I am embarrassed to shake hands with people because my hands have a rash. What is it?
Dyshidrotic dermatitis (pompholyx) is a form of hand eczema, slightly more common in women, which starts on the sides of the fingers as itchy little bumps and then develops into a rash. The condition can also affect only the feet. Some patients have involvement of both the hands and feet. It is often confused with a fungus.

What causes it?
People who have dyshidrotic dermatitis are genetically predisposed to it. Dyshidrotic dermatitis often appears during times of stress. Smokers have a higher incidence of this condition.

How do I treat it?
People who have dyshidrotic dermatitis are genetically predisposed to it. Skin protection is an important part of treatment. Protect your hands from direct contact with soaps, detergents, scouring powders, and similar irritating chemicals by wearing waterproof, cotton-lined, gloves. Wear waterproof gloves while peeling and squeezing lemons, oranges, or grapefruit, peeling potatoes, and handling tomatoes. Wear heavy-duty gloves when doing heavy work and gardening. Also, wear cotton gloves when doing dry housework. If you have a dishwasher, use it regularly. If not, let a member of the family do the dishes. Do your laundry by machine, not by hand. Avoid direct contact with turpentine, paint thinner, and paints. Also, avoid polishes for furniture, metal, floors, and shoes. When using them, wear heavy-duty gloves because they contain irritating solvents. When washing your hands, use lukewarm water and a small amount of mild soap such as Dove or Basis. Rinse the soap off carefully and dry gently. All soaps are irritating. No soap is "gentle to your skin." Soap free cleansers are less irritating than soap and are recommended for this condition. Rings often worsen dermatitis by trapping irritating materials beneath them. Remove your rings when doing housework and before washing your hands. When outdoors, in cold or windy weather, wear unlined leather gloves to protect your hands from drying and chapping.

Use only the prescribed medicines (usually cortisone ointments) and lubricants such as Cetaphil cream. Protect your hands for at least four months after your dermatitis has healed. It takes a long time for skin to recover, and unless you're careful, the dermatitis will recur. If you have a tendency to develop dyshidrotic dermatitis of the feet, you should wear socks which are at least 60% cotton. You should change your shoes everyday. Alternate 2-3 pairs of shoes, so the shoes will dry out completely before you use them again. An infection will develop if careful attention is not given at home.