Dyshidrotic eczema — also known as pompholyx, dyshidrosis, or palmoplantar eczema — is a skin condition in which blisters develop on the soles of your feet or the palms of your hands and fingers.

The blisters can appear as tiny bumps on fingers or can grow together and cover larger areas on the hands and feet. These blisters are usually very itchy and may contain fluid.

Blisters can last 2–4 weeks. Possible triggers include sweating, an allergy, genetic features, stress, smoking, exposure to UV light, and other factors.

If symptoms last longer, a doctor may test for an underlying cause.

The exact cause of dyshidrotic eczema is unknown. Sweat is a common trigger, although experts do not know precisely why.

People living with dyshidrotic eczema may have a hypersensitivity to:

Stress can be another trigger for dyshidrotic eczema, as can changes in the weather.

Factors that may increase your risk of dyshidrotic eczema include:

The first symptoms of a dyshidrotic eczema flare may be a burning, itching sensation without any visual clues. Symptoms often appear suddenly.

Tiny, itchy blisters might then develop, most likely on your:

  • palms
  • sides of fingers
  • feet

It can sometimes affect the back of the hands, limbs, and feet.

These tiny blisters can grow together and form larger areas that are very itchy, red, and raised. If the skin becomes infected, the blisters can become painful and ooze pus.

Some people describe the appearance as looking like tapioca pudding.

Typically, dyshidrotic eczema heals on its own in 2–4 weeks, but as the blisters heal, they can cause your skin to become dry and peel. Individuals with a dark skin tone may develop dark spots where the blisters have healed.

If the palms of your hands or soles of your feet have been inflamed and itchy for more than a week, it’s a good idea to see a doctor or dermatologist.

A doctor will most likely:

  • look at your skin
  • ask if you’ve noticed a pattern around your blisters, such as using a new product
  • ask if your activities involve coming into contact with metals
  • ask if you have a history of eczema or allergies

The doctor may do an allergy test or take a skin sample to test for an infection if the lesions don’t heal.

They may also recommend over-the-counter (OTC) or prescription medication.

For mild flare-ups, your doctor may recommend:

  • using a medicated soak or applying a cool compress two to four times a day for 15 minutes each
  • using a moisturizer or barrier repair cream to damp skin after a soak or bath
  • applying a corticosteroid cream that helps heal the blisters and reduce inflammation
  • anti-itch medication in the form of a pill or cream
  • meditation and other techniques to manage stress
  • taking note of any jewelry, soaps, and other products that seem to make symptoms worse and avoiding them
  • keeping the nails short to prevent scratching, which could lead to an infection

Dietary changes

Nickel and cobalt are natural elements in many foods.

Cobalt is in vitamin B12 and occurs in dairy products, fish, poultry, and meat.

Nickel occurs in many foods, such as:

  • cereals
  • tea
  • dried fruit
  • cocoa and chocolate
  • soy products
  • legumes

If your doctor suspects your dyshidrotic eczema flares are caused by a nickel or cobalt allergy, they may suggest a point-based plan to limit cobalt and nickel in the diet.

It is not possible to do this without professional help because many foods containing these substances are also important sources of essential nutrients.

More severe or frequent symptoms might require other treatments, such as:

  • prescription steroid creams
  • pimecrolimus cream
  • tacrolimus ointment
  • systemic medications to suppress the immune system
  • light treatment at a doctor’s office (but avoiding unprotected sun exposure and tanning beds)
  • getting plenty of rest, if possible
  • biofeedback or other techniques to help manage stress

Dyshidrotic eczema can be uncomfortable and may affect your quality of life.

You may, for instance, have difficulty:

  • walking
  • using your hands
  • working
  • sleeping

There’s also a risk of an infection from scratching.

It is not always possible to prevent dyshidrotic eczema, but the following tips may help:

  • Keep a journal of possible triggers and avoid them if possible.
  • Speak with a doctor about dietary changes.
  • Avoid smoking and second-hand smoke.
  • Wear protective gloves, for instance, when using detergents.
  • Use footwear made with natural products, such as white cotton socks without dye.
  • Use a strong moisturizer and emollient soap.
  • Manage stress through meditation, deep breathing, and so on.
  • Work with a doctor or dermatologist on a prevention plan.

Wearing two pairs of cotton, dye-free socks may help reduce the risk of contact with allergens.

Flares of dyshidrotic eczema usually resolve in 2–4 weeks without leaving noticeable marks or scars. However, it may recur if it’s not possible to avoid triggers.

People with dark skin may experience hyperpigmentation after a flare.

Scratching the affected area may lead to an infection and delay healing. It may also lead to scarring.

Dyshidrotic eczema, also known as dyshidrosis or palmoplantar eczema, causes blisters on the soles of the feet or palms of the hands.

The exact cause is unknown, but it may stem from hypersensitivity to certain metals, medical treatments, tobacco smoke, and other substances. Stress and weather changes may trigger it.

It’s most likely to affect people who work with products containing various metals and those with asthma, eczema, or other allergies and sensitivities.

Moisturizers and corticosteroids can help manage symptoms, but a doctor may also prescribe more potent medications as needed for symptom relief.