I want to hide my hands.
July 1, 2010 1:18 AM   Subscribe

YANMDermatologist: What's up with these mini-blisters, it's annoying and making me self-conscious. Wall of late night text-babble inside.

They're colorless, don't itch, don't hurt, develop in close-in clusters, and form pockets of fluid inside them that act like blisters when I poke them. After a while, they went away and my skin peeled like hell. Now they're back again.

The first time, they manifested mostly on the sides of my knuckles. This time they're generally sticking to the sides of my fingers except for a couple on my palm, and a couple on the side of my big toe.

They don't QUITE match the description of hives or a rash, since they're not discolored or itchy. It might not bother me nearly so much if I didn't think it's incredibly embarrassing and self-conscious-inducing when the skin starts peeling on my hands. I'm also hoping it's not contagious (doubt that, but y'never know).

If it IS an allergy of some kind, it may be related to a skin lotion I started using again that has SPF in it. It's older, and I'd used it for years without any trouble. The first time, it appeared after I started using it again. After I noticed it was gone, I tried the stuff again, and yay it's coming back. I'm antsy about it and I'd like to find out if it's SPF that's doing it (ARGH) or just that lotion ... but I'd have to wait until after this attack fades.

Difficulty: I have a complete lack of insurance. If I had insurance, I'd have gone in a couple weeks after the first time it hit. (It took about 3-4 weeks for it to clear up completely the first time.)

I've searched for hives on MF and didn't find anything like what I've described, but it's also 2 am and I may have missed it. I may try taking some of the advice in one thread and start a diary to track stuff, but meh...
posted by Heretical to Health & Fitness (19 answers total) 2 users marked this as a favorite
I used to get eczema on my hands. It was exactly what you describe. (It does seem to be aggravated by allergies in my case, too.)

I saw a dermatologist who gave me a bunch of steroid creams that only kind of helped the eczema but had a lot of side effects I wasn't willing to put up with, considering my case wasn't especially uncomfortable or disfiguring or anything, just really annoying. It's been a long time since I've broken out, but I wait for my skin to dry out and start the peeling phase, and then I hit it with Aquaphor.
posted by adiabat at 1:36 AM on July 1, 2010

Best answer: Sounds like eczema to me, or more specifically, dyshidrosis. If that's what it is, a mild steroid cream or ointment would probably help. If you can't consult a GP, try asking a pharmacist to see if they have something that might help.
posted by le morte de bea arthur at 1:39 AM on July 1, 2010

Best answer: Is it the same bottle of lotion? Because they do go off and/or pick up bacteria over time. You could have given yourself a mild infection, in which case steroid cream would be the worst thing to put on it. At the same time if it's an allergy then steroids are the right thing to put on it, which is why it probably needs to see a Dr if throwing away the lotion doesn't let it heal and go away on it's own.
posted by shelleycat at 1:53 AM on July 1, 2010

I have little blisters that sound like you describe, and they're about as big as the head of a pin. I have eczema, but these only tend to appear after I've been rubbing (as opposed to scratching) the affected area. I did once get masses of them after using a Neutrogena spray on sun block.
posted by Solomon at 2:48 AM on July 1, 2010

Best answer: Yeah, it sounds like dyshidrosis, I get it occasionally when it gets warm/humid. Although much milder than that horror shot from Wikipedia, damn.

What helps is to get my hands as dry as humanly possible after washing, which means using a high-quality cotton towel, dabbing/drying everywhere with particular attention towards any skin that will tend to be touching other skin (i.e. webs of the fingers, areas next to the knuckles), moving to a new spot after the part of the towel I'm using is damp, etc. Skin should feel dry as the desert afterwards. Lotion in general makes it vastly worse IME.

When it's particularly bad I put Gold Bond on it overnight, which dries everything out and keeps it from spreading, although it's obviously both tragic and inauspicious to bring Gold Bond Smell anywhere near the bed zone.

Dermatologists I have seen about it appear to not know what causes it or what fixes it, which the online descriptions back up, so you can really spend a lot of time and money seeing them about it, followed by a steroid cream prescription which will reduce the symptoms but not fix the syndrome at all, which I'd kind of say is skippable. It is probably a combination of contact dermatitis from soap and excessive moisture from the humidity, but ceasing to use hand soap isn't so much of an option so yeah, try to keep things dry.
posted by Your Time Machine Sucks at 3:57 AM on July 1, 2010 [3 favorites]

I had much the same thing only they (the dermatologists) called it pompholyx. I, too, tried a whole bunch of stuff, including steroid creams, anti-fungal creams and combinations of anti-fungal / steroid creams. None of it really worked for me. I also tried using vaseline as a barrier cream which was successful, but made everything I touched feel horrible.

What has worked for me is a kind of barrier cream I bought here in Japan. I don't know exactly what's in it (ha!), but it seems to put some kind of silicone layer into the skin which prevents moisture getting out, and more importantly, doesn't wash off easily (I apply it twice a day). I have heard of a similar product called Derma Shield, which is supposed to be quite good, but I have never tried it.

I also recommend switching to pH5.5 soap-free soap for your hands. That and the cream have all but cleared up my symptoms. It still comes back if I'm not careful but it has made a huge difference to the way I feel.

Good luck!
posted by mukade at 5:35 AM on July 1, 2010

I have developed this same problem within the last few weeks. I've been using aquaphor at night with soft cotton gloves and that seems to help a lot. I also don't have insurance but I am seeing a dermatologist in about an hour, for this, among other things. I'll let you know what she says!
posted by shmurley at 7:16 AM on July 1, 2010

Are you sure they're not warts? I know warts aren't usually soft enough to prod and feel liquid, but the coloring, size, and location you describe sounds an awful lot like warts to me.
posted by Eicats at 7:25 AM on July 1, 2010

Then again...I've gotten cysts on a couple of my knuckles thanks to arthritis. They are somewhat similar to what you've described: along side of knuckle, don't itch, can manipulate it and feel the fluid inside, eventually dissipates. However, I've never had the skin peel and I don't think they would occur anywhere other then on a joint.

Do the bumps like like the cysts shown here?
mucous cysts
(about half way down the page)
posted by Eicats at 7:30 AM on July 1, 2010

Just came in to say that I have been thinking about posting this exact same question for the last couple of weeks. I've had these little blisters on my fingers on and off for most of my life, especially in the summer. I've always chalked it up to summer sweat combined with wearing rings that aggravate my fingers.

I do have mild eczema on other parts of my body, so now that I've read the green's response, I know what's going on. Thanks for posting the question!

Solomon: Re the Neutrogena spray sunblock, did you get a bit of a sunburn? I've had that (masses of tiny bubbles under the skin post sun-exposure) happen once or twice before, but learned that it's because the sun killed the topmost layer of skin and those little bubbles were -- wait for it -- sweat trapped under the skin. Once you exfoliate/pop them they go away for good, at least for me.
posted by alleycat01 at 7:41 AM on July 1, 2010 [1 favorite]

I have similar symptoms and have been diagnosed with contact dermatitis due to a mild allergy.
posted by NortonDC at 9:56 AM on July 1, 2010

Best answer: Definitely sounds like dyshidrotic eczema/pompholyx. Lots of tiny, tiny pinprick-sized blisters, especially on/around the hands. Pop them with a pin and a clear fluid comes out. Unlike a lot of skin conditions, it's more common in the summer than in the winter. For many people, they're not itchy.

Similar symptoms can result from dermatitis, but if it's dyshidrotic eczema, I've dealt with it summer and winter, with and without all sorts of lotions and soaps, with different sorts of gloves (I work in a lab), etc. While it sometimes goes away on its own (without me having changed anything), the only the that's actively driven it away is steroid-based medications. (When I was on prednisone for something unrelated, for example, they disappeared.)
posted by ubersturm at 10:02 AM on July 1, 2010

I just got back from the dermatologist and she told me I do have dyshidrotic eczema and she gave me a scrip for Lidex steroid cream to use at night when it gets really bad. She said she also has it and she uses aquaphor about 20x everyday. If you use a small amount (about 1/8 tsp) it shouldn't get you and everything you touch greasy. She also said a GP can treat this as well as a dermatologist. Of course, YMMV, and IANAD. Oh yeah, she also mentioned that this started for her in her early to mid 30's and that's my age too. Sigh.
posted by shmurley at 10:42 AM on July 1, 2010

I've had these little blisters on my fingers on and off for most of my life, especially in the summer.

I used to get them too. A dermatologist told me that it sounded like a sun sensitivity. Mine were itchy though and my hands would also feel a bit swollen. I'd just soaked my hands in cold water and that seemed to help make them feel more comfortable at least in the short term. OTC hydrocortizone cream worked, but you don't want to use for longer than two weeks at a time. I believe it thins the skin with prolonged use.
posted by kaybdc at 11:34 AM on July 1, 2010

Response by poster: le morte de bea arthur -- The pictures in your link look like what I had on the side of my foot earlier this year. I hadn't thought they could be related!

shelleycat -- It is the same bottle. It may have picked up something, but some of the other stuff I bought around the same time doesn't have the same effect. And it's not appearing on my face. o.O I won't discount that idea though, and I've stopped using that bottle altogether. Bacteria or allergy, I don't want to use it!

Your Time Machine Sucks -- That link helped A LOT. The spots in those pictures look more reddish than mine, except the top right picture which looks EXACTLY like the side of my finger right now. The heat factor is interesting -- it did flare up realy badly for me when I travelled south for a few weeks and went from 40 degree weather to mid 80s.

Eicats -- it does not look anything like those cysts, thank god. I think I'd have already gone insane if that were the case. I've also had warts before and this definitely doesn't fit that description. Still useful to read about though, thank you!

Generally to everyone -- this is insanely useful. It hasn't been going on long, but it's very nice to hear everyone's opinions and suggestions, even the ones that don't fit.
posted by Heretical at 12:04 PM on July 1, 2010

Definitely throw the bottle away. It could just be that the skin on your hands is more susceptible for some reason to whatever it is, maybe because they tend to be more dry. Maybe it was just a bad batch in that bottle, maybe you've become sensitised to an ingredient in there in general. Either way sounds like you're better off without it!

When I had a staph infection on my feet it was pretty much exactly what you're describing. When my boyfriend had an unrelated staph infection he needed outpatient surgery on some of the lesions. In both cases putting steroids on it would have been disastrous, an open invitation for an otherwise self limiting infection to go systemic, so please don't start any kind of treatment based on random advice from the internet. At this point you know it'll probably go away on it's own so you're better off doing nothing that treating it inappropriately, but seeing a medical professional is still the only really right thing to do here. Blindly buying steroid cream definitely isn't.

Of course if it is eczema the steroids generally work really well but, again, that's why you need a real diagnosis.
posted by shelleycat at 1:52 PM on July 1, 2010

Has your stress level increased lately? I do not have eczema generally, but had a bout of this a few years ago. The blisters were not red or itchy and seemed to come out of nowhere and cover both my hands. My doctor at that time said that it can be aggravated by stress (it was in fact the most stressful time in my life). After that one incident (treated with steroids if i remember correctly) they have never returned.
posted by heybearica at 8:29 PM on July 2, 2010

Steroid cream doesn't really work that well IME, it basically works at the time of application and after a couple of weeks your skin is thinner, which means that if you stop using it you end up with a much worse case since it doesn't really promote healing of the underlying problem. Useful for getting a bad case under control but not really a great maintenance strategy.

I wanted to update since I was interested to see how many people managed this with a skin moisturizer/protective lotion of some kind, so I decided to try changing my method to keep the careful towel-drying but lose the powder and replace it with using some Nivea. To my surprise, it is working quite acceptably and without the bad Gold Bond bed karma.

So, since it's obviously going to be better for your skin in general to use a lotion versus a substance which dries it out, I'm going to amend my advice to: be careful about drying your hands after washing, and use a lotion that doesn't irritate your skin as a barrier afterwards. Thanks AskMe!
posted by Your Time Machine Sucks at 2:28 AM on July 5, 2010

Response by poster: Heyberica: Actually my stress level's been going DOWN the last couple few months. The first breakout began during the early stages of spring, and got really bad when I went down south for a few weeks. Now it's back again, but it's generally finally summer here so that may be part of it.

YTMS: That's what I'm doing -- towel-drying my hands, waiting till they're fully dry, and then putting on a light layer of not too froofy lotion. The stuff I have is pretty thick, not mostly water, so it works a lot better.
posted by Heretical at 8:41 PM on July 5, 2010

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