Some skin diseases may be behind itchy and weeping blisters on the fingertips, palms and soles. One of them is dyshidrosis, an eczema whose causes have not yet been fully researched. Certain treatments nevertheless provide relief by relieving the itching as well as allowing the symptoms to heal.
What is dyshidrosis?
Dyshidrosis involves more or less large blisters on certain areas of the skin. They often bring redness to the skin and are filled with substances produced by the body. If the blisters burst, there is a further risk of infection due to the escaping fluid. Most sufferers complain of severe itching, which tempts them to scratch open the blisters, allowing the disease to spread. Dyshidrosis occurs in episodes and especially in warm months, which is why it was previously suspected that there was a connection with the sweat glands. This has since been disproved, but the disease still owes its name to the sweat glands. If the disease is cured, it is usually accompanied by desquamation of the skin. It can come particularly with an intensively appeared illness to the emergence of cornea.
Causes
The causes of dyshidrosis are still not fully understood. However, it is noticeable that it occurs more frequently in people who also suffer from neurodermatitis, psoriasis or from allergies. Atopics are particularly affected, who even react allergically to contact with environmentally compatible substances. Likewise, the skin disease can be triggered by medications, contact with heavy metals, especially nickel, chromium and cobalt salts, or massive sun exposure. Dyshidrosis could be a result of heavy skin exposure, such as alkaline soaps or cleaning products. Other suspects are fungal diseases and hereditary predispositions. While the enumerated factors favor the development of dyshidrosis, the onset of the skin disease due to stress is discussed.
Symptoms, complaints, and signs
Dyshidrosis is primarily noticeable by the typical vesicles. These vesicles are usually only a few millimeters in size and occur in groups. Occasionally, the vesicles coalesce into larger blisters as the disease progresses. The vesicles are localized under the epidermis. They cause severe itching and pain, as well as infection and inflammation. In a mild episode, the vesicles often dry up without major discomfort. During the healing process, the skin scales and a callus develops. This can tear open and become inflamed if not treated properly. In addition, the cornea is interrupted by cavities that can fill with water, pus or blood, depending on the causative disease and the location of the blisters. In a severe course, dyshidrosis may cause further symptoms such as bleeding, eczema or even ulcers. The skin in the area of the blisters is particularly sensitive and tears quickly. If dyshidrosis occurs in conjunction with an allergy, the typical allergy symptoms usually develop. Then, for example, further skin irritations and breathing difficulties occur. The disease can be clearly diagnosed on the basis of the typical symptoms and treated in a targeted manner.
Course
Dyshidrosis is manifested by the appearance of numerous vesicles. These often measure only a small diameter of about one millimeter. If they lie in groups particularly close together, they may combine to form larger blisters. The blisters are located under the epidermis. A deeper location is also possible, but occurs rather rarely. In addition to severe itching and pain, infections and inflammations may also occur. However, these complications do not necessarily have to occur; in the case of only a mild episode of dyshidrosis, it is also possible for the blisters to dry out and the skin to heal without further infection. During the healing process, the skin dries, scales, and forms calluses, which can later crack. The cornea is typically punctuated by round cavities, which are particularly prone to desquamation as the disease progresses.
Complications
In dyshidrosis, the patient suffers from limitations in daily life due to the developed vesicles on the fingers and feet. These can reduce the quality of life and are often associated with unpleasant itching.However, it is advisable not to scratch the blisters, as this usually only intensifies the itching and promotes the formation of sores. Patients often also suffer from pressure pain in the affected areas, so that many actions and activities are no longer possible. Movement restrictions may also occur when dyshidrosis develops on the feet. The skin may also begin to flake. Treatment is usually possible, although the underlying condition is always explored first. The symptoms themselves are treated with the help of creams and baths, with no further complications. Usually the symptoms disappear after about a week. During the healing process, the patient must take care of the affected areas and not wear gloves, for example. After the treatment there are no further difficulties. If the dyshidrosis occurs due to stomach problems, diet may be necessary. However, in most cases, there is a positive course of the disease.
When should one go to the doctor?
If skin redness, itching or blisters are noticed on the skin, dyshidrosis may be present. Whether the symptoms require medical treatment depends primarily on the course of the underlying disease. In most cases, the skin changes disappear by themselves after a few days to weeks. If this is not the case, a visit to the family doctor or dermatologist is recommended. Patients suffering from neurodermatitis, psoriasis or allergies should always see a doctor. This is especially true if complications occur – for example, severe itching or infections. If the blisters open, an immediate visit to the doctor is indicated. Otherwise, dyshidrosis can cause severe inflammation. Medical examination and treatment will prevent this and provide information about the causes of the skin disease. Depending on the trigger, the doctor will then refer the patient to the appropriate specialist. If an allergy is the cause, vaccinations and preventive measures are indicated. In addition, the doctor will issue the sufferer with an allergy passport for medical emergencies.
Treatment and therapy
Not only the causes of the disease seem to be versatile, but also the treatment options differ greatly. First of all, the trigger of the disease should be researched in order to be able to avoid it afterwards. Otherwise, external applications such as creams or baths should provide relief. These are often zinc shake mixtures, yellow substance preparations, urea or fat-containing cortisone creams. During treatment, attention is also paid to the condition of the blisters. Burning blisters and swellings can often be relieved by homeopathic remedies, such as Apis mellifica C5, pus-like fluids require the use of Mezereum C4 to C5. It should be applied several times a day. Oral treatment is also possible. This is based on taking vitamin D derivative alitretinoin or cortisone. Also sometimes used is neotigasone, which are actually intended for the treatment of psoriasis, but can also help with dyshidrosis. When dyshidrosis occurs, care should be taken to avoid frequent disinfection of the hands. It is also disadvantageous to wear latex, rubber as well as PVC gloves, under which a moist climate is formed, which can negatively influence the healing process. Affected people are advised to avoid meat and dairy products if possible, or at least to reduce them considerably, which also applies to peppers. In alternative medicine, acupuncture, homeopathic remedies and intestinal rehabilitations are offered, which aim to treat deeper processes that are expressed only through dyshidrosis, but consider it a symptom and not a disease in its own right.
Outlook and prognosis
In dyshidrosis, self-healing does not occur. For this reason, patients are dependent on treatment in any case to permanently relieve the symptoms. If dyshidrosis is not treated, those affected suffer from a number of different skin complaints, which also intensify as the condition progresses. This results in itching and the formation of eczema. The skin itself can often be reddened. Cracks that occur cause wounds, pain and scarring may occur.Often, the patients also suffer from inferiority complexes or a significantly reduced self-esteem due to the complaints, as the patients no longer feel beautiful. Likewise, the healing of the wounds is significantly slowed down with the disease. With the help of medication and various creams or ointments, the symptoms of dyshidrosis can be relatively well limited. The further course of the disease depends on how well the affected person takes care of his or her hands and whether the skin is possibly injured at work. In some cases, dyshidrosis can also be treated causally. However, dyshidrosis can be completely limited by intensive care and by protecting the skin.
Prevention
Dyshidrosis has different causes, so it can be difficult to prevent the condition effectively. However, it may help to avoid stressful situations, avoid using strong chemical cleaning products, limit contact with chromium and nickel, and avoid increased sun exposure. When doing work that requires contact with alkaline soaps and chemicals, it would be appropriate to adequately protect the hands. An allergy test can also have a preventive effect. Only recognized allergies can be treated or avoided and thus limit the risk of developing dyshidrosis.
Aftercare
In most cases of dyshidrosis, follow-up care proves to be relatively difficult. In this regard, the affected person is primarily dependent on early detection of this disease so that further complications or complaints can be avoided. The symptoms of dyshidrosis can only be alleviated by comprehensive treatment, as this also does not lead to self-healing. At the same time, an early diagnosis with subsequent immediate treatment always has a positive effect on the further course of the disease. In most cases, those affected by this disease are dependent on taking medication. Regular intake should always be observed. The correct dose must also be observed, and a doctor should always be consulted if there are any questions or uncertainties. Furthermore, a relatively high standard of hygiene must be maintained to prevent further infections of the skin. The affected person should disinfect and wash frequently. Whether dyshidrosis can be completely treated depends very much on the exact underlying disease. However, as a rule, the patient’s life expectancy is not negatively affected by this disease.
What you can do yourself
The causes of dyshidrosis have not yet been conclusively clarified. However, a connection between the disease and certain factors is suspected. These include, for example, atopias (hypersensitivities) and allergies. Those affected should therefore keep a diary in which they record what activities they have performed and what they have eaten. In this way, it is possible to determine after some time whether an acute illness flare-up is possibly related to certain substances or certain foods. If, for example, blisters always form on the hands after washing windows, then it is likely that the person affected is allergic to a cleaning agent or auxiliary used in this activity. In addition, a connection with aggressive cleaning agents and excessive personal hygiene is suspected. Affected persons should therefore only use mild, ph-neutral washing lotions and shampoos and not shower for too long or too hot. Contact with metal salts is also blamed for the disease. Metal salts are found in many everyday products. For example, in hair dyes, deodorants or textiles. Certified natural cosmetics are usually free of metal salts because the standards that the product must meet prohibit their use. Organic-certified textiles are also dyed with eco-dyes that are low in chemicals. If the trigger cannot be determined, sufferers can only combat the symptoms of dyshidrosis. Antihistamines, which are available over the counter at pharmacies, help against the often severe itching.
