2012-03-21 18.48.06 - Salomon,Round-001.jpg

image from 3.21.2012 with visible blisters highlighted though there are actually many more - similar to a rash.

over the years i've been dealing with these recurring tiny and extremely itchy patches of blisters that develop on the palms of my hands. they are usually small, barely visible to the eye unless you're under the right light or know they're there, and filled with clear fluid with the appearance of a tiny dark dot in the middle which most people describe as similar to the look of tapioca. if i pop them they are often a little painful and can tingle a bit. they usually go away quickly but i never really knew before what they were. after doing a little online searching, i've self-diagnosed (i know, i should have a doc look at it, but blah money and blah insurance deductibles and etc) them as a mild case of dyshidrotic eczema (mine aren't nearly as bad as the severe cases i've seen in photos). i've decided to keep a little diary to see if i can pinpoint the cause and hopefully help others that may find themselves with the same condition (though of course, please note that i am no medical expert or any expert at all and that this is only a document of my personal journey towards understanding this condition).



larger side blister, popped - 05.04.2012.

diary: one larger blister on bottom of left palm developed early thursday of may 3rd. a second even larger blister on side of left palm noticed upon waking the morning of may 4th. popped and drained both blisters. still feeling itchy and tingles. a few very tiny bumps as well. i have noticed slight rashes on arms at some points, but might be in my head (like, maybe they're just marks from the couch or sheets when napping). weird that these blisters almost always develop on my left palm. i also don't really experience the scaling over stage that i've read about.



smaller blister at bottom of palm, developed and popped may 3rd. now mostly just red and itchy.

theory of possible causes: i've read that dyshydrosis can be linked to stress, especially feelings of frustration and anguish, and milton and i did have a rather large fight on the night of may 2nd. chemical reactions: i bought a bottle of extra strength febreeze for the couch on afternoon on may 3rd and sprayed it. and i wonder if the hair products i apply may be causing my palms to become dry or irritated, but i'm not using anything new or different. i did use miracle gro in the garden on may 2nd and wonder if some of the mixture might have gotten on my hands. also should note an increased use of my laptop after returning from my visit home - this laptop runs hot which leads to increased heat exposure to my hands and may cause my palms to become sweaty. i also read nickel and other diet allergies may be a cause but i need to watch my diet a little more closely to see if those are related. i think i read that almonds are nickel heavy and i did buy a carton of almond milk on may 2nd that i have been drinking. and also seasonal changes and seasonal allergies may be a cause which i have been having problems with while i was visiting mississippi and taking a few sinus meds for though i did not have any bumps or itching while on my trip. i have gotten these bumps in the past and notice that it mostly (maybe only) happens in the hotter months of the year. currently about 7-9 days from start of period. so many possible causes, hard to pin down which one it may be.

a little more info may be found below which i'm also posting as a sort of bookmark for myself since i always seem to forget the name of the condition and have to do searches for something like "tiny blisters on palms" to find the info again.

from wikipedia:

Dyshidrosis (also known as "acute vesiculobullous hand eczema," [1] "cheiropompholyx," [2] "dyshidrotic eczema," [2] "pompholyx," [2] and "podopompholyx" [2] ) is a skin condition that is characterized by small blisters on the hands or feet. It is an acute, chronic, or recurrent dermatosis of the fingers, palms, and soles, characterized by a sudden onset of many deep-seated pruritic, clear vesicles; later, scaling, fissures and lichenification occur. Recurrence is common and for many can be chronic. Incidence/prevalence is said to be 1/5,000 in the United States. However, many cases of eczema are diagnosed as garden-variety atopic eczema without further investigation, so it is possible that this figure is misleading.

This condition is not contagious to others, but its unsightly nature can lend to awkward social interaction. The compromised integument can increase susceptibility to infection, and the accompanying itching can be a source of psychological duress.

The name comes from the word "dyshidrotic," meaning "bad sweating," which was once believed to be the cause, but this association is unproven; there are many cases present that have no history of excessive sweating. There are many different factors that may trigger the outbreak of dyshidrosis such as allergens, stress, or seasonal changes. Emotional stress may also further aggravate the condition.

Symptoms


Small blisters with the following characteristics:


  • Blisters are very small (3 mm or less in diameter). They appear on the tips and sides of the fingers, toes, palms, and soles.

  • Blisters are opaque and deep-seated; they are either flush with the skin or slightly elevated and do not break easily. Eventually, small blisters come together and form large blisters.

  • Blisters may itch, cause pain, or produce no symptoms at all. They worsen after contact with soap, water, or irritating substances.

  • Scratching blisters breaks them, releasing the fluid inside, causing the skin to crust and eventually crack. This cracking is painful as well as unsightly and often takes weeks, or even months to heal. The skin is dry and scaly during this period.

  • Fluid from the blisters is serum that accumulates between the irritated skin cells. It is not sweat as was previously thought.

  • In some cases, as the blistering takes place in the palms or finger, lymph node swelling may accompany the outbreak. This is characterised by tingling feeling in the forearm and bumps present in the arm pits.

  • Nails on affected fingers, or toes, may take on a pitted appearance.

Causes of dyshidrosis are unknown. However, a number of triggers to the condition exist:


  • Dyshidrosis has been historically linked to excessive sweating during periods of anxiety, stress, and frustration. However, many cases present that have no history of excessive sweating, and the hypothesis of dyshidrosis as a sweating disorder is largely rejected. Some patients reject this link to stress, though as a trigger of vesicular eruption it cannot be overlooked, as with other types of eczema.

  • Vesicular eruption of the hands may also be caused by a local infection, with fungal infections, like Athlete's foot being the most common. Sunlight is thought to bring on attacks: Some patients link outbreaks to prolonged exposure to strong sunlight from late spring through to early autumn. Others have also noted outbreaks occurring in conjunction with exposure to chlorinated pool water or highly treated city tap waters.

  • Allergic reactions of various kinds, including allergies to nickel which is present in many foods and vitamins (i.e. oatmeal, canned foods). [3]

  • Ingestion of alcohol; the dehydrating effects of alcohol may exacerbate the severity of the fissures and cracking.

  • Inherited, not contagious. Often, patients will present with other types of dermatitis, such as Seborrhoeic dermatitis or atopic eczema. For this reason, among others, dyshidrosis is often dismissed as atopic eczema or contact dermatitis.

  • Can be the secondary effect of problems in the gut[ citation needed ] (or alternatively, it can be the cause of secondary effects of problems in the gut [4] [5] [under discussion] ). Some sufferers claim diet can ease symptoms (relieving internal condition of IBS or intestinal yeast infection).[ citation needed ] Also Inflammatory bowel diseases of Ulcerative colitis and Crohn's disease.[ citation needed ]

  • Bandages, plasters or other types of skin-tapes may be irritating to dyshidrosis and should be avoided. As the skin needs to breathe, anything that encourages maceration (the softening and whitening of skin that is kept constantly wet) of the palms should be avoided.

  • Multiple chemical sensitivity

at home treatments to try from eczematreatmenthelp.com

Baking Soda Scrub


Similarly to treating eczema scars, you can use a baking soda scrub to help with skin peeling. You make the baking soda paste by simply mixing baking soda with water, and you rub the paste into your skin for five minutes. Afterwords, rinse the paste off and pat your hands or feet dry. You will need to do this two to three times daily, and as early as a week to a few weeks later, you should see your dyshidrosis condition improve.

Salt


You can use salt, that's right, common household table salt as a dyshidrosis treatment! Like the baking soda scrub, all you are doing is mixing a 1/4 cup of salt for every 1 cup of water. Pour the solution into a shallow pan or tub, and soak the affected areas (hands, fingers, soles, and toes) for 40 minutes to an hour. What the salt solution will do for you is to dry out your blisters. If soaking soles and toes, be sure not to place the rest of your foot into the solution, as the salt water may severely dry out your feet, leading to irritation. You will want to do this once a day until you see signs of improvement from blisters or peeling.

White Vinegar Soak


This is used as an alternative to the salt soak. Follow the same directions for the salt soak above, but instead of using salt and water, use undiluted white vinegar instead. The benefits of both treatments are similar, but the difference between these two options is that a vinegar soak will stop any additional fungal growth by changing your skin's pH balance.

Oatmilk Soak


Once again, the method is the same as the previous two treatments. Just replace the solutions with oatmilk instead. You will have the added benefit of pain relief and soothing itching when using an oatmilk soak.

Rubbing Alcohol, Hydrogen Peroxide, and Potassium Permanganate


This method is only suggested for use with persistent blisters. Depending on which you use, the result may be painful. However, this treatment is recommended to be used only once a week regardless of the solution you use. With rubbing alcohol or 3% hydrogen peroxide, you will apply directly to the blisters (it is recommended to use a cotton ball to apply the solution). Unfortunately, open sores may heal faster from this method than closed blisters, so if you already have open wounds, you may want to go directly to this treatment. These solutions will help clear your blisters in a few days, and should be replaced by peeling skin.

Potassium permanganate, much like the rubbing alcohol, is a painful solution that you will have to endure. The difference is that you will have to dilute the solution. Potassium permanganate will not only kill bacteria, but it works effectively to dry out blisters, much like a salt or vinegar soak would.

Nickel-Free Diet


This is more of a preventative measure than a treatment, but you can prevent future outbreaks by removing nickel from your diet. Some foods to avoid would include canned vegetables (we recommend switching to fresh or frozen vegetables), shellfish, almonds, and chocolate. Surprisingly, you will want to avoid eating oatmeal as well. Oatmeal is high in nickel, and while it has properties that would be good for you skin for other types of eczema, such as atopic eczema, it serves to work against you when you have dyshidrosis.

These treatments should be fairly easy to try on your own. These aren't substitutions for medication, however, but they will serve to alleviate annoying blisters or skin peeling when the time calls for it. Also, these treatments are very good on your budget. If you have dyshidrosis, try one of these dyshidrosis treatments for yourself, and if you would like, let us know if you have experienced any positive results.

drug and medical treatments from the mayo clinic :

Corticosteroid creams or ointments. Your doctor may prescribe high-potency corticosteroid topical creams to help speed the disappearance and improve the appearance of the blisters, and to treat the cracks and fissures that occur after the blisters have dried. In severe cases, your doctor may prescribe oral steroids.

Compresses. Wet or cold compresses can help alleviate itching, increase the effectiveness of the topical creams and minimize blisters.

Antihistamines. Your doctor may recommend anti-itching medications called anti-pruritics or antihistamines, such as diphenhydramine (Benadryl) or loratadine (Claritin, Alavert, others), to help alleviate itching.

Phototherapy. If these treatments aren't effective, your doctor may recommend a special kind of ultraviolet light therapy called psoralen plus ultraviolet A (PUVA). This treatment combines exposure to ultraviolet light (phototherapy) with drugs that help make your skin more receptive to the effects of ultraviolet light (psoralens). A newer type of ultraviolet B light known as narrow-band ultraviolet B also may be of help in some people.

Immune-suppressing ointments. These medications, such as tacrolimus (Protopic) and pimecrolimus (Elidel), may be helpful when other treatment options haven't worked. But because they suppress the immune system, skin infections may be more likely.

Botulinum toxin injections. Some doctors may consider recommending botulinum toxin injections to treat severe cases of dyshidrosis. However, this is a relatively new treatment option that has not yet gained acceptance among all physicians.

Also more extensive info and treaments can be found at emedicine.

Other tidbits:

Have read that may be associated with wearing certain rings - watch when wearing costume jewelry.

Note time of month - menstrual cycle.

Some people say their drs recommend cetaphil cream and wash.

Some recommend Lamisil AT or generic ingredient Terbinafine Hydrochloride.

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