Dyshidrotic eczema (also known as pompholyx) is a type of eczema affecting the hands and feet. The condition typically presents as itchy, fluid-filled blisters on the sides of the fingers, palms of the hand, and soles of the feet. You will usually feel intense itching and a burning sensation on your skin which is followed by the development of a cluster of small blisters. These blisters may merge to form larger ones as the condition worsens. Dyshidrotic eczema is most common in adults under 40, and women are more likely to get the condition than men. There are various creams available to help manage dyshidrotic eczema. We will look at these below.
Emollients are moisturising treatments applied directly to the skin to soothe and hydrate the skin. They cover the skin with a protective film to trap moisture. Emollients are often used to help manage dry, itchy, or scaly skin conditions such as eczema, psoriasis, and ichthyosis. They are available as creams but can also come as ointments, lotions, gels, and sprays. Some emollients can also be used as soap substitutes in the bath or shower. All emollients are generally safe for babies, the elderly, pregnant women, and breastfeeding women.
Some people experience dyshidrotic eczema just once, and it never comes back. However, if your condition is long-standing, then you should be using emollients as maintenance to keep your skin in good condition. If your condition flares up, this is when you may need a steroid, but you should continue with emollients twice daily or more throughout treatment. This may require a trip to your doctor.
Topical formulations of steroids are used to treat skin inflammation due to eczema for a short period. They should be applied thinly to your skin on the affected areas only. Mild steroids such as 1% hydrocortisone can be purchased over the counter but are not suitable on the face or for children under 10. For children under 10, use on the face, or if the lower strength isn’t making the difference you were hoping for, you will require a prescription from your doctor for the right treatment.
They mostly come as creams, but ointments are available as well. Creams are often preferred by patients as they are less messy and absorb more quickly. Doctors use a steroid ladder for prescribing steroids to patients, often starting with the mildest steroid that's appropriate for your condition, but they can move up the ladder to a more potent (stronger) one if it's not effectively clearing your condition.
Sometimes dyshidrotic eczema can lead to a bacterial skin infection when pathogens enter your body through breaks in your skin. If you have a bacterial skin infection, it makes your eczema worse. Indications of an infection are your usual eczema treatment, like a steroid cream, isn't having the same effect, or the skin looks red and weeping or crusty. You should see your doctor, and they may take a skin swab and prescribe antibiotics. Antibiotic creamS like fucidin is not usually enough, so they are likely to be in tablet form or liquid for children. Infected eczema usually needs both a steroid cream and antibiotics to get better and emollients throughout and afterwards to help skin repair.
If you are using both an emollient and a steroid, it is best to apply the emollient first and then wait around 30 minutes before applying the steroid. This prevents the emollient from diluting the effect of the steroid and spreading it to areas that do not require it.
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