Dyshidrotic eczema (pompholyx)
Dyshidrotic eczema is a type of eczema affecting the hands and feet, with deep blisters that itch intensely.
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Medicines commonly prescribed for Dyshidrotic eczema (pompholyx)
For informational purposes only. Always consult a doctor before using any medicine.
Dosage form: CREAM, 0.1%Active substance: mometasoneManufacturer: Laboratorio Reig Jofre, S.A.Prescription requiredDosage form: TOPICAL SOLUTION, 1 mg/gActive substance: mometasoneManufacturer: Organon Salud S.L.Prescription requiredDosage form: CREAM, 1 mg/gActive substance: mometasoneManufacturer: Organon Salud S.L.Prescription required
Dyshidrotic eczema is a type of eczema affecting the hands and feet, with deep blisters that itch intensely. Its older name suggests a link with the sweat glands, but that is not correct: it is not a problem of sweating. It is not contagious, it runs in flares, and it can be controlled, though it tends to recur.
How it develops
- first, intense itching and burning on the palms, the sides of the fingers or the soles;
- then small, deep, firm blisters with clear fluid appear, resembling tapioca grains under the skin;
- they can merge into larger blisters;
- after a few days they dry and the skin peels in sheets;
- painful cracks are left, particularly on the fingertips;
- the nails can change: transverse ridges, pitting, thickening;
- a flare lasts two to four weeks and usually recurs every few weeks or months.
What triggers it
- stress: one of the most consistent triggers;
- contact with water, soaps, detergents and solvents;
- heat and sweating, and also prolonged use of rubber gloves;
- nickel and other metal allergy, including dietary in some cases;
- cobalt and chromium, found in cement, tanned leather and costume jewellery;
- fungal infection of the feet, which can provoke a reaction at a distance on the hands;
- atopic dermatitis and an allergic tendency;
- smoking;
- some medicines and intravenous immunoglobulin;
- in some people it worsens in spring and summer.
When to see a doctor
- flares recur or last a long time;
- itching stops you sleeping or working;
- there are painful cracks that bleed;
- pus, yellow crusts, extensive redness, swelling or fever appear — bacterial infection;
- very painful grouped blisters and fever appear — this may be a herpes infection on top of the eczema, which is urgent;
- the nails have become deformed;
- your work involves contact with water or chemicals: an occupational component is worth assessing;
- you are unsure whether this is eczema or a fungal infection.
How it is diagnosed
By appearance and site. Skin scrapings are taken to exclude fungal infection, which looks quite similar and is treated the opposite way. If it recurs, patch testing is arranged to detect contact allergies, particularly to nickel: this is what most often resolves a chronic case. In severe flares a swab may be taken if superinfection is suspected.
Treatment
- potent topical corticosteroids — the basis of flare treatment, sometimes under overnight occlusion with cotton gloves;
- topical calcineurin inhibitors for maintenance;
- cool or astringent compresses during the blistering phase;
- greasy emollients several times a day, essential between flares;
- antihistamines to allow sleep;
- antibiotics if there is infection;
- oral corticosteroids in a short course for severe flares;
- localised phototherapy of hands and feet;
- alitretinoin or immunosuppressants for severe chronic hand eczema;
- treating fungal infection of the feet if that is the origin;
- botulinum toxin where excessive sweating clearly contributes.
Hand care
This part decides more than the cream does. In hand eczema, daily protection is what separates short flares from endless ones.
- wash with lukewarm water and a gentle syndet rather than soap, and dry well between the fingers;
- emollient after every wash: carry it with you;
- cotton gloves under rubber ones for all wet work, and no more than 20 minutes at a time;
- gloves also for peeling fruit, cutting citrus and handling cleaning products;
- gloves in cold weather;
- take rings off before washing your hands: soap and moisture collect underneath;
- avoid alcohol gel on cracked skin, which stings badly; prefer washing and cream;
- cotton socks and breathable footwear if the feet are affected;
- reduce nickel contact: costume jewellery, metal buttons, buckles;
- manage stress and sleep well.
Common questions
Is it contagious? No.
Can I pop the blisters? No. It opens the door to infection and speeds nothing up.
Is it because I sweat a lot? No. The name misleads: sweating can worsen it, but it is not the cause.
Should I avoid nickel in my diet? Only if testing confirms nickel allergy and your doctor advises it, not as a general measure.
Can it be cured? It tends to recur, but with consistent protection and treatment of flares most people manage it well.
Online consultation
In an online consultation the doctor reviews photographs, distinguishes dyshidrotic eczema from a fungal infection and from palmoplantar psoriasis, adjusts the strength of the corticosteroid, assesses whether contact allergy testing is worthwhile and helps you build a protection routine compatible with your work.
This material is for information only and does not replace a medical consultation.
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Reviewed on Aug 4, 2026
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