Pompholyx (dyshidrotic eczema)

Pompholyx causes itchy blisters on the hands or feet that come and go. The symptoms usually last 2 to 3 weeks at a time.

The first symptom is often itchy skin with a burning or prickling feeling in the affected area.

Fluid-filled blisters then appear on the skin. These are usually very itchy and may leak fluid.

When the blisters go away, the skin may be dry, cracked and sore. Sometimes it might bleed.

The blisters may look darker on black or brown skin.

Pompholyx most often affects the fingers and palms of the hands.

It can also affect the toes and soles of the feet.

Get medical help if you think you have pompholyx or you have any changes to your skin you’re worried about.

• you think you have pompholyx
• you have pompholyx and the blisters are very painful, leak yellow or green pus or are covered in a yellow-brown crust – these are signs of an infection
• you have any other changes to your skin you're worried about

Pompholyx is usually a long-term condition that comes and goes over time. Treatment can help control the symptoms.

The main treatments for pompholyx are:

• moisturisers (emollients) – used every day to stop the skin becoming dry
• steroid creams and ointments (topical steroids) – used for a few weeks at a time to reduce irritation and soreness

If the blisters leak fluid, a GP may suggest soaking your skin in potassium permanganate solution. This helps dry the blisters and reduces the risk of them getting infected.

If the blisters become infected, a GP may prescribe antibiotics.

Treatments from a specialist

If your symptoms are severe or treatment is not helping, a GP may refer you to a skin specialist (dermatologist).

A dermatologist may recommend other treatments, such as:

• steroid tablets
• treatment with ultraviolet (UV) light
• other medicines, such as alitretinoin

The dermatologist will closely monitor your progress while you’re using these treatments.

If you have pompholyx, your skin may get irritated easily. There are some things you can try to see if they help.

• wash your hands with warm (not hot or cold) water and use a moisturiser (emollient) soap substitute instead of regular soap

• wear protective gloves (ideally with a cotton lining) when using chemicals like shampoos, cleansers and detergents

• wear socks, tights or stockings made from cotton or silk, rather than nylon

• wear shoes made from leather, rather than plastic or rubber

• avoid anything you think causes your symptoms, such as cleansers or detergents

• do not burst your blisters

If your skin gets very itchy and it affects your sleep, ask a pharmacist about antihistamines that make you drowsy (sedating antihistamines).

If you take these before going to bed, they can help you get to sleep.

It's not clear exactly what causes pompholyx.

Certain things are thought to cause symptoms in some people, including:

• contact with strong chemicals like soaps, cleansers and detergents
• an allergy or sensitivity to certain metals, such as nickel or cobalt
• getting your hands wet regularly – for example, if you’re a hairdresser
• stress
• heat and sweat

If you notice something causes your symptoms, avoiding it as much as possible may help keep your symptoms under control.

Pompholyx causes itchy blisters on the hands or feet that come and go over time. When the blisters go away, the skin may be dry, cracked and sore.

You should see a GP if you think you have pompholyx or you have any changes to your skin you’re worried about.

The main treatments for pompholyx are moisturisers and steroid creams. If treatment does not help, you may be referred to a skin specialist.

It’s not clear what causes pompholyx. It has been linked to irritation from things like strong chemicals, certain metals, stress and sweat.

If you have pompholyx, things you can do to help reduce skin irritation include wearing protective gloves and using moisturiser instead of soap.