cases, dyshidrosis can arise as a result of nickel allergy. In this case, eating foods with this metal would trigger the disease. If this is the case, a dietary change is needed, avoiding canned foods, acidic foods, foods cooked in stainless steel pans, oysters, asparagus, beans, mushrooms, onions, corn, spinach, tomatoes, peas, whole wheat, pears, tea, chocolate and baking powder.

Treatments for the most serious cases

When none of the previous treatments have proven effective, the doctor may recommend phototherapy, exposing the wound to ultraviolet light, which strengthens the skin, reducing irritation. In even more serious cases, it is possible that the doctor recommends injections of botulinum toxin (botox), decreasing the functioning of the sweat glands.

During the treatment, it is very important to pay attention to the proper hygiene of the affected region, which should be done with warm water and neutral soap. The skin should be very dry after cleansing, and moisturized at least twice a day. It is also important to avoid contact with irritating substances.

home treatments for dyshidrosis

There are some things you can do at home to control the disease and prevent flare-ups. Check out some recipes and homemade measures to treat dyshidrosis:

Aloe Vera Gel

Homemade or industrialized Aloe Vera (Aloe Vera) gel can be applied to the affected area to reduce inflammation and itching, prevent bacterial infections, and speed up the skin’s healing process.

cold water compresses

In case the blisters are very irritated and there is intense itching, applying cold water compresses with gauze or other clean, soft textured fabric can relieve this sensation.

white vinegar solution

White vinegar works to balance the pH of the skin, preventing the growth of fungi. To apply it, mix one cup of vinegar for every liter of water and soak your feet or hands in this mixture for 15-20 minutes, twice a day.

Dried Chamomile Grass Infusion

Chamomile has several anti-inflammatory substances that can reduce allergic skin reactions. To achieve this effect, place dried chamomile grass in a cup of boiling water and steep for 15 minutes. Let it cool and, with a clean gauze, apply the infusion on the affected region. Apply two to three times a day.

Cream of peas and yogurt

Blend a handful of fresh peas with the required amount of yogurt in a blender so that the mixture becomes a consistent cream. Apply this cream to the affected area and leave it on for 10 minutes. Then remove with a cotton ball soaked in warm water.

cabbage juice

With a rolling pin, mash several fresh cabbage leaves until they let out some of their juice. Collect this liquid and apply with gauze to the affected area. Leave it on for 10 or 15 minutes and then wash your hands or feet as normal.

Avocado Cream or Butter

Vitamins D and E present in avocado help in the formation of collagen, stimulating skin regeneration. Avocado butter can be purchased ready-made at stores that carry essential oils and vegetable butters, but avocado cream can be made at home. To do this, crush a little of the avocado pulp and apply it on the affected area, removing it after 15 minutes.

marigold tea

Calendula contains healing and soothing substances that help relieve itching and dry out the blisters caused by dehidrosis. To be able to enjoy all its benefits, it is necessary to prepare it in the form of an infusion.

Ingredients

• 2 tablespoons of marigold flowers
• 200 ml of water

Preparation mode

Boil water in a pan, then turn off the heat and place the marigold flowers in the water, letting it rest for 10 minutes. Then, strain, let it cool a little until it is warm and apply in clean compresses to the affected region, leaving for 5 to 10 minutes.

jasmine tea

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