Dyshidrotic eczema (aka pompholyx, dyshidrosis or vesicular eczema) is a form of eczema that manifests in clusters of tiny but very itchy fluid-filled blisters on hands and feet. It can be hard to pinpoint what has triggered a flare of dyshidrosis, and the condition can be pretty challenging to shift, but there are some tried and tested strategies for managing it.

Most treatment for dyshidrosis centres around avoiding triggers and managing symptoms. There’s no easy treatment for any kind of eczema, unfortunately: it’s all about helping the skin calm down and repair itself, while making yourself feel more comfortable.

Why is dyshidrotic eczema so difficult to treat?

Itchy and inflamed eczema, of which dyshidrosis is one kind, can be intensely distressing as well as uncomfortable, even painful. Sore hands and feet can make simple tasks such as writing or walking very difficult, and the appearance of blistered, bleeding or inflamed hands can be a blow to self-confidence.

Unfortunately, getting rid of the eczema can be really hard; the reasons for a flare up aren’t always immediately obvious, especially since it’s often caused or aggravated by factors that are ongoing in the sufferers life, things like soap, humidity, stress, nickel, shampoo etc.

How do you avoid triggers of dyshidrotic eczema?

First, you need to identify them! As with many kinds of eczema, the things that make sufferers flare up can be very different from person to person. They can even change year on year, with something you’ve tolerated perfectly well one summer being an immediate trigger for itchiness the next. 

However, it’s worth looking down lists of potential culprits to see if any might apply to you and your skin. Look at what sorts of things can trigger an attack of dyshidrosis, and whether you can change to other products or put strategies in place to change what you’re reacting to.

For a detailed list of triggers, see our blog What Triggers Pompholyx?

How can you reduce the symptoms of dyshidrotic eczema?

As well as avoiding triggers, you can also fight dyshidrosis on another front: making your skin more comfortable to be in! There’s a few options for this, including keeping your hands or feet cool, clean and dry, to dial down the heat and inflammation that causes such unbearable itchiness. 

To reduce the itch, try cold compresses, bowls of cold water (remembering to moisturise immediately after drying), antihistamines, calamine lotion.

Towel dry then moisturise with a scentfree balm after any contact with water.

Are there any other options for treatment?

If these at-home management strategies aren’t helping, then your doctor or pharmacist might have some other suggestions for you:

• Potassium permanganate: a mild antiseptic which can be used as a soak for affected hands or feet
• Topical steroids: a treatment to dampen inflammation; short-term use only
• Immunosuppressants: topical or oral medicines to reduce inflammation 
• Phototherapy: can help make skin more resilient
• Antibiotics: for if the pompholyx is infected
• Lancing the blisters: GPs can use sterile equipment to burst any large or very uncomfortable blisters

Skincare for dyshidrosis

Using appropriate skincare is fundamental for managing the condition. It’s not just important to find moisturisers and cleansers that don’t contain potentially irritating ingredients (whether perfumes, preservatives, soap, irritant metals or sulphates), but also ones which will actively support the healthy working of the skin’s barrier function.

That can come from skincare that is rich in oils which can support the production and maintenance of the skin’s natural lipids. An oil-based balm is good to protect affected skin from external irritation, moisture loss, and reinforce the oily barrier.

Choose products with naturally anti-inflammatory herbs and oils to help calm inflamed and itchy skin: Balmonds uses calendula, nettle, chamomile, and chickweed for this reason.

You can also apply naturally antimicrobial plant-based oils to affected skin, to reduce the risk of infection or microbe overload: tea tree is a good choice to balance microbial growth.

From our range, we’d suggest washing your hands and feet with our Natural Shampoo & Body Wash, and moisturising your skin with Skin Salvation if it is very cracked and sore. If it is itchy but not broken, try our Cooling Cream to take the heat down a notch, or our tea tree-rich Scalp Oil to keep the area clean.

Recommended products:

Balmonds Skin Salvation
with hemp and beeswax

Balmonds Cooling Cream
with shea, menthol, aloe vera & lavender

Balmonds Scalp Oil
with tea tree, nettle, borage & rosemary

Balmonds Natural Shampoo & Body Wash
with calendula & chamomile