DYSHIDROSIS

General Information

DEFINITION--A skin condition, characterized by small blisters on the hands or feet--apparently related to stress.

BODY PARTS INVOLVED--Tips and sides of the fingers, toes, palms and soles.

SEX OR AGE MOST AFFECTED--Both sexes and all ages, but most common in men between ages 20 and 50.

SIGNS & SYMPTOMS--

Small blisters with the following characteristics:

• Blisters are very small (1mm or less in diameter). They appear on the tips and sides of fingers, toes, palms and soles.
• Blisters are opaque and deep-seated; they are either flush with the skin or slightly elevated. They don't break easily. Eventually, small blisters come together and form large blisters.
• Blisters may itch, cause pain or produce no symptoms. They worsen after contact with soap, water or irritating substances.

CAUSES--Unknown, but they are probably related to periods of anxiety, stress and frustration in ambitious people who internalize their emotions. Persons with dyshidrosis have difficulty relaxing--even during non-stressful periods. This problem is not caused by sweat retention, as was once believed. Excessive sweating is often associated with it.

RISK INCREASES WITH

• Stress and internalized frustration or irritation.
• Obsessive-compulsive personalities.

HOW TO PREVENT--Follow instructions under General Measures. These are helpful in preventing recurrences, as well as in treating active episodes.

What To Expect

DIAGNOSTIC MEASURES--

• Your own observation of symptoms.
• Medical history and physical exam by a doctor.

APPROPRIATE HEALTH CARE

• Self-care after diagnosis.
• Doctor's treatment.
• Psychotherapy or counseling to learn to cope with stress more effectively.

POSSIBLE COMPLICATIONS--Secondary bacterial infection (sometimes).

PROBABLE OUTCOME--

• Symptoms can be controlled with treatment, but recurrence is common. Often heals spontaneously.
• Persons with mild problems have occasional attacks, and the skin returns to normal between episodes.
• Persons with severe problems sometimes have persistent peeling and fissuring of the involved skin.

How To Treat

GENERAL MEASURES----Keep heat and moisture away from the affected areas whenever possible:

• Wear cotton socks and leather-soled shoes. Don't wear tennis shoes or other footwear made of man-made materials.
• Remove shoes and socks frequently to allow sweat to evaporate.
• Wear heavy-duty, cotton-lined vinyl gloves to prevent contact with irritating substances, such as: water; soap; detergent; metal scrubbing pads; scouring powder; and other chemicals. Dry insides of gloves after use. Discard gloves if they develop a hole. Wear gloves when you peel or squeeze acid fruits and vegetables.
• Wear leather or heavy-duty fabric gloves for housework or gardening.
• Use a dishwashing machine to wash dishes if possible. If not, ask someone else to wash them.
• Avoid contact with irritating chemicals, such as: paint; paint thinner; and polish for cars, floors, shoes, furniture and metal.
• Remove rings before doing housework or washing hands.
• Use lukewarm water and very little mild soap to shower or bathe.

MEDICATION--You may use non-prescription topical steroid preparations to reduce inflammation and decrease itching. Apply once or twice a day after bathing, unless directed otherwise. If these are not effective, your doctor may prescribe stronger steroid preparations.

ACTIVITY--Avoid activities or environments that lead to stress or excessive sweating. Sweating does not cause the disorder but may aggravate it.

DIET--No special diet.

Call Your Doctor If

• You have symptoms of dyshidrosis.
• Signs of infection (swelling, redness, tenderness or warmth) appear around blisters.
• Symptoms don't improve after 1 week, despite treatment.
• Improvement begins and then symptoms recur.