I have blisters on my hands. I don’t have poison ivy or oak. It’s not any kind of mite. I don’t know what it is. No other symptoms involved. I carry the herpes virus and haven’t had any outbreaks. This happenened last summer too. It goes away, but lasts for a long time, and is annoying. I’ve been to the doctor, but I am frustrated with no correct or effective diagnosis. Any ideas?
Although I can’t make a diagnosis without seeing the skin problem myself, from your description, this sounds most like dyshidrosis, also called pompholyx. It usually consists of deep small vesicles (small blisters) on the palms of the hands, soles of the feet, and along the edges of the fingers. In severe cases vesicles may come together, producing larger blister-like bumps.
The cause of dyshidrosis is not known. It is very common, and many people have an occasional mild outbreak. The vesicles, when they have dried and come to the skin surface, leave the little round scaling spots that we often get on our hands. The vesicles can itch, and scratching them produces an unpleasant sensation, not like the pleasure one can get from scratching a mosquito bite for instance.
I had always thought that dyshidrosis was caused by a malfunction of the sweat glands in the areas described, since the vesicles contain a clear fluid like sweat, and the condition is more common in the summer when one is sweating more. However, the expert opinion now is that this is not a disorder caused by sweating, although the cause is still not known. In my limited experience, it is more common in younger people, and infrequent in people over 50. I had dyshidrosis myself for quite a few years during my 20s and 30s, but have not had an outbreak since then.
Dyshidrosis is treated with cortisone-type creams or ointments. In mild cases, if any treatment at all is necessary, the one percent hydrocortisone cream that is available without a prescription may be sufficient. A more severe case, such as you have described, will probably require a stronger cream or an ointment. Ointments are generally more effective than creams of the same strength, but the greasiness of ointments makes them unacceptable for many people. If a strong cortisone cream doesn’t reduce the vesicles, wearing plastic gloves through the night after applying the cream or ointment to the affected areas will improve the activity of the medicine.
Although you mention having herpes, and herpes can affect the fingers as it can any part of the skin surface, I would doubt that what you describe is a herpes outbreak. They are usually localized in a fairly small area, the blisters break quickly leaving a patch of little ulcers, and an outbreak typically lasts five to seven days, and then heals by itself. The most common site of herpes outbreaks on the fingers is at the base of the nail, where the virus gets into the skin through breaks in the cuticle. Since 80 percent of us carry herpes in our mouths, it is surprising that we don’t see more on the fingers, given that lots of people chew at their nails and cuticles.
Your doctor may not have recognized the symptoms of dyshidrosis. I would suggest that you see your physician again — ask if the outbreak could be dyshidrosis, and if you could have a strong cortisone cream to treat it. If your doctor doesn’t agree with the diagnosis, or still doesn’t recognize it, then a referral to a dermatologist would be in order.