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I suffer from eczema on my hands, I’ve been told it could be Atopic or Dyshidrosis. I’m sure the later is more accurate.

I get small blisters on the side of my fingers and in the webbing between each digit. The blisters do not break easily but when they do, they weep and when it dries the skins becomes very dry, flaky and crusty. The skin is very scaly and when the blisters do burst they can take weeks or months to heal.  Sometimes the skin can crack by itself, this is very painful. In the past, the worse affected fingers have lead to my fingernails looking dented. This hasn’t happened in many years, but you can still see some evidence of when it did.

Things like washing up liquid really irritate it and when it’s at it’s worse it can be painful just to wash or shower – especially if you get any soap/products in the cracked skin.

Wikipedia has been my most useful resource for this type of eczema, below is a list of treatment ideas and things to avoid. I will be trying some of these as times goes on…so jsut keep checking out the maing blog pages.

There are many treatments available for dyshidrosis, however, few of them have been developed or tested specifically on the condition.

  • Topical steroids[2] – while useful, can be dangerous long-term due to the skin-thinning side-effects, which are particularly troublesome in the context of hand dyshidrosis, due to the amount of toxins and bacteria the hands typically come in contact with.
  • Nutritional deficiencies may be related, so addressing diet and vitamin intake is helpful
  • Potassium permanganate dilute solution soaks – also popular, and used to ‘dry out’ the vesicles,[3] and kill off superficial staphylococcus aureus,[4] but it can also be very painful. Undiluted it may cause significant burning.[5]
  • Domeboro (OTC) helps alleviate itching in the short term, and can help to quicken the natural healing process. The active ingredient in Domeboro is aluminum acetate, also found in Borow’s solution, an OTC antistringent available at most drug stores. Either product is effective in helping to dry out the blisters which leads to faster healing. Affected areas should be soaked in Domeboro or Borow’s solution for 20–30 minutes several times a day to be effective.
  • Emollients during the drying/scaling phase of the condition, to prevent cracking and itching. While petroleum jelly may work well as a barrier cream, it does not absorb into the skin and or allow it to breathe, so may actually be less helpful.
  • Salt soaks – maintaining palms for 40 minutes to an hour immersed in a salt solution of 1/4 salt dissolved in water. Repeating treatment for 3–4 days or additionally if required. It is best to soak only the palm and avoid exposing the top of the hand to the saline solution as salt can severely dry and irritate the skin on the top of the hand.
  • White vinegar soaks
  • Avoidance of known triggers – dyshidrosis sufferers may need to abstain from washing their own hair or bodies, or wearing gloves when they do so, however waterproof gloves are often potential irritants.
  • Zinc oxide ointment
  • Nickel-free diets
  • Alcohol and caffeine free diets
  • When in the scaling phase of the condition, the scales may cause deep cracks and fissures in the skin. Filing (as with an emery board) may help to minimize this.
  • Stress management counseling
  • Light treatment: UVA-1, PUVA, Grenz rays, Low Level Light Therapy using a Red + NIR (LED) combination
  • Ciclosporin a strong immunosuppressant drug used to combat dyshidrosis caused by ulcerative colitis
  • Efalizumab (Raptiva) a medication used to treat psoriasis
  • Clobetasol Propionate (0.05%) (potent corticosteroid cream or ointment ) has been an effective treatment.
  • Tacrolimus and Pimecrolimus, immunomodulators often used to prevent organ rejection in topical, ointment form, may be used in severe cases.
  • Unbleached cotton gloves may be used to cover the hands to prevent scratching and vulnerability of the skin to bacteria
  • Plantain (Plantago major) infused in olive or other oil can be soothing.
  • Band-Aid brand liquid bandage regularly applied during the (often painful) peeling stage allows the skin to breathe while protecting it from further irritation. Some suffers have found that with regular application the skin will close and reform within 1 to 2 days. Protection is sufficient that the user can (gently) wash their hands with no irritation, however additional application after each hand wash is suggested. It does not cure the condition and only aids healing during the peeling stage. Other spray-on or brush-on liquid topical coatings can contain irritating ingredients and have not been found to be helpful, some will aggravate the condition significantly.
  • Avoid metal computer keyboards and track pads which contain nickel.

Many sufferers of dyshidrosis will find that treatments that were previously suitable for them no longer work or have induced sensitive reactions, which is common in most types of eczema.

  • It may be prudent to wear light cotton gloves while reading newspapers, books and magazines. The inks and paper may irritate the condition.
  • Avoid Purell and other hand sanitizing products which contain alcohol. These may aggravate the condition.
  • Wash affected hands and feet with cool water and apply a moisturizer as soon as possible. While hot water seems to kill the itch it may aggravate the condition.
  • Avoid moisturizers that contain water (cremes and lotions). Stick with ointments. Use only thin applications of ointments as excessive amounts of ointment may restrict breathing of the skin and aggravate the condition.
  • Aloe Vera may be applied after cleaning hands
  • When itchy or inflamed 100% lavender oil can be applied occasionally to soothe and reduce irritation for those who are not sensitive to the oil making sure to pat excess oil with a tissue. A patch test on the wrist is recommended before application to the palms.
  • Saline solution for washing hands may be very useful.
  • Avoid soaps with Sodium Laureth Sulfate (SLS). Many pump style soaps and common shampoos contain SLS.

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