Eczema is a general term that includes many conditions that cause inflammation of the skin. It is more common in children and infants, where about 10 to 20 percent have some form of eczema. The symptoms of eczema vary, but they generally appear as dry, red, and extremely itchy patches of skin. Small blisters may also form. Eczema can occur on any part of the body, including the foot. It can occur in anyone - children or adults - and is not contagious, meaning, you cannot catch it from or give it to anyone.
There is no known cause for eczema, but it often affects people with a family history of allergies and is very manageable. Dyshidrotic (dis-hi-drah-tic) eczema (DE) is a type of eczema in which the skin cannot protect itself resulting in itchy, dry skin. People with DE can develop small, deep blisters, usually on their hands and feet. The blisters are very itchy and painful and will go away in two or three weeks, leaving the skin red, dry, cracked and scaly. The exact cause of DE is not known, and there is no cure, so people can have episodes that come and go, known as flares. For many people, the DE flares when they are under a lot of stress, temperatures rise (such as in the summer), or if their hands or feet stay wet for long periods. Exposure to metal salts, such as cobalt, chromium, and nickel can also lead to a flare. DE flares can be mild or severe. A severe flare on the feet can make walking very difficult and painful.
Symptoms of dyshidrotic eczema
Fluid-filled blisters form on your fingers, toes, hands, or feet, especially on the edges. They can be painful, very itchy and may come together to form into larger blisters. The blisters may last up to three weeks before they begin to dry. As they dry up, they'll turn into cracks in the skin and become dry, scaly and painful. If you scratch the area, it may become thicker or feel spongy.
Diagnosis
In many cases, your doctor will be able to diagnose dyshidrotic eczema from the symptoms and by examining your skin. They may choose to run more tests, like a skin biopsy, or a test to look for a fungal infection or allergies.
Treatment
The treatment is based on the severity of the flare and the symptoms. To avoid making your pain and itching worse, do not scratch or break your blisters.
Although it's important to wash your hands regularly, you may want to avoid extensive contact with water, such as frequent foot-washing or bathing. You should also avoid using products that can irritate your skin, such as perfumed lotions and harsh soaps that dry the skin.
Medications that may be helpful
Corticosteroid cream or ointment that is applied directly to the skin for mild outbreaks or, for more severe outbreaks, you may be prescribed a corticosteroid injection or pill which will help to reduce inflammation and clear the blisters.
Other medical treatments that can be used are UV light treatments, draining large blisters, antihistamines, various anti-itch creams, or immune-suppressing ointments. The DE site may get infected by bacteria or fungus and will need to be treated with an antibiotic or antifungal medication based on the type of infection present. These are important to reduce scratching because scratching will make DE worse.
Things you can do at home to help with DE flares
Wet, cold compresses or short soaks can help reduce the discomfort from dry, itchy skin. Soaks or cool compresses can be done or applied two to four times a day. You apply these for 15 minutes at a time and apply a medicated cream or ointment, such as a corticosteroid afterward.
A moisturizer may also help with the dryness and therefore also reduce some itching. Using moisturizers such as petroleum jelly, Vaseline, heavy creams such as Lubriderm or Eucerin, mineral oil or soaking with witch hazel may also be helpful for a short time.
Diet
Changing your diet can also help to delay and treat flare-ups. Since it is believed that a nickel or cobalt allergy can cause eczema, removing foods that contain these may help. Eating a diet high in fruits and vegetables and low in processed junk food is recommended. Supplementing with vitamin A has also helped. But check with your doctor before starting this.
What can be expected in the long term
Most times, DE will usually disappear in a few weeks without any complications, especially if you don't scratch the skin. It may not leave any noticeable marks or scars. If you do scratch the area, you may experience more discomfort, some scarring or your flare may take longer to heal.
Although your DE outbreak may heal completely, it can also recur. Because the cause of DE isn't known, doctors have yet to find effective ways to prevent or cure the condition. The best advice is to protect and help strengthen your skin by applying moisturizers daily, avoiding triggers such as perfumed soaps or harsh cleansers, and staying cool and hydrated.
• For more information visit www.apma.org or email foothealth242@gmail.com. To see a podiatrist visit Bahamas Surgical Associates Centre at Hilltop Medical Centre, Centreville or call 603-1814/15/16 for an appointment. In Grand Bahama, visit Lucayan Medical Center call 373-7400 for an appointment.
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