It's so itchy! How to deal with these "little blisters" that often appear on your hands in summer?

Every time this season comes, many people develop blisters on their hands, which itch terribly. And once they are scratched, some unknown liquid will flow out... This happens almost every year, and sometimes several times a year. What is going on?

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Today, let’s talk about these small transparent blisters on the hands that bother many people - dyshidrotic eczema.

Correctly identify herpes zoster

As the saying goes, first ask if, then ask why.

Although blisters on the hands (or feet) can be dyshidrosis, they can also be other problems. Therefore, when blisters appear, you must first find out what the problem is, and then prescribe the right medicine. Otherwise, it is easy to misdiagnose and treat it, and take a lot of detours.

The so-called dyshidrotic eczema is also called dyshidrotic eczema or acute palmoplantar eczema. It is essentially a kind of eczema with the following characteristics:

Most common in young people, rarely in children or the elderly;

The main rash is blisters, which are deep and difficult to break;

May be accompanied by redness and peeling after the blisters subside;

The prominent symptom is severe itching, with little pain;

The disease is characterized by recurrent attacks, which may occur frequently over months or years;

The affected areas are almost exclusively on the hands and/or feet, and are relatively symmetrical on both sides. Specifically, the affected areas are the palms, sides of the fingers, backs of the fingers, and the front of the soles of the feet.

The following pictures are typical examples of dyshidrotic eczema.

Figure 1. Pompholyx (Source: https://www.nhs.uk/conditions/pompholyx/)

Figure 2. Dyshidrosis

Now that we have discussed the characteristics of dyshidrotic eczema, what other blisters can also grow on the hands or feet? There are many. The following table lists several common ones that are easily misdiagnosed as dyshidrotic eczema for you to distinguish.

Why do you get herpes?

Because of sweating?

Rather than discussing what dyshidrotic eczema is, people may be more eager to know how to treat it.

But as a dermatologist and popular science writer, I still want to talk about why it happens and what situations are prone to sweat herpes. This is because only by deeply understanding the ins and outs can the treatment be more relaxed, as the saying goes, knowing the cause and the reason.

There is a common misunderstanding about dyshidrotic eczema, which is that dyshidrotic eczema is caused by sweating or excessive sweating. In fact, this is not the case. Here are two points to share:

First, dyshidrotic eczema, or dyshidrotic eczema, is a misnomer in medicine. In other words, the name of the disease is not worthy of its name. Similar situations are very common, such as using "onychomycosis" to refer to fungal infection of the nails, which is also problematic because the medical characteristic of onychomycosis is not graying of the nails.

Second, the relationship between sweating and dyshidrotic eczema is relatively weak. There are actually many causes or triggers of dyshidrotic eczema, and the cause is not even clear for many people.

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In summary, the factors associated with dyshidrotic eczema may include the following:

· Have atopic dermatitis (also called atopic eczema), especially dyshidrotic eczema in children;

· Exposure to certain allergens, such as metal products containing nickel and other allergens;

Fungal infections in other parts of the body (such as the feet) can cause dyshidrosis elsewhere (such as the hands), which is an autoimmune response;

· There is indeed excessive sweating of the hands and feet;

I am a smoker, whether I smoke cigarettes or e-cigarettes;

Sun exposure;

· Drastic mood swings and high mental stress.

For each individual, the specific triggering factors and aggravating factors are actually different. Many people even have it happen inexplicably, and it is difficult to determine the specific cause. If you want to find the source, one is to pay more attention to suspicious factors before each attack in life, and the other is to seek regular medical treatment and ask a dermatologist to help judge. If necessary, you can do patch tests to help find the cause.

How to treat dyshidrosis

Rather than being controlled by it

The treatment of dyshidrosis can be very simple, and it is easy for dermatologists to recommend drugs. We already know that dyshidrosis itself is a kind of eczema, and topical glucocorticoid ointment is the most common treatment. Just refer to the instructions or use it according to the doctor's advice.

However, we need to be more meticulous and have a longer-term vision when treating dyshidrotic eczema. This can better control the current condition and reduce future recurrence and rebound.

When taking medication, there are a few details to pay attention to:

You can choose stronger glucocorticoids, such as mometasone furoate cream and halometasone cream, because the inflammation of dyshidrotic eczema is relatively deep and the stratum corneum of the hands and feet is thick, so weak glucocorticoids such as desonide are not expected to be very effective;

When itching is severe, you can also add antipruritic drugs, such as menthol ointment for external use;

If necessary, try oral antihistamines, such as cetirizine (use as directed by your doctor);

If repeated treatments do not work, do not just treat it on your own, but consult a doctor to review your condition and adjust the treatment plan.

Drug treatment is only one aspect. There are many other important nursing details that need to be done simultaneously with drug treatment, which are also very important and are easily overlooked by many patients.

On the one hand, we should pay attention to reducing some unfavorable factors of hands and feet, and pay attention to protecting local skin. For example, you can wash your hands with warm water or mild detergent (weak acid hand soap is recommended). After washing your hands and feet, wipe off the water, and pay attention to using moisturizer more often. Moisturizing, moisturizing, and moisturizing again is very important.

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On the other hand, if you have to come into contact with special chemicals when working or doing housework (such as washing clothes or dishes), you can wear gloves to do the work. If you are exposed to water for a long time, you can take off your rings, watches and bracelets to reduce the microscopic reaction between the metal elements in the alloy and the skin.

The best situation is that if there are certain items that are problematic or highly suspected of being risky, you can avoid them in your daily work and life, which will also be of great help in reducing recurrence. If you encounter this annoying "little demon" and cannot handle it yourself, then remember to ask for help - a dermatologist.

I hope all patients with dyshidrotic eczema can have a happy, comfortable and itch-free summer!

Note: This article is only for health science popularization. If you have related symptoms, please go to a regular medical institution in time and follow the doctor's advice. The content of this article is not used as a basis for medical diagnosis.

References

[1] Acute palmoplantar eczema (dyshidrotic eczema). UpToDate. https://www.uptodate.com/contents/en/acute-palmoplantar-eczema-dyshidrotic-eczema

[2] Pompholyx. NHS. https://www.nhs.uk/conditions/pompholyx/

[3] Dyshidrotic Eczema (Dyshidrosis). Cleveland clinic. https://my.clevelandclinic.org/health/diseases/17728-dyshidrotic-eczema

Author: Tang Jiaoqing, MD, attending physician of dermatology

Review | Feng Jun, deputy chief physician of the Dermatology Department of Sinopharm Tongmei General Hospital