Blisters Beneath the Skin: Eczema or Something Else?

Q: Blisters Beneath the Skin: Eczema or Something Else?

Hello： I apologize! According to medical regulations, a doctor cannot diagnose or prescribe medication without personally examining the patient, so I cannot prescribe medication for you. <br>First of all, you should not attempt to break or scratch the skin yourself, as this incre

There are blisters under the skin?

I have had atopic dermatitis since childhood, and recently I noticed that the skin on my palms and fingers has developed something resembling blisters underneath.
From the surface, it looks like there are many tiny holes in the skin, but the skin feels smooth to the touch.
However, if I break them, a small amount of fluid oozes out.
There are some areas on my fingers that are slightly raised.
If I break the raised blisters, a lot of fluid comes out, and when I peel back the skin, I find that the areas where the blisters were are indented, almost like empty holes filled with fluid.
Sometimes these blisters itch, and sometimes they don't.
When they do itch, if I scratch them excessively, fluid also comes out, and after a while, the scratched areas heal on their own, but the blisters remain underneath.
The blisters are very small, about the size of a pinhead, with some even smaller, and they are not very deep.
If I lift the surface skin, the blisters break easily.
Sometimes there are few blisters, sometimes many, and they can change locations.
I had a similar issue in the past, but those blisters disappeared within a few days.
However, this time it has been two months.
Sometimes my hands seem to be getting better, with fewer blisters, but within a few days, the blisters increase again, and the condition worsens.
This has been a recurring issue for two months.

I also have some problems on my feet, and I'm not sure if it's a fungal infection because I previously injured my foot, causing the epidermis to wear away and form blisters.
I peeled off the damaged skin and broke the blisters, thinking that removing the excess skin would help it heal, but for the past four months, the affected areas have been very itchy.
When I scratch the skin, I notice that it resembles the condition on my hands, as the scratched areas also ooze fluid and have indentations in the skin.
Is this similar to what I have on my hands? How should I treat this? I am currently abroad and have been advised to see a doctor.
I hope to understand what this condition is, as my hands are extremely itchy, and I am scratching them raw.
Thank you, doctor, for your help.

fufu, 10~19 year old female. Ask Date: 2010/01/21

Dr. Huang Ruiyun reply Dermatology

Hello: I apologize! According to medical regulations, a doctor cannot diagnose or prescribe medication without personally examining the patient, so I cannot prescribe medication for you.
First of all, you should not attempt to break or scratch the skin yourself, as this increases the risk of infection and can trigger an excessive immune response.
I recommend that you see a doctor for a proper evaluation.
Wishing you peace and good health.

Reply Date: 2010/01/21

More Info

Based on your description, it sounds like you are experiencing a skin condition that may be related to eczema, specifically a type known as dyshidrotic eczema or pompholyx. This condition is characterized by the formation of small, itchy blisters on the palms of the hands and the soles of the feet. These blisters can be filled with fluid and may appear shiny or smooth on the surface. When they burst, they can ooze a clear fluid, which can lead to crusting and further irritation.

Eczema, including dyshidrotic eczema, is often triggered by various factors such as stress, allergens, irritants, and changes in temperature or humidity. The fact that you have a history of atopic dermatitis (eczema) suggests that your skin may be more sensitive and reactive to these triggers. The cyclical nature of your symptoms, where the blisters appear and then subside, is also typical of eczema flare-ups.

In terms of treatment, it is crucial to manage the symptoms effectively to prevent further skin damage and to promote healing. Here are some recommendations:
1. Moisturization: Keeping your skin well-hydrated is essential. Use a thick, fragrance-free moisturizer regularly, especially after washing your hands. This helps to create a barrier that locks in moisture and protects the skin.

2. Topical Steroids: If the itching and inflammation are significant, a topical corticosteroid may be prescribed to reduce inflammation and alleviate itching. It's important to follow your healthcare provider's instructions regarding the use of these medications, especially on sensitive areas like the hands.

3. Avoid Irritants: Identify and avoid any potential irritants that may trigger your symptoms. This includes harsh soaps, detergents, and certain fabrics. Wearing gloves while doing household chores can help protect your hands.

4. Cool Compresses: Applying cool, damp compresses to the affected areas can help soothe itching and reduce inflammation.

5. Antihistamines: If itching is severe, over-the-counter antihistamines may help to reduce the urge to scratch, especially at night.

6. Consult a Dermatologist: Since your symptoms have persisted for two months and are causing significant discomfort, it is advisable to see a dermatologist. They can provide a definitive diagnosis and tailor a treatment plan specific to your condition. They may also consider other potential causes for your symptoms, such as a fungal infection, especially since you mentioned issues with your feet.

7. Foot Care: For the issues on your feet, it is essential to keep the area clean and dry. If you suspect a fungal infection, antifungal treatments may be necessary, which a dermatologist can prescribe.

8. Avoid Scratching: While it can be difficult, try to avoid scratching the affected areas as this can lead to secondary infections and worsen the condition.

In summary, while your symptoms may be consistent with dyshidrotic eczema, a proper evaluation by a healthcare professional is necessary for an accurate diagnosis and appropriate treatment. Managing eczema often requires a multifaceted approach, including lifestyle modifications, topical treatments, and possibly systemic therapies in more severe cases. It is essential to seek medical advice, especially since you are experiencing significant discomfort and the condition has persisted for an extended period.

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