You are more likely to develop this condition if:

• You wash your hands frequently.

• You have a personal or family history of eczema, allergies, asthma, or hay fever.

• You are allergic to metals, such as nickel or cobalt.

• You work with cement.

• You smoke.

Symptoms of this condition may affect the hands, the feet, or both. Symptoms may come and go (recur), and may include:

• Severe itching. This may happen before blisters appear.

• Blisters. These may form suddenly.

  • In the early stages, blisters may form near the fingertips.

  • In severe cases, blisters may grow to large blister masses (bullae).

  • Blisters resolve in 2–3 weeks without bursting. This is followed by a dry phase in which itching eases.

• Pain and swelling.

• Cracks or long, narrow openings (fissures) in the skin.

• Severe dryness.

• Ridges on the nails.

This condition may be diagnosed based on:

• Your symptoms and a physical exam.

• Your medical history.

• Skin scrapings to rule out a fungal infection.

• Testing a swab of fluid for bacteria (culture).

• Removing a small piece of skin (biopsy) to test for infection or to rule out other conditions.

• Skin patch tests. These tests involve using patches that contain possible allergens and placing them on your back. Your health care provider will wait a few days and then check to see if an allergic reaction occurred. These tests may be done if your health care provider suspects allergic reactions, or to rule out other types of eczema.

There is no cure for this condition, but treatment can help relieve symptoms. Depending on the amount and severity of the blisters, your health care provider may suggest:

• Avoiding allergens, irritants, or triggers that worsen symptoms. This may involve lifestyle changes, such as:

  • Using different lotions or soaps.

  • Avoiding hot weather or places that will cause you to sweat a lot.

  • Managing stress with coping techniques, such as relaxation and exercise, and asking for help when you need it.

  • Diet changes as recommended by your health care provider.

• Using a clean, damp towel (cool compress) to relieve symptoms.

• Soaking in a bath that contains a type of salt that relieves irritation (aluminum acetate soaks).

• Medicines, such as:

  • Medicine taken by mouth to reduce itching (oral antihistamines).

  • Medicine applied to the skin to reduce swelling and irritation (topical corticosteroids).

  • Medicine that reduces the activity of the body’s disease-fighting system (immunosuppressants) to treat inflammation. This may be given in severe cases.

  • Antibiotic medicines to treat bacterial infection.

• Light therapy (phototherapy). This involves shining ultraviolet (UV) light on the affected skin in order to reduce itchiness and inflammation.

Bathing and skin care

• Wash skin gently. After bathing or washing your hands, pat your skin dry. Avoid rubbing your skin.

• Remove all jewelry before bathing. If the skin under the jewelry stays wet, blisters may form or get worse.

• Apply cool compresses as told by your health care provider. To do this:

  • Soak a clean towel in cool water.

  • Wring out excess water until towel is damp.

  • Place the towel over the affected skin. Leave the towel on for 20 minutes at a time, 2–3 times a day.

• Use mild soaps, cleansers, and lotions that do not contain dyes, perfumes, or other irritants.

• Keep your skin hydrated. To do this:

  • Avoid very hot water. Take lukewarm baths or showers.

  • Apply moisturizer within 3 minutes of bathing. This locks in moisture.

Medicines

• Take and apply over-the-counter and prescription medicines only as told by your health care provider.

• If you were prescribed an antibiotic medicine, take or apply it as told by your health care provider. Do not stop using the antibiotic even if you start to feel better.

General instructions

• Do not use any products that contain nicotine or tobacco. These include cigarettes, chewing tobacco, and vaping devices, such as e-cigarettes. If you need help quitting, ask your health care provider.

• Identify and avoid triggers and allergens.

• Keep fingernails short to avoid breaking the skin while scratching.

• Use waterproof gloves to protect your hands when doing work that keeps your hands wet for a long time.

• Wear socks to keep your feet dry.

• Keep all follow-up visits. This is important.