Pompholyx (Dyshidrotic Eczema): Causes, Triggers and Treatment for Blisters on Hands and Feet
Hand and foot eczema
Pompholyx, also called dyshidrotic eczema, is a type of eczema that causes small, deep, intensely itchy blisters on the palms, sides of the fingers and soles of the feet. Flares often follow sweating, hot weather, stress or contact with metals such as nickel. Treatment focuses on calming the itch, drying the blisters, protecting the skin barrier and avoiding triggers.
- Pompholyx is not contagious and is not caused by blocked sweat glands, although sweating is a common trigger.
- Metal allergy, especially to nickel and cobalt, is an important trigger in some people.
- Blisters usually dry and peel within about three weeks, but flares can recur.
- See a doctor if blisters are painful, contain pus or keep coming back.
What is pompholyx (dyshidrotic eczema)?
Pompholyx is a form of hand and foot eczema with tiny, tapioca-like blisters deep in the skin of the palms, the sides of the fingers and the soles. It is also called dyshidrotic eczema, dyshidrosis or acute and recurrent vesicular hand dermatitis. Although it often occurs in people who sweat heavily, the blisters form from eczema-type inflammation around the sweat ducts, not from blocked sweat glands (Nishizawa, 2016). It is most common in young adults and in people with a personal or family history of eczema, hay fever or asthma. For irritant, allergic and other types, see the full hand eczema guide.
How does a pompholyx flare develop?
| Stage | What you notice | Care focus |
|---|---|---|
| 1. Warning | Burning, prickling or itching before blisters appear | Cool the skin; avoid triggers |
| 2. Blisters | Clusters of small, deep, very itchy blisters | Cool compresses or soaks; do not pop |
| 3. Drying and peeling | Blisters dry into brown spots, then peel | Moisturise and soothe itch |
| 4. Cracking | Dry, thickened, sometimes painful cracks | Thick ointments; protect hands |
What causes pompholyx and what triggers flares?
- Sweating and heat. Flares are common in hot, humid weather and in people with sweaty hands and feet.
- Metal allergy. Nickel and cobalt allergy is linked with dyshidrotic eczema, and removing the metal allergen can improve symptoms (Nishizawa, 2016).
- Irritants. Frequent handwashing, detergents, solvents and wet work.
- Atopy. A personal or family history of eczema, hay fever or asthma.
- Fungal infection elsewhere. Athlete's foot can trigger an itchy blistering reaction on the hands. See athlete's foot.
- Stress and seasons. Many people notice flares in spring, summer or during stressful periods.
For the itchy, peeling stage. QICAOGANGMU pairs Ku Shen and She Chuang Zi with cooling borneol and menthol, tested steroid-free by TÜV SÜD PSB. Rated 4.5 to 4.7 out of 5 on Amazon. See the formula
How do you treat pompholyx at home?
- Cool the skin. Use cool, damp compresses or soak hands or feet in cool water for 10 to 15 minutes, two or three times a day.
- Do not pop the blisters. Popping increases the risk of infection.
- Moisturise after every wash with a fragrance-free cream or ointment.
- Wash with lukewarm water and a gentle, soap-free cleanser, then pat dry.
- Protect your hands. Wear cotton gloves under waterproof gloves for wet work, and remove rings when washing.
- Manage sweat. Change socks often and choose breathable shoes.
What medical treatments are used?
| Treatment | When it is used |
|---|---|
| Potent topical steroids | Short courses during a blistering flare |
| Tacrolimus or pimecrolimus | Steroid-free option for longer-term control |
| Patch testing | When metal or other contact allergy is suspected |
| Phototherapy | Recurrent or persistent hand and foot eczema |
| Alitretinoin, dupilumab and other systemic medicines | Severe chronic hand eczema that does not respond to creams (Garnock-Jones 2009; Riva 2026) |
How does Traditional Chinese Medicine view pompholyx?
In TCM, fluid-filled blisters, oozing and itch are described as Dampness, often combined with Heat and Wind. Recurrent blisters on the hands and feet may also be linked with a weak Spleen that does not transform Dampness well. External treatment aims to dry Dampness, clear Heat and stop itching. She Chuang Zi and Ku Shen are classic external herbs for this pattern and are among the core herbs in topical Chinese herbal eczema treatments (Wang et al., 2023).
Modern studies support their itch-calming potential: osthole from She Chuang Zi reduced scratching by blocking the TRPV3 itch channel (Sun et al., 2018), and borneol relieved itch through cold-sensing nerve channels (Tian et al., 2023). See how TCM explains eczema.
Where QICAOGANGMU fits
QICAOGANGMU Steroid-Free Herbal Cream
4.7/5 (243 ratings) and 4.5/5 (666 ratings) on Amazon. Read reviews
QICAOGANGMU is a steroid-free Chinese herbal cream built on the Damp-drying, itch-stopping pair She Chuang Zi 3% and Ku Shen 1.5%, with cooling Bing Pian (borneol) 2%, menthol 0.5% and Bai Bu 0.5% in a moisturising glycerin and petrolatum base. It is best suited to the itchy, drying and peeling stages of pompholyx and to daily care between flares. Avoid open, weeping or cracked areas, where cooling ingredients may sting.
- Steroid-free: TÜV SÜD PSB found none of 8 corticosteroids (lab reports)
- Fully declared formula: every active ingredient and its percentage on the label
- 100-day money-back guarantee
- US shipping in 2 to 6 business days, free over US$20
Patch test on a small area first, use a thin layer on intact skin and avoid the eyes, lips and genitals. Hand eczema · Product details
When should you see a doctor?
- Blisters are large, very painful or contain yellow pus
- Redness spreads, or you have a fever
- Flares keep coming back or affect your work or sleep
- No improvement after two to three weeks of home care
- You suspect a contact allergy and need patch testing
Frequently asked questions
What triggers pompholyx?
Common triggers include sweating and hot weather, nickel or cobalt allergy, frequent handwashing and detergents, stress, and a fungal infection such as athlete's foot.
Should I pop dyshidrotic eczema blisters?
No. Popping the blisters increases the risk of infection. Cool compresses or soaks help them dry naturally. A doctor can drain very large, painful blisters safely.
How long does a pompholyx flare last?
Blisters usually dry and peel within about three weeks, but flares can come back, especially in hot weather or after contact with triggers.
Is pompholyx contagious?
No. Pompholyx is a type of eczema and cannot spread to other people. Infected blisters should still be seen by a doctor.
Can a herbal cream help dyshidrotic eczema?
A steroid-free herbal cream with itch-calming herbs and a moisturising base can soothe itch during the drying and peeling stages and support the skin between flares. Avoid applying it to open or weeping blisters.
Related articles
References
- Nishizawa A. Dyshidrotic eczema and its relationship to metal allergy. Curr Probl Dermatol. 2016;51:80-85. PMID 27584966
- Garnock-Jones KP, Perry CM. Alitretinoin: in severe chronic hand eczema. Drugs. 2009;69(12):1625-1634. PMID 19678713
- Riva HR, et al. Dupilumab for chronic hand eczema: a systematic review and meta-analysis. Dermatitis. 2026. PMID 39501849
- Wang MC, Chou YT, Kao MC, et al. Topical Chinese herbal medicine in treating atopic dermatitis (eczema): a systematic review and meta-analysis with core herbs exploration. J Ethnopharmacol. 2023;317:116790. PMID 37328084
- Sun XY, Sun LL, Qi H, et al. Antipruritic effect of natural coumarin osthole through selective inhibition of thermosensitive TRPV3 channel in the skin. Mol Pharmacol. 2018;94(4):1164-1173. PMID 30108138
- Tian W, He D, Liu J, et al. Topical borneol relieves nonhistaminergic pruritus via targeting TRPA1 and TRPM8 channels in peripheral nerve terminals of mice. Eur J Pharmacol. 2023;953:175833. PMID 37290679
- American Academy of Dermatology. Dyshidrotic eczema.
Educational information only. Painful, infected, widespread or recurrent blisters should be assessed by a qualified healthcare professional.
