Dyshidrotic eczema | American Academy of Dermatology

How do dermatologists diagnose dyshidrotic eczema?

When dyshidrotic eczema (DE) flares, a dermatologist can diagnose it by looking at your skin.

Your dermatologist will also ask about your medical history, work, hobbies, and recent stress level.

If your dermatologist thinks that the DE could be due to an allergy, an allergy test called patch testing may be recommended. During patch testing, small amounts of substances that you may be allergic to are placed on your skin often the skin on your back.

Your treatment plan will be designed to treat your signs and symptoms. You may be responsible for doing much of the treatment at home. It is important to carefully follow your treatment plan, which may include several of the following:

After each soak or cool compress, youll likely need to apply a medicated cream or ointment, such as a corticosteroid.

Having an infection can stop DE from clearing.

In one study, researchers found that about 33% of patients who had DE on their hands got rid of the DE only after treating an infection on their feet.

If the above treatments fail to work or you have severe DE, your dermatologist may recommend one of the following:

Botulinum toxin is FDA approved to treat wrinkles and excessive sweating in the underarms but not DE. Its legal to prescribe a medicine for a condition other than its FDA-approved use. This is called off-label use, which can be very helpful for some patients.

Its extremely important to get these treatments at a hospital, clinic, or your dermatologists office. Trying to treat your skin by using a tanning bed is not recommended.

Eliminating foods that contain nickel or cobalt helps some people.

Many foods contain nickel or cobalt. If you are allergic to either, your dermatologist can tell you how to change your diet.

Other treatments than the ones listed here can also be helpful. Your dermatologist can tell you what treatment may be best for you.

Some people have one mild outbreak that clears without treatment. Its much more common to have flares throughout your life. Treatment can help control DE, which cannot be cured.

References:Egan CA Rallis TM, et al. Low-dose oral methotrexate treatment for recalcitrant palmoplantar dyshidrotic dermatitis. J Am Acad Dermatol. 1999;40(4):612-14.Gerstenblith MR, Antony AK, et al. Pompholyx and eczematous reactions associated with intravenous immunoglobulin therapy. J Am Acad Dermatol. 2012;66(2):312-6. Habif TP, Campbell JL, et al. Pompholyx (card #16). Dermatology DDxDeck. Mosby 2006.Klein AW. Treatment of dyshidrotic hand dermatitis with intradermal botulinum toxin. J Am Acad Dermatol. 2004:50(1):153-4.Miller JL, Hurley HJ. Diseases of the eccrine and apocrine sweat glands. In: Bolognia JL, Jorizzo JL, et al, eds. Dermatology. Mosby Elsevier 2008. p. 543.Peterling H, Breuer C, et al. Comparison of localized high-dose UVA1 irradiation versus topical cream psoralen-UVA for treatment of chronic vesicular dyshidrotic eczema. J Am Acad Dermatol 2003;50(1):68-72.Schnoop C, Remling R, et. al. Topical tacrolimus (FK506) and mometasone furoate in treatment of dyshidrotic palmar eczema: A randomized, observer-blinded trial. J Am Acad Dermatol. 2002;46(1):73-7.

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Dyshidrotic eczema | American Academy of Dermatology