DYSHIDROSIS – POMPHOLYX

Dyshidrosis, also referred to as Pompholyx or Dyshidrotic Eczema has a relatively low occurrence in the general population (around 20 cases per 100,000) and is not contagious. However, people that are prone to this skin condition will often see it reoccur. The condition manifests itself as small blisters (vesicles) that usually show up on the fingers, palm, soles of the feet – or all of the above.

The opaque blisters start out very small (1mm or less in diameter), and gradually become bigger and more abundant over a period of days or weeks. Sometimes the blisters are itchy – and sometimes not. Eventually, they do seem to subside after a period of three to four weeks. As the blisters dry-out, cracks and fissures in the skin can form and become quite painful.

Causes

Originally, it was thought that Dyshidrotic Eczema (meaning “bad sweating”) was brought on by excessive sweating. However, sweating does not appear to directly influence the development of Pompholyx. There does seem to be some connection with “stress” – and since people under extreme stress can sweat more – it’s possible to see why it was thought sweating caused the problem.

The medical community is still not sure what causes Dyshidrotic Dermatitis. There are a few things other than stress or anxiety that seem to increase the likelihood of a Pompholyx outbreak, and these triggers can include:

• Localized fungal infection
• Prolonged exposure to intense sunlight
• Exposure to metal salts like chromium, cobalt or nickel, or a systemic allergy to foods high in nickel
• Prolonged or frequent skin dampness
• Exposure to highly chlorinated pool water
• The presence of other skin conditions or sensitivities such as Atopic Dermatitis or Contact Dermatitis

Several treatment options for Dyshidrosis are available; however most have not been specifically developed or tested for this condition.

• Topical Steroids can be helpful to reduce the inflammation and itching associated with Pompholyx. Long-term use of prescription strength corticosteroids is not recommended due to the skin-thinning side-effects common with these medications.
• Soaks and/or Compresses such as diluted hydrogen peroxide, potassium permanganate, Epson salts, and white vinegar may offer some relief. You will need to experiment with these – and remember that too much contact with water during the process could exacerbate the condition.
• Clobetasol Propionate (0.05%)
• Antihistamines can help to reduce the itching, if present.
• Ultraviolet Light Therapy PUVA or narrow-band B combined with medications to increase phototherapy effectiveness have been used with some success.

Prevention

Since doctors are not quite sure of the cause, prevention strategies are tough to determine. However, avoiding certain suspected triggering mechanisms can help. Here are a few suggestions to hopefully lower your likelihood of a reoccurrence of Dyshidrosis.

• Lower or manage your stress and anxiety levels
• Reduce or eliminate exposure to excess moisture (i.e. avoid skin moisturizers that contain water)
• Avoid using hand sanitizing products like Purell. The alcohol may aggravate your condition.
• Avoid soaps containing Sodium Laureth Sulfate (SLS)
• Avoid prolonged exposure to strong sunlight
• Avoid direct contact with metal salts

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