Dermatology-Online

Eczema on the foot

introduction

Eczema of all types represent a large group of skin disorders. They occur very frequently and can be observed in various sub-forms. What they all have in common is that they are an inflammation of the skin that occurs without an infectious cause. Eczema on the foot can present with different symptoms depending on the cause. To clarify the cause, it can sometimes be advisable to consult a doctor.

Symptoms of eczema on the foot

In patients with dyshidrotic eczema, only the hand and / or foot on one or both sides is affected. There is a very characteristic vesicle formation. The sequence of the skin reaction is always identical regardless of the affected body part. First of all, the affected skin area is reddened, but it may already be itchy. In the further course, small vesicles become visible, which burst at a certain point in time, then oozing (excess fluid is secreted over the skin barrier) and then crusts. Towards the end of the reaction, the skin flakes, which has now become very dry and brittle. If the skin is no longer exposed to the eczema trigger at this point, the skin can regenerate itself, this one sequence remains and one speaks of an acute eczema reaction or the acute stage. However, if the trigger persists or if it irritates the skin permanently, in the worst case the eczema becomes chronic and no longer heals. All manifestations of the acute stage can now appear side by side and break out repeatedly.

Typical, clear vesicles on the surface of the skin are characteristic of dyshidrotic foot eczema. In most cases, they occur on the sole of the foot. If these vesicles burst after a certain time, tissue fluid emerges as a clear liquid. Usually these bubbles are very small. In some cases they can still unite and then even grow to the size of a cherry stone.

itching

Most people affected experience itching as a very painful feeling. Often times, eczema is accompanied by itching or a burning sensation. This is especially the case when the skin is particularly dry. Foot eczema can also be accompanied by severe itching.
A very itchy eczema, which mainly affects the feet, but also the hands, is dishydrotic eczema, too Pompholyx called. Typically there are densely grouped vesicles on the soles of the feet and palms that contain a clear liquid. Contrary to what is often assumed, dishydrotic eczema of the feet is not a disease of the sweat glands. The name of eczema is historical and does not suggest the cause of the disease.
Rather, the dishydrotic eczema of the sole of the foot is assigned to neurodermatitis. The very itchy eczema is treated with cortisone for external and internal use, light therapy and care measures.

Blisters on the foot

Eczema on the feet, which is accompanied by blisters, can have very different reasons. One possible cause of such eczema is herpes zoster, which is also known colloquially as shingles. In herpes zoster, the vesicles typically run in a kind of segment-like arrangement so that, for example, only a certain section of the outside of the foot is affected. The vesicles are tightly grouped together and the skin under the vesicles is reddened. Over time, the blisters will burst.
Herpes zoster of the feet is accompanied by severe pain and must be treated with special drugs that fight the virus that causes it. Acyclovir is a commonly used drug. Synthetic tanning agents are used for external application.
Another possible cause of eczema with blisters on the feet is dishydrotic eczema. In dishydrotic eczema, the palms and feet are often affected by the itchy and painful blisters. The vesicles are filled with a clear liquid. Dishydrotic eczema can occur in the context of neurodermatitis or have toxic and allergic causes. Mild forms of dishydrotic foot eczema are treated with topical cortisone and light therapy. In the case of very pronounced forms, internal therapy with cortisone is used.
Another possible cause of eczema with blisters on the feet is bullous pemphigoid, which is one of the blistering skin diseases. The bullous pemphigoid is characterized by very firm and resistant blisters on otherwise healthy skin. As a differential diagnosis to bullous pemphigoid, diabetic eczema can also be considered, which can also be accompanied by blistering of the feet.

Causes of Eczema on the Foot

Eczema on the foot can have many different causes. Often this type of disease is genetic (also in combination with neurodermatitis, psoriasis and other skin diseases). Stress is generally considered to be an aggravating factor in the development of such eczema.

A so-called contact allergy can also be a possible trigger. The latter usually shows strong skin reactions with reddening, blistering, flaking of the skin surface and itching up to 48 hours after touching the allergy trigger. Typical triggers of a contact allergy are, for example, metals such as nickel or cobalt, which are used in costume jewelry but also in clothing, and various cosmetics and other personal care products. The most common type of eczema on the foot, however, is dyshidrotic foot eczema. This subtype of the disease can only be found on the hands or feet of those affected. External factors that have a direct effect on the affected skin areas also play an important role: frequent hand washing, increased work in liquids or contact with strong cleaning agents can, for example, trigger severe dyshidrotic eczema of the hands.

Read more on the subject at: Rash on the back of the foot

Eczema of the sole of the foot

Since the soles of the feet are exposed to constant mechanical stress, be it from running or simply wearing socks or shoes, the integrity of the skin is particularly important. Eczema on the soles of the feet is therefore particularly problematic. They not only hinder walking, but also tend to heal more poorly due to the constant mechanical irritation.
There are several reasons and causes of eczema on the sole of the foot.
One possible cause of eczema on the sole of the foot is dishydrotic eczema. This disease mainly affects the soles of the feet and the palms of the hands and is characterized by small vesicles that are arranged in groups and contain a clear liquid. Strong itching and pain are typical. The localization of the eczema often makes healing difficult. Foot baths, light therapies, as well as cortisone creams and - in severe cases - internal cortisone therapy with tablets are among the common treatment methods.
Another possible cause of eczema of the sole of the foot is allergic contact eczema. This can be caused, for example, by textiles, costume jewelry or other substances that come into contact with the sole of the foot. Allergic contact eczema is characterized by symptoms such as itching, reddening of the skin, cracked skin, small blisters or nodules known as papules. In the case of allergic contact eczema on the sole of the foot, the triggering allergen, such as costume jewelry, should be avoided.
Local treatment with cortisone ointments is also carried out. In contrast to allergic contact eczema, which only occurs when you are allergic to a certain substance, toxic contact eczema can occur when you come into contact with substances that are toxic to the skin.

diagnosis

An experienced dermatologist can often formulate an initial suspicion about the appearance of the blisters and the course of the disease so far.

when did the first blisters appear?
Has the condition of the skin got worse or better since then?
Has there been direct skin contact with unusual substances or objects?

Diagnostic testing is usually followed by an allergy test and / or evidence of a predisposition to neurodermatitis. A possible fungal infection should also be excluded.

The treatment of eczema on the foot

The therapy of eczema consists, if a certain allergen can be found as the trigger, above all in avoiding the incompatible substance. For this reason, special occupational safety measures - such as wearing gloves or special stockings - may be necessary in daily life. If the eczema is caused by excessive stress on the skin, consistent skin protection and careful care are advisable. Very good and almost allergen-free care products can be found in every pharmacy. As long as the eczema persists, it is also important to ensure that the damaged skin is protected against infection and, if possible, to avoid tight-fitting socks or shoes. Even after the actual (visible) healing phase of the eczema, the skin is not immediately fully resilient again. The final regeneration takes a few weeks.
According to conventional medicine, eczema therapy is always symptomatic and prophylactic, since the actual cause - an allergy or the tendency to develop skin eczema - remains lifelong. Some home remedies and various ointments and creams that are applied topically are suitable for therapy. In very severe cases, the systemic administration of glucocorticoids (cortisone or similar preparations) via tablets can be considered.

Ointment / cream

Eczema on the foot can be treated with various ointments and creams. The ingredients and active ingredients of the respective cream or ointment depend on the cause and type of eczema. A frequently used active ingredient is cortisone in various concentrations, as it is very effective against various eczema. It causes the inflammation to subside and often leads to healing. It is used as a basic therapy for almost every eczema.
Depending on the stage of eczema, a cream or ointment is more likely to be used. The difference between a cream and an ointment or even a gel lies in the ratio of water and fat. Ointments are anhydrous preparations on a fat basis, for example Vaseline, in which active ingredients such as cortisone are mixed. Creams, on the other hand, contain a certain amount of water. Ointments are suitable, for example, for the treatment of chronic, dry eczema.
In the acute stage of eczema, shaking mixtures and moist compresses are more likely to be used. Creams are used in the middle stage of eczema. In the event of further infections of the damaged skin areas (superinfection), antibiotic or antiseptic creams can also be considered.

Home remedies

Eczema on the foot can be very painful for those affected. Since the feet and especially the soles of the feet are constantly stressed in everyday life, it is often very difficult to heal the eczema. Careful grooming and some home remedies can help treat eczema on the feet and improve its condition. A good way to treat eczema on your feet naturally is to use soothing and soothing foot baths. However, one should pay attention to the ingredients of the foot bath. Soothing additives such as chamomile, aloe vera or ginger have anti-inflammatory effects, but should be used with caution. Depending on the type of eczema, they can also cause irritation or worsening of the skin's condition. This is especially the case if the person concerned suffers from so-called dishydrotic eczema, which usually also has a certain predisposition to allergies and intolerances. In this case one should be very careful with herbs, essential oils and other ingredients and discuss the treatment with a specialist dermatologist.
Another way to treat foot eczema with a simple home remedy is to use soothing packs with healing clay or cooling quark. However, the following rule also applies here: Every eczema reacts differently to external influences. If a home remedy is irritating, treatment should be stopped with it. Yoghurt packs can help relieve itching, especially with itchy eczema. In order to prevent the stressed areas from scratching, it is advisable to continue to wear special cotton socks. Materials such as animal wool or polyester should be avoided as they encourage itching.
In the case of very dry eczema, as is typical for neurodermatitis, for example, it is advisable to take sea salt baths. They help gently remove dead skin and renew the skin.

Another simple home remedy for eczema in the foot area is sufficient oiling of the skin and careful skin protection. To do this, it is particularly important to avoid all those things that additionally dry out the skin. Strongly alkaline soaps should be mentioned here as well as sunbathing and bubble baths as well as water with a temperature of over 35 degrees Celsius.

homeopathy

For the treatment of eczema on the feet, various homeopathic remedies are recommended by naturopaths. The recommendations are based on the type and symptoms of the eczema. For example, the homeopathic remedies petroleum, mezereum and graphite are recommended for weeping eczema. For example, Cardiospermum, Graphites and Belladonna are recommended for eczema that is itchy and inflammatory. Allergic eczema, on the other hand, react more to Apis mellificia or Tubercullinum. Since there are numerous other options in therapy with homeopathic remedies, these specific questions should best be discussed with a specialist in individual cases.
For stress-related eczema and severe itching, however, some homeopaths recommend the remedy Staphisagria. Five globules about three to four times a day are often recommended for all of the above remedies. The potencies of the remedies, however, differ. If you are seriously interested in a supportive, homeopathic treatment of foot eczema, you should seek advice from a homeopath or knowledgeable pharmacist. However, homeopathic treatment should not delay a visit to the doctor, as this can worsen the eczema.

forecast

Since the cause of eczema is usually bad or even worse not curable patients remain at risk of recurring eczema for life. With appropriate care and therapy, however, this can be contained well. Unfortunately, chronic courses are usually difficult to assess. Spontaneous "healings" can follow a strong outbreak. The eczema may not show up at all for years and then suddenly show up again to a severe extent. The episodic course of the disease is then of course also psychologically stressful for those affected. Eczema, because it has no infectious cause, not infectious and not transferable. However, they often go along stronger social impairment together because affected patients themselves be ashamed and people around them feel repulsed by ignorance. The most serious purely medical complication in relation to eczema of the foot is a subsequent superinfection of the burst vesicles with viruses and / or bacteria, which then requires particularly careful treatment. Under adequate Antibiotic therapy but also heals this without consequences.

How can you prevent eczema?

Especially people who frequently irritate the skin in exposed areas due to their work (e.g. through frequent washing, disinfecting, contact with strong cleaning agents or other chemicals) should ensure good skin protection and special work gloves. Regular creaming and greasing of the skin is recommended.
In addition, the water contact of sensitive skin should be kept as low as possible. In the case of an allergic cause of a known eczema, the most effective prophylaxis is consistent lifelong avoidance of the trigger. Caution is also advised with substances that have not yet triggered an allergic reaction in the person concerned, but which often do so. Those affected should ensure that they use high-quality cosmetics and care products that contain as few additives and preservatives as possible. If you have found products that are good for your own skin, it is advisable to stick with them if possible.