Monday, April 7, 2014

Skin update

My hands have been doing good.  I don't take anything for granted any more.  I am enjoying and thankful for the trouble free hands.  But the blisters are back.  This is a bad cycle for me.  They are not itchy or anything (yet) and there aren't a lot of them.  I am wary because the cycle always start with these bastards.



So I am doing a bit more research...

Eczema Blisters: What You Should Know

In some cases blisters can develop along with the red, itchy skin of eczema. Treatment for eczema blisters needs to be tailored to the underlying type of eczema you have.


Medically reviewed by Lindsey Marcellin, MD

When you have eczema, you learn about managing red, inflamed patches of skin that can itch intensely. You might also sometimes have to contend with another type of outbreak — eczema blisters that can cause even more discomfort and embarrassment.
Eczema is not a single skin condition, but rather a family of conditions that cause the skin to become swollen, irritated, and itchy.

These are the types of eczema that are most often accompanied by eczema blisters:
  • Dyshidrotic eczema. This form of eczema is seen on the hands and feet and is more common in women. Usually, small deep blisters form on the palms of the hands, soles of the feet, and sides of the fingers. The blisters are extremely itchy and cause scaly skin patches that flake constantly.
    First-line eczema treatments for this type of eczema include cool compresses and corticosteroid creams or ointments. Dermatologists may drain larger blisters to relieve pain. Other medications, like antihistamines, may be prescribed to relieve itchiness.
  • Allergic contact dermatitis. If you’ve ever brushed up against poison ivy, oak, or sumac and broken out in a blistery, itchy rash, you’ve experienced allergic contact dermatitis. Usually, people develop small lines of eczema blisters where the leaves rubbed against them. Plants are among the 3,000 allergens known to cause this type of eczema. Other common culprits are metals (especially nickel) and fragrances. These blisters may break open and dry up as a small crust.
  • Irritant contact dermatitis. Acids, solvents, harsh soaps, or detergents can aggravate the skin and cause irritant contact dermatitis. The reaction usually resembles a burn, but eczema blisters may also bubble up immediately, especially if the irritant is strong.
    Treatment for eczema due to irritants or allergens involves thoroughly washing the skin to remove any trace of the substance that is irritating you. Of course, avoid anything that you know causes a rash or eczema blisters to break out.
    Sometimes, the best treatment for contact dermatitis is just leaving the area alone. But with more severe reactions, doctors may prescribe either steroid creams or lotions, or oral medications to reduce inflammation and other symptoms.
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I think I have Dyshidrotic eczema.


Dyshidrotic eczema is a condition in which small blisters develop on the hands and feet. Blisters are often itchy.

Causes

This blistering type of eczema is twice as common in women than men.
People are more likely to develop dyshidrotic eczema when:
  • They are under stress
  • They have allergies, such as hayfever
  • Their hands are often in water or moist
  • They do cement work or other work that exposes their hands to chromium, cobalt, nickel
The cause is unknown. The condition seems to appear during certain times of the year.

Symptoms

Small fluid-filled blisters called vesicles appear on the fingers, hands, and feet. They are most common along the edges of the fingers, toes, palms, and soles. These blisters can be very itchy. They also cause scaly patches of skin that flake  or get red, cracked, and painful.
Scratching leads to skin changes and skin thickening. Large blisters may cause pain.

Exams and Tests

Your health care provider may be able to diagnose this condition by looking at your skin.
skin biopsy may be needed to rule out other causes, such as a fungal infection.
If your doctor thinks the condition may be due to an allergic reaction, allergy testing (patch testing) may be done.

Treatment

Scratching only  the condition worse.
  • Anti-itch medicines taken by mouth, such as diphenhydramine (Benadryl) and loratiadine (such as Claritin), may help you stop scratching.
  • Take an anti-itch medicine before bed if you scratch in your sleep.
Apply an ointments or creams to your hands at least two times per day, and after every hand washing.
  • Heavy ointments are best. Petroleum jelly (such as Vaseline), mineral oil or vegetable shortening may be best but can be messy.
  • Creams are thicker than lotions. Creams such as Eucerin and Lubriderm may be helpful.
Your doctor may prescribe steroid (or corticosteroid) ointments or creams. Other creams or ointments such as tacrolimus or pimecrolimus may also be used.
Your doctor may recommend the following if your symptoms are very bad:
  • Steroid pills
  • Coal tar preparations
  • Phototherapy (ultraviolet light therapy)
Avoid frequent bathing, hand washing, and irritating substances, which can make itching worse.

Outlook (Prognosis)

There is no cure. Dyshidrotic eczema normally goes away without problems, but symptoms may come back. Excess scratching may lead to thick, irritated skin. This makes the problem harder to treat.

Possible Complications

  • Pain and itching that limits the use of the hands
  • Bacterial infection from scratching

When to Contact a Medical Professional

Call your health care provider if you have:
  • Signs of infection such as tenderness, redness, warmth, or fever
  • A rash that does not go away with simple home treatments

Alternative Names

Dyshidrosis; Pompholyx

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