Dyshidrotic Eczema

Q I've had dyshidrotic eczema for over 10 years that flares on both palms and soles. Can even this improve with Korean medicine treatment?

A. Even chronic dyshidrotic eczema of over 10 years is not impossible to treat, but a marked reduction in symptoms and improvement in quality of life is a more realistic goal than complete clearance. In long-standing cases, skin regeneration takes more time, and managing hand irritation is also needed. With consistent treatment, the main complaints such as itching, sleep disturbance, and blister frequency often decrease first.

Q I had atopic dermatitis as a child. Is that why I get dyshidrotic eczema easily? Do other skin allergies come along with it too?

A. Dyshidrotic eczema tends to appear more readily in people with allergic predispositions such as atopy, allergic rhinitis, and asthma. These share a common root of immune hypersensitivity, so they easily accompany one another. So if you have dyshidrotic eczema, it is best to also watch for other allergic symptoms and manage them in an integrated way.

Q I usually have poor digestion and a bloated, heavy stomach. Is the state of my stomach related to the blisters on my hands?

A. Declined digestive function and dyshidrotic eczema may be closely related. When a weak stomach cannot properly process waste products and heat, they accumulate in the body and can lead to skin inflammation. Since blisters often worsen along with spicy, greasy food or alcohol that burdens the stomach, managing the digestive system is important alongside skin care.

Q At night my hands and feet itch so much that when I scratch, the blisters burst and I can't sleep. What should I do when it itches?

A. When it itches, scratching bursts the blisters, causing oozing and raising the risk of secondary infection, so not scratching is most important. Covering the affected area with a cold wet towel to cool the heat sensation reduces the urge to scratch. If nighttime itching is severe, strengthening moisturizing before bed and keeping a cool sleeping environment can help.

Q After the blisters dry, my hands crack badly, feel tight, and hurt. How should I moisturize and care for my hands?

A. During the cracking phase after the blisters dry, moisturizing is most important. Right after washing your hands while moisture remains, apply plenty of a low-irritant cream or ointment free of fragrance and preservatives. When working with water and detergent, wear gloves, and wash briefly with lukewarm water instead of hot water to protect the oil film of your hands.

Q I'm going to a Korean medicine clinic for dyshidrotic eczema. What symptoms mean I should go to a hospital or emergency room immediately?

A. Dyshidrotic eczema itself is not life-threatening, but the following warning signs require immediate hospital care. If yellow oozing or pus from burst blisters worsens, or honey-colored thick crusts form along with fever, suspect secondary bacterial infection. If the hands or feet become red and swollen with severe pain and accompanying fever, it may be a sign of spreading infection, and you should be seen right away.

Q I'm using steroid ointment and antihistamines prescribed by a dermatologist. Is it okay to take herbal medicine at the same time?

A. Topical steroid ointment is an external preparation, so it is unlikely to clash directly with oral herbal medicine. Antihistamines rarely conflict with herbal medicine, but their sedative effects can overlap and cause drowsiness, so separating the dosing times keeps it safe. At Dongjedang, we prescribe herbal medicine only after checking all of the conventional medications you are taking, and we proceed with combined treatment.

Q It's been two years since I was diagnosed with dyshidrotic eczema. Can it be cured? Usually, how long do I need to be treated?

A. For dyshidrotic eczema, controlling symptoms and preventing recurrence are more realistic goals than complete cure. If you avoid triggers and treat and manage it consistently, in most cases it can be brought down to a level that does not interfere with daily life. Treatment duration varies with the duration and extent of the disease; at Dongjedang we generally use about three months of consistent treatment as a benchmark, aiming to noticeably reduce blisters and itching within that period.

Q Even after it heals, it flares again in summer when I sweat more or when I get busy at work. Is there a way to reduce recurrence?

A. The keys to preventing recurrence are avoiding triggers, consistent moisturizing, and maintaining the skin barrier. Even after symptoms disappear, if you keep protecting your hands from irritation and continue moisturizing, the interval between recurrences lengthens. Preparing in advance for periods when it worsens, such as sweaty summers or busy times, can lower the intensity of recurrence.

Q I'm in my 30s and run a hair salon in Dongincheon. Clusters of tiny, clear, millet-like blisters keep forming on the sides of my fingers and on my palms, and they itch like crazy. What on earth is this?

A. A condition in which small, clear, deep-seated itchy blisters cluster on the sides of the fingers, palms, and soles is called dyshidrotic eczema (pompholyx). It is common in jobs with repeated exposure of the hands to water, detergents, and perm solutions, and it is a type of chronic eczema that flares and improves repeatedly in step with sweating, stress, and seasonal change.

Q I'm an office worker in my 40s. Even when I haven't touched anything, blisters come up on my hands whenever I'm stressed or the seasons change. Don't they only appear when something gets on my hands?

A. Dyshidrotic eczema arises not only from external irritation but also from internal factors such as sweating, stress, seasonal change, and immune hypersensitivity. Because it is a multifactorial eczema with no single proven cause, it can recur whenever your condition declines, even without any memory of contact. That is why avoidance alone has limits, and managing your overall bodily state is also needed.

Q I'm an office worker in my 20s, and the blisters on my hands seem to get worse the day after drinking or on days I eat spicy food. Does food affect dyshidrotic eczema too?

A. Alcohol and spicy, greasy food are representative triggers that raise the body's inflammatory response and burden the stomach, worsening dyshidrotic eczema. There are also reports that foods high in nickel (canned goods, nuts, chocolate, etc.) aggravate symptoms in some patients. Food is rarely a direct cause, but aggravating foods differ from person to person, so it is best to keep a food diary to find your own pattern.

Q I do a lot of dishwashing at a restaurant, so my hands are in water and detergent all day. What things especially make dyshidrotic eczema worse?

A. Irritants that repeatedly contact the hands, such as water, detergent, rubber gloves, metal (nickel), and perm solutions, directly worsen dyshidrotic eczema. A sweaty environment and frequent hand-washing also have an effect. Simply wearing cotton gloves under rubber gloves, or drying and moisturizing your hands right after work, can reduce the frequency.

Q I work full-time and find it hard to come often. How frequently do I need to come for dyshidrotic eczema treatment at Dongjedang?

A. During the acute phase, visits 2-3 times a week are recommended, and once symptoms stabilize, this is reduced to once a week. Herbal medicine is usually adjusted while observing your condition at two-week intervals. The whole course is benchmarked at about three months; office workers can maintain their daily routine while being treated by using evening and Saturday appointments.

Q If I get treated for dyshidrotic eczema at Dongjedang, in what order does it proceed?

A. Dongjedang's dyshidrotic eczema treatment proceeds in three stages: clearing heat and resolving toxin, immune stabilization, and skin regeneration. First we discharge the heat-toxin and waste products accumulated in the body to reduce itching and oozing; next we balance the internal organs to settle the over-reactive immune system; finally we regenerate the damaged skin barrier to prevent recurrence. At each stage we combine herbal medicine and acupuncture tailored to your constitution and symptoms.

Q Is treatment different for the blistering phase with lots of oozing versus the phase when the hands thicken and crack?

A. Even for the same dyshidrotic eczema, the treatment direction changes by phase. The acute phase with oozing and severe itching and heat is treated mainly by clearing the damp-heat within the body, while the phase after the blisters dry, when the skin thickens and cracks, is treated in the direction of replenishing blood to nourish the skin. At Dongjedang, we determine the prescription after distinguishing which type it is through pattern differentiation at the first visit.

Q Steroid ointment only works while I'm using it, and the blisters come right back when I stop. Can herbal medicine provide a fundamental cure?

A. Topical steroids quickly calm itching and inflammation, but the immune hypersensitivity and weakened skin barrier that keep dyshidrotic eczema coming back remain unchanged. Korean medicine treatment approaches by discharging the heat-toxin and waste products accumulated in the body and settling the over-reactive immune system, aiming to lengthen the interval between recurrences. During severe acute phases, it is best to combine conventional treatment.

Q I'm in my 50s and live in Dong-gu, Incheon. I have chronic dyshidrotic eczema that flares on both hands and feet. Does acupuncture really work?

A. Acupuncture helps regulate the balance of over-reactive skin immunity, soothe itch signals, and lower stress, so it is used as an adjunctive treatment for chronic, recurrent dyshidrotic eczema. Rather than solving everything on its own, it is more effective when combined with herbal medicine. While dispersing the heat built up in the hands and feet, you should also keep up lifestyle care such as moisturizing after work.