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Dyshidrotic Eczema: What causes these summer finger bumps?

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Dyshidrotic eczema is a type of eczema that leads to itchy, painful bumps or blisters on the fingers and palms of the hands, sometimes referred to as summer finger bumps. This eczema can also involve the soles of the feet.

Dyshidrotic eczema is a chronic condition and can lead to recurring blisters on fingers and hands. This condition can be triggered by a hot and humid environment, sweating, stress, and irritants. There are several treatment options that can help you manage this condition.

Dyshidrotic eczema (summer finger bumps).
Table of Contents

What is dyshidrotic eczema?

Dyshidrotic eczema is a chronic skin condition that leads to small itchy bumps or blisters on hands and feet especially on the sides of fingers and toes. In addition to summer finger bumps, it is known by several other names:

  • Dyshidrosis
  • Acute palmoplantar eczema
  • Vesiculobullous dermatitis
  • Pompholyx
  • Hand and foot eczema
  • Vesicular hand/foot dermatitis

It is commonly seen in adults, particularly between the ages of 20 and 40, and is more frequently diagnosed in females. 

Symptoms

Summer finger bumps mainly appear as little bubbles or water blisters on the hands.

Dyshidrotic eczema bumps or blistering rash are very often seen in between the fingers. In some cases, they may appear on the feet too.

For some individuals, these bumps may appear as round spots on the fingers, especially on the tips.

How the rash starts may vary. In some people, it is preceded by burning and itching, followed by the appearance of red bumps on the fingers and hands. These bumps or blisters may form a cluster on the hands that may resemble “tapioca pudding.”

These blisters are usually small; however, multiple blisters can come together to form a large blister. These bumps can be painful and are often associated with itching. Frequent scratching may lead to sores on fingers, hands, and feet.

The blisters usually resolve in a few weeks (2-3 weeks), leaving behind small rings or round spots of scaling. One may also see red, scaly, and peeling skin on the fingers (especially between the fingers), hands, and feet.

Dyshidrotic eczema is not contagious, and one cannot spread it to others.

Pictures

The picture below shows small round bumps or water blisters of dyshidrotic eczema on the sides of the fingertips.

Dyshidrotic eczema painful bumps on sides of fingers.

The pictures of dyshydrotic eczema below show red bumps on the sides or in between fingers.

Dyshidrotic eczema rash on sides of fingers.
Dyshidrotic eczema rash on sides of fingers.

The picture below shows dyshidrosis on the tips of the fingers.

Dyshidrotic eczema bumps on tips of fingers.

The picture of dyshidrotic eczema below shows red and dry skin between the fingers.

Dyshidrotic eczema in between fingers.

The picture below shows a clear or water blister on the hand due to dyshidrotic eczema.

Dyshidrotic eczema itchy bumps on palm of hand.

The picture below shows a red bump on the feet caused by dyshidrotic eczema.

Dyshidrotic eczema bumps on feet.

Complications

The painful bumps on the sides of the fingers and hands can be large in some cases, and they may interfere with daily activities and work. Bumps and blisters on the feet can make it difficult to walk. 

In some cases, intense itching may cause sores that may become infected. Some symptoms to look out for include:

  • Visible discharge, such as pus
  • Intense pain
  • Swelling
  • Fever

To avoid infections, it’s best not to scratch the bumps. Proper care, hygiene, and following medical advice can prevent further complications and promote healing.

Causes

It is not clear what really causes dyshidrotic eczema. However, it is often seen in individuals who have a history of allergies, eczema, or a family history of dyshidrotic eczema.

The summer heat and excessive sweating may trigger dyshidrosis bumps on the hands and fingers, and hence it is sometimes referred to as “summer finger bumps.”

It may also be one of the reasons behind stress bumps on the fingers.

Associated risk factors include:

  • A hot and humid environment
  • Sweat
  • Contact with metals like nickel
  • Contact with detergents, harsh cleansing supplies, chemicals at work, etc.
  • Contact with hairstyling products
  • Stress
  • History of other types of eczema
  • Genetics
  • Seasonal allergies

Understanding these risk factors can help in managing and preventing outbreaks.

Diagnosis

Dyshidrotic eczema is usually diagnosed by examining the skin lesions. Your doctor may inquire about the onset of the rash, asking you for specific details about how and when the rash began, and whether there are any associated symptoms such as itching or discomfort.

Your doctor may also ask about your past medical history and any relevant family history of skin conditions or allergies, as this could provide additional insights into your condition.

In some cases, further testing may be necessary to differentiate dyshidrotic eczema from other skin disorders. These tests may include:

  • Scrapings: Your doctor may take a small scraping of the affected skin to examine under a microscope, which helps in identifying any fungal elements.
  • Patch test: This test helps to identify any allergens that might be triggering the eczema. Small patches containing common allergens are applied to the skin, and the reactions are observed over a period of days to determine any sensitivities.
  • Skin biopsy: Although rarely needed, a skin biopsy may be performed in uncertain cases. A small sample of the affected skin is removed and examined under a microscope by a pathologist to provide a definitive diagnosis.

Treatment

The treatment of dyshidrotic eczema depends on the severity of the condition and may include home remedies and/or prescription medications.

Home remedies

  • Avoid further contact with known irritants.
  • Do not pop the blisters.
  • Protect the blisters using a bandage.
  • A cold compress can relieve itching.
  • Use barrier repair moisturizers to prevent dry and cracked hands.
  • Your doctor may recommend over-the-counter topical steroids and antihistamines. These may reduce itching and inflammation.
  • Avoid using hot water; instead, use warm water to wash hands.
  • Use gentle hand or body wash to avoid further skin irritation.
  • Keep your hands and feet clean and dry. Always dry them well after swimming or bathing.
  • Avoid wearing gloves or socks that trap moisture.
  • Wear shoes made of breathable material
  • To avoid coming into contact with harsh cleansers, chemicals, or cleaning supplies, use protective gloves.

Prescription medications

  • Prescription topical steroids may be used to reduce inflammation and itching.
  • Oral steroids may be prescribed for a short time, such as prednisone if topical steroids are not effective.
  • Topical calcineurin inhibitors, like tacrolimus (Protopic) and pimecrolimus (Elidel), may be prescribed.
  • Immunosuppressive medications affect how our immune system responds. These may include methotrexate, mycophenolate mofetil, azathioprine, and cyclosporine.
  • Retinoid alitretinoin may be used in resistant cases.
  • Phototherapy may be recommended in some cases. It involves exposing the skin to ultraviolet rays under medical supervision to reduce inflammation.
  • Botulinum toxin injections may help in decreasing excess sweat, which is one of the precipitating factors.
  • Antibiotics or antifungal medications may be prescribed if there is a secondary bacterial or fungal infection.

Diet change

If you are sensitive to nickel, your doctor may recommend a low-nickel diet or avoid foods with a considerable amount of nickel.

These may include chocolate, tea, soy products, red kidney beans, peas, lentils, peanuts, soya beans, chickpeas, dried fruits, and canned foods.

Prevention

One cannot fully eliminate the risk of developing dyshidrotic eczema; however, the following measures may be helpful:

  • Keep your hands and feet dry.
  • Use a mild soap that is free of fragrance or other irritants.
  • Moisturize your hands regularly.
  • Use protective gloves when using harsh cleansers or detergents.
  • Avoid metal jewelry containing nickel.
  • Wear well-fitting shoes that allow your feet to breathe.
  • Manage or reduce your stress through techniques such as meditation, yoga, deep breathing exercises, or talking to loved ones.

Differential diagnosis

The red bumps on the fingers due to dyshidrotic eczema may be confused with several other skin conditions which include:

  • Herpetic whitlow: This is a contagious viral infection of the fingers and usually involves the tip of the fingers. It can lead to a painful and itchy blister rash, which is usually localized to one hand, unlike dyshidrotic eczema, which often involves both hands. (Dyshydriotic eczema vs herpetic whitlow)
  • Scabies: Hands and wrists are some of the commonly involved areas affected by scabies. It can lead to itchy skin with bumps that may form blisters.
  • Contact dermatitis: Contact with an allergen or irritant can lead to a rash called contact dermatitis. It can result in itchiness, redness, and sometimes blister formation.
  • Tinea manuum: Ringworm of the fingers and hands can present with dry, scaly spots on the palmar aspect of the hands.
  • Palmoplantar pustulosis: This is an uncommon chronic skin condition that leads to pus-filled bumps on the palms and soles.

Read more: Blisters on fingers and hands

Key points

Dyshidrotic eczema leads to small, itchy bumps or blisters on the fingers and hands, sometimes referred to as summer finger bumps. This rash can also affect the soles of the feet.

Other names for dyshidrotic eczema include dyshidrosis, pompholyx, and hand and foot eczema. Hot environments, sweat, stress, and contact with irritants can lead to a flare-up of this eczema.

There are several ways to manage the symptoms, including home remedies and prescription medications. Your doctor may help you in choosing the right medication.

References

Disclaimer: This blog post is for information purposes only and does not replace medical advice.

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