Let's learn about the annoying water blisters that appear on the palms and soles (Dyshidrotic Eczema)?

Do you have annoying, small blisters between your fingers, on your palms, or on the soles of your feet, which are also dry, cracked, and itchy? Sometimes the itching can be so bad that it wakes you up at night. If you have experienced this, today we are going to talk about a topic that is very important to you. In medical terms, we call this condition Dyshidrotic Eczema . Some people also call it Dyshidrosis or Pompholyx. This condition belongs to the group of skin diseases called Eczema. It is not as dangerous as you might think, but it can be so annoying that it can interfere with your daily activities. So don't worry, we will talk about it clearly.

What are the symptoms of this disease?

Dyshidrotic eczema symptoms tend to come on suddenly, last for a few weeks, and then go away. When it does, the main changes are in your skin.

Simply put, these blisters are like little pearls filled with water. Sometimes they are as small as a pinhead . But sometimes these small blisters can join together and become larger blisters. After these blisters dry up, the skin in that area starts to peel off like scales, and the skin can also crack.

The main symptoms seen are:

• Small, hard, watery blisters: These are the main symptom of this disease. They are most commonly seen on the sides of the fingers, palms, and soles of the feet.
• Severe itching: These blisters can cause unbearable itching.
• Pain: Sometimes there may be pain or tenderness in the area where the blisters have formed.
• Peeling of the skin: After the blisters dry up, the skin in that area peels off.
• Skin discoloration: Some people may experience a temporary change in skin color in the affected area after the disease has healed.
• Excessive sweating: Some people with this condition experience abnormal sweating on their palms and soles.
• Dryness and cracking of the skin: After the blisters heal, the skin in that area may become dry and develop deep, painful cracks.

In some severe cases, these blisters can spread to the tops of the fingers, hands, and feet. However, they do not spread to other parts of the body .

Why does something like this happen?

Doctors still don't know exactly what causes Dyshidrotic Eczema. But they believe that it is caused by both genetic and environmental factors . This means that it can be passed down from generation to generation. If your mother, father, or sibling has the condition, you have a higher chance of developing it. Also, certain things in our environment, such as allergens or stress, can trigger these symptoms.

What are the triggers of the disease?

There are several reasons why these symptoms can suddenly increase, or what we call a "flare-up." Sometimes one or more of these reasons combine to make the disease worse.

Who is most at risk of developing this condition?

Although this condition can develop in anyone, some people are more likely to develop it.

• If you are between 20 and 40 years old .
• If you are a woman .
• If anyone in your family has eczema .
• If you have an allergic reaction when you touch something.
• If you receive some antibody infusions to boost your immunity.
• If you are taking certain medications, such as aspirin or birth control pills .

What happens if you bite? (Complications)

The itching that comes with these blisters is very difficult to bear. But if you scratch these blisters, the skin is very likely to be damaged and a bacterial infection may develop. If this happens, the wounds may ooze pus, swell, and become more painful. If you see signs of such an infection, see your doctor immediately . He or she will prescribe the necessary antibiotics.

Over time, the skin on your hands and feet can become thick, dry, and cracked due to constant scratching. Since this condition is visible on your hands and feet, some people may feel embarrassed and uncomfortable in public. The stress caused by this can lead to further flare-ups. Therefore, your skin health is just as important as your mental health . Don't hesitate to talk to your doctor about this.

Doctor, how do you diagnose this?

When you go to see a doctor, the first thing he or she will do is carefully examine the affected areas of your skin. Then, they will ask about your medical history and whether anyone in your family has had similar skin conditions.

It is very important to tell your doctor about any new products you have recently started using.

• A new type of soap, a cream, a shampoo
• Newly purchased jewelry (especially imitation)
• A new type of food

This information will be of great help in finding out what is causing your disease to worsen.

Sometimes, to confirm the diagnosis and rule out other diseases with similar symptoms (e.g., contact dermatitis, hand, foot, and mouth disease), your doctor may also order several tests, such as:

• Allergy test
• A biopsy is a test that involves taking a small piece of skin.
• Blood tests

What are the treatments for this?

There are several main goals in treating dyshidrotic eczema: controlling itching and pain, preventing infection, and controlling relapse.

Things you can do at home

When you have mild symptoms, there are some simple things you can do at home.

• Wash with cool water: Soak the affected hands and feet in cool water for a while. This will reduce the itching and provide relief.
• Cool compress: Soak a clean cloth in cold water and apply it to the blistered area for about 10-15 minutes. Then let it air dry and immediately apply a good moisturizer .
• Use of moisturizer: This condition weakens the skin's protective layer. Therefore, it is essential to use a good, unscented moisturizer frequently throughout the day. This can prevent the skin from drying out and cracking.

Treatment recommended by the doctor

If home care is not enough to control the condition, your doctor will prescribe medication.

• Creams and Ointments:
• Corticosteroid creams: These are the most commonly used treatments. They help reduce itching and swelling. While milder creams like hydrocortisone are available over-the-counter, a doctor may prescribe stronger steroid creams for more severe cases.
• Non-steroidal ointments: Topical calcineurin inhibitors, such as tacrolimus or pimecrolimus, are sometimes prescribed.
• Types of pills:
• Antihistamines: Tablets like `(Fexofenadine)` or `(Cetirizine)` can help control itching.
• Oral Corticosteroids: In very severe cases, pills like `(Prednisone)` may be given for a short period of time.
• Other treatments:
• Immunosuppressant drugs: Drugs like `(Methotrexate)`, `(Mycophenolate)`, or injections like `(Dupilumab)` are used in very severe cases that do not respond to other treatments.
• Phototherapy: A method of treating the skin using ultraviolet (UV) light.

When should you definitely see a doctor?

If your symptoms are new or worsening, be sure to see a doctor. Seek medical advice immediately, especially if you notice signs of infection .

• Pus coming out of wounds
• Severe pain
• Swelling
• Feeling warm to the touch
• Yellow crust formation

If you have these symptoms, it could be a bacterial infection, and it's important to get treatment quickly.

How can I prevent it from recurring?

Although this condition cannot be completely cured, frequent outbreaks can be controlled by staying away from triggers and taking good care of your skin.

• When washing your hands, use lukewarm water instead of hot water .
• If you touch something you know you are allergic to, wash the area thoroughly immediately .
• Wear gloves when washing dishes or handling harsh chemicals.
• If you have allergies to metals, avoid wearing imitation jewelry .
• Dry your hands and feet thoroughly after bathing or swimming. Do not leave them wet.
• Try to manage stress . Things like meditation and exercise can help with this.

This condition can make it painful to do everyday tasks, sometimes even holding a cup of coffee or shaking someone's hand. But with proper treatment and skin care, you can overcome these difficulties and enjoy doing the things you love. Your doctor is there to help you with that.

Dyshidrotic Eczema, pompholyx, water blisters, blisters on hands, blisters on soles, skin diseases, itching, eczema in Sinhala