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Eczema types: Dyshidrotic eczema causes

Who gets dyshidrotic eczema?

Your risk of developing dyshidrotic eczema increases if you have one or more of the following:

  • Another type of eczema, especially atopic dermatitis

  • Hay fever, asthma, or allergic sinusitis

  • An allergy, especially to nickel or cobalt

  • Sweaty (or wet) hands often

  • One or more blood relatives who have (had) dyshidrotic eczema, atopic dermatitis, hay fever, asthma, or allergic sinusitis

  • Worked (or work) as a metalworker or mechanic

  • Worked (or work) with cement

If you develop dyshidrotic eczema, it’s likely to begin between 20 and 40 years of age.

Dyshidrotic eczema can also begin earlier or later in life. While rare, children sometimes develop this disease.

Dyshidrotic eczema can come and go

Many people find that warm weather or feeling stressed out can trigger the itchy blisters.

Stressed woman on cell phone

What causes dyshidrotic eczema?

This is still a bit of a mystery. In studying this disease, researchers have learned that it is NOT caused by a problem with a person’s sweat ducts, as previously thought.

It appears that people who get dyshidrotic eczema have a hypersensitivity to something. The list of things that can cause this hypersensitivity include:

  • Metal, especially nickel or cobalt

  • An ingredient in a personal care product

  • Medication, especially aspirin or birth control pills

  • An infusion of intravenous immunoglobulin (IVIG)

  • Smoking tobacco

  • A skin infection, such as athlete’s foot

When you come into contact with something that causes a hypersensitivity, it’s thought that this triggers the dyshidrotic eczema. For example, if you have a hypersensitivity to an ingredient in your soap, dyshidrotic eczema may flare up every time you use that soap.

Some people find that when they avoid what causes this hypersensitivity, they avoid flare-ups. For example, if you have dyshidrotic eczema on your hands and you are hypersensitive to the fungus that causes athlete’s foot, getting rid of the athlete’s foot may get rid of the dyshidrotic eczema on your hands. You may never get another flare-up of dyshidrotic eczema unless you develop athlete’s foot again.

While avoiding your hypersensitivity may prevent flare-ups, figuring out what causes your hypersensitivity can be difficult. If you’re hypersensitive to nickel, so many things could cause dyshidrotic eczema to flare. This long list includes jewelry, something that you work with at your job or for a hobby, foods you eat, and dental fillings

Stress or weather can trigger dyshidrotic eczema

Some people find that dyshidrotic eczema flares only at certain times. You may develop dyshidrotic eczema only when you feel stressed out. Many people say the blisters appear when stress hits and continue to appear until their stress lessens.

Stress cannot cause dyshidrotic eczema

If you have dyshidrotic eczema, however, stress may trigger a flare-up.

Stressed out student

A change in weather can also trigger a flare-up. In the United States, flare-ups occur more often in areas with warm weather. Some people only get flare-ups during the spring and summer months when the temperature rises.

Others develop blisters when it’s cold or very humid outdoors.

Another seasonal trigger may be the sun’s UVA rays. During the spring and summer months, when UVA rays are strongest, some people find that dyshidrotic eczema flares.

When dyshidrotic eczema flares, treatment can help ease the discomfort and reduce flare-ups. Find out how dermatologists treat dyshidrotic eczema at, Dyshidrotic eczema: Diagnosis and treatment.

Getty Images

Amini S, Burdick AE, et al. [chief editor] James WD. “Dyshidrotic eczema (pompholyx).” Medscape. Last updated 4/22/2020. Last accessed 9/30/2020.

Guillet MH, Wierzbicka E. “A 3-year causative study of pompholyx in 120 patients.” Arch Dermatol. 2007;143(12):1504-8.

Nishizawa A. “Dyshidrotic eczema and its relationship to metal allergy.” Curr Probl Dermatol. 2016;51:80-5.

Reider N, Fritsch PO. “Other eczematous eruptions.” In: Bolognia JL, et al. Dermatology. (fourth edition). Mosby Elsevier, China, 2018: 237-8.

Stuckert J, Susan Nedorost S. “Low-cobalt diet for dyshidrotic eczema patients.” Contact Dermatitis. 2008;59(6):361-5.

Written by:
Paula Ludmann, MS

Reviewed by:
Dara D. Spearman, MD, FAAD
Elaine T. Kaye, MD, FAAD
Emily Chu, MD, PhD, FAAD

Last updated: 11/16/20