Pompholyx or dyshidrotic eczema is a type of eczema that typically affects the sides of the fingers, palms of the hands, and soles of the feet. It can also affect the nail folds. The small blisters characteristic of pompholyx are itchy and painful. Once they dry up and peel, the skin underneath may be red and sensitive. The blisters tend to recur for months or years.
This condition typically starts with a burning sensation and prickling in the palms of the hands and soles of the feet. Then, small blisters develop, which turn into bigger blisters that may weep. These blisters may become infected, leading to pain, swelling, redness, and pustules. The skin can develop painful cracks as it dries out.
As previously mentioned, blisters that form on the palms of your hands, sides of your fingers, and soles of your feet are the characteristic signs of pompholyx. Sometimes new blisters begin to develop before the existing blisters have completely healed. While the condition can occur at any age, it is most commonly seen in individuals 40 years and younger.
The exact cause isn't known. However, certain factors can trigger the condition or make it worse. An allergic reaction to things that have touched the skin, such as certain metals, laundry detergent, soap, perfume, cosmetic products, and household cleaners, seem to trigger and make pompholyx worse. Stress and fungal infections can also aggravate the condition. Sweating is a common cause, and the condition occurs more often in spring and summer in warm climates and individuals with hyperhidrosis or excessive sweating.
For some individuals, pompholyx is simply an inconvenience. For others, the intense itchiness and pain may limit the ability to use the hands and feet. In severe cases, blisters become very large and spread to the backs of the hands and tops of the feet. Scratching increases the risk of developing a bacterial infection. Signs of infection developing include redness, intense pain, swelling, pus coming out of the blisters, and a golden crust on the blisters.
Emotional or physical stress, sensitive skin, a family history of pompholyx, and a history of certain medical conditions such as atopic eczema, hay fever, and contact dermatitis all put an individual at higher risk of developing the condition. People are more likely to develop pompholyx if exposed to certain metals, such as nickel and cobalt. Those between the ages of 20 and 40 are most susceptible, and women are more likely to get the condition than men.
A doctor can typically diagnose pompholyx with a physical examination, and laboratory tests can help rule out other medical conditions with similar symptoms. A skin scraping can test for fungal infections. Allergy tests can determine if contact with specific allergens is causing eczema.
The prescribed treatment depends on the severity of the condition. Corticosteroid ointments and creams can help speed up the healing of blisters, or oral steroids for severe cases. Immune-suppressing ointments offer an alternative to steroids. Another option for severe cases is botulinum toxin injections. If the condition doesn't respond to other types of treatment, phototherapy is an option.
Cool, wet compresses and over-the-counter antihistamines may decrease itchiness. Additionally, soaking the blisters in witch hazel may speed up the healing process. Try to refrain from scratching blisters, as this can lead to bacterial infections. Avoid contact with products that may irritate your skin, such as soaps and household chemicals. Use emollients to prevent the skin from drying out.
The blisters typically heal on their own within three weeks. The skin will become dry and may peel and crack during this time. Sometimes, new blisters will begin to form before the existing ones have fully healed. Pompholyx may occur once and never comes back, but more commonly, it recurs over months or years.
There's no proven way to prevent dyshidrotic eczema because the exact causes remain unknown. However, people with existing risk factors can reduce their likelihood of developing the condition by avoiding exposure to metals such as nickel and cobalt, managing stress, and caring for skin by using mild soap and lukewarm water to wash, wearing gloves when using household chemicals, and moisturizing after showering.
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