- The cause of dyshidrosis isn't clear, but exposure to detergents, chemicals and metals, such as nickel, may trigger an outbreak. According to Dr. L. West at Discovery Health, other common triggers are balsam (a plant product) and cobalt (a metal used to make blue dye and stainless steel). If you have seasonal allergies, an outbreak of dyshidrosis may occur with your allergies. You should use preventive measures, such as wearing gloves to work with water and detergent, keeping your hands moistened with lotions and avoiding contact with nickel, dye and anything you identify as a personal trigger. Diets low in nickel and cobalt (both found in fruits and vegetables) usually have little effect.
- Most treatment aims to reduce itching and dry the rash. DermNet NZ recommends Burrow's solution (aluminum acetate) compresses applied to the blisters to dry them and help prevent infection, usually for 15 minutes four times daily. According to the Mayo Clinic, topical steroid cream or ointment (clobetasol propionate) applied to the affected area also reduces inflammation and itch. Psoralen ultraviolet A (PUVA) treatment (in which psoralen is applied to the skin before exposure to ultraviolet light) or narrow band ultraviolet B may help to heal your skin if other treatments are ineffective. Ointments (such as tacrolimus and pimecrolimus) that suppress the immune system may provide relief if other treatments fail, but you are more likely to develop an infection because the body's immune system to fight bacteria is impaired by the medication.
- Because of the open sores, your hands are susceptible to infections, usually evident by increased redness, swelling, and purulent (pus) drainage. You may need to take oral antibiotics to treat the infection. Dr. West notes that in severe cases of dyshidrosis, your doctor may prescribe short periods of treatment with oral steroids (such as prednisone), but your symptoms may return after you finish the medication, and long-term use is not advised because steroids have many side effects. According to the Mayo Clinic, you may benefit from antihistamines, such as Benadryl or Claritin, which can help reduce the allergic response causing the itching. A new experimental treatment with botulinum toxin may control your outbreak.
