Dyshidrotic eczema under the skin

Early dyshidrotic eczema may feel prickly, tight or intensely itchy before much can be seen. Small fluid-filled vesicles then become visible on the sides of fingers, palms, toes or soles. Their deep position can make them look like clear beads under a thicker surface. As the flare settles, the fluid dries and the surface may peel, crack or become tender. This pattern is different from a solid lump, but other conditions can resemble it.

Resist squeezing or piercing the bumps, which can create an opening for bacteria and delay healing. Clean gently with lukewarm water, pat dry and use a bland moisturiser to reduce cracking. Cover a fragile area with a clean dressing if friction is unavoidable, changing it when damp or dirty. Avoid detergents, solvents, prolonged soaking and tight footwear. If inflammation is significant, a clinician can assess whether a topical corticosteroid or another treatment is suitable.

Seek an appointment if the deep bumps persist, recur often, affect both hands or feet without a clear trigger, or are being mistaken for another skin problem. Prompt assessment is needed for pus, honey-coloured crust, spreading redness, warmth, swelling, severe pain or fever. A dermatologist may examine the pattern and test for alternative causes when appropriate.

Tell your clinician when the sensation began, whether blisters are clear or cloudy, and what touches the area at work or home. Ask how to protect cracked skin, whether treatment should be applied to the palms or soles, and which symptoms indicate infection.