Blisters on your hands and feet? How to deal with the most common sweat herpes in summer? Doctor's detailed answer
Small blisters develop on the hands or feet, accompanied by an itching sensation and constant urge to scratch. Not only is it painful to scratch the skin, but the skin may also become thicker and rougher, which not only affects the appearance but is also very disturbing. It is very likely that It's sweat herpes that's to blame.
Mrs. Chen recently discovered that several small blisters appeared on the side of the index finger and middle finger of her right hand, which caused itching. A few days later, small blisters also appeared on the palm of her left hand. The more she scratched, the more itchy she was. Some of the blisters dried up. Later, small circles of peeling formed, so I went to see a dermatologist to confirm that it was sweat herpes.
Recurrent eczema disease
Huang Yuhui, an assistant professor-level attending physician at Taipei Linkou Chang Gung Memorial Hospital, said that dyshidrosis is an eczema-like change that occurs on the hands or feet. During an attack, the patient Small, scattered or clustered blisters like sago will appear on the palms of the hands, soles of the feet, and the sides of the fingers or toes. This is a recurring eczema disease.
In the acute phase, sweat herpes is often accompanied by itchy blisters. These blisters will be relieved and eliminated after treatment, but they will still relapse. Some blisters will naturally absorb, dry up, and peel. But be careful, if you can't stand the itching and scratch the blisters, it is likely to cause bacterial infection and even develop into cellulitis.
When sweat herpes occurs repeatedly and enters the chronic phase, the lesions will appear red plaques, thickening, rough surface lichenification, and even painful cracks on the skin. .
Zhu Jianhe, an attending physician at the Department of Dermatology at Hsinchu Cathay Hospital, said that sweat herpes is an eczema disease that tends to occur when the seasons change, especially when spring turns to summer. According to statistics, 70% of symptoms appear in the hands, 10% in the feet, and 20% in the hands and feet at the same time. The prevalence rate is about 0.05 to 10%. Due to the hot and humid weather in Taiwan, there are quite a lot of patients.
9 causes of sweat herpes
Zhu Jianhe said that the English name of sweat herpes is dyshidrotic eczema or pompholyx, because most of the lesions of sweat herpes are in the eccrine sweat ducts. , at first the medical community thought it was caused by abnormalities or disorders of the eccrine glands, but further research found that sweat herpes has nothing to do with abnormalities in the eccrine glands, and a more appropriate name should be "acute recurrent vesicular hand eczema". There are many theories about the causes of sweat herpes, and the related factors are roughly as follows:
1. Constitution: Innate physical factors.
2. Stress: It occurs especially when the pressure is high.
3. Staying up late or having abnormal work and rest schedules.
4. Climate or seasonal changes: It is more likely to occur when seasons change, temperature or climate changes. Spring and summer are also seasons where the disease is more likely to occur.
5 Hyperhidrosis: Studies have found that hyperhidrosis is more common in patients, especially those with sweaty hands and feet. About 7.5 to 33.3% of patients with dyshidrotic herpes also have hyperhidrosis. trouble.
6 Smoking: Smoking is a worsening factor of sweat herpes.
7 Fungal infection: About 10% of patients with sweat herpes may have potential fungal infections, such as athlete's foot. When patients with sweat herpes have recurring attacks, it is recommended to check whether they have athlete's foot, because when When immune cells attack athlete's foot mold, they may induce an "auto-sensitive eczema reaction", which may make sweat herpes easy to recur.
8 Atopic dermatitis constitution: People who have had atopic dermatitis in childhood are more likely to develop sweating herpes when they grow up.
9 Contact allergy: Especially contact or ingestion of heavy metals such as nickel, cobalt, chromium, etc. These heavy metals are commonly found in soil, as well as canned food, cocoa, chocolate, nuts, oats, and beans. .....In food, there are also necklaces, glasses, earrings and other accessories containing metal. In addition, substances such as fragrances and preservatives may also induce sweat herpes.
Use topical steroid ointments, don’t worry about side effects
Huang Yuhui said that the treatment of sweat herpes is mainly to apply steroid ointments. If the situation is more serious, it can be combined with oral antihistamines to relieve itching. medications, or give a brief course of oral steroids. Generally, oral steroids are used in low doses and for a short period of time. As long as they are used in accordance with the doctor's instructions, there is no need to worry too much about side effects.
Zhu Jianhe also pointed out that applying topical steroid ointments is the most important way to treat sweat herpes. Many people have misconceptions about steroid drugs. In fact, they are safe as long as they are used under the supervision of a doctor. Yu's. Side effects of steroid creams are thinning of the skin, dilation of blood vessels, and possible secondary bacterial and fungal infections. However, the cuticles on the finger sides and palms are relatively thick, and the side effects are not obvious. Unless you use it in large quantities for a long time, you don’t need to worry. If the patient is really worried or has special circumstances, he or she can use non-steroidal ointments, but currently health insurance does not cover the treatment of sweat herpes.
When the condition of sweat herpes is severe, oral steroids are recommended. Zhu Jianhe said that oral steroids will have obvious side effects only if they are used continuously for more than 3 to 4 weeks. It only takes one week, so side effects such as obvious immune suppression, moon face, and buffalo shoulders that patients worry about will basically not occur.
If the situation is still difficult to control, you can consider using immunosuppressive drugs. These drugs are mainly used for patients with rheumatic immune diseases. They are also effective for severe sweat herpes. They are relatively late-line treatments and will increase side effects. burden on liver and kidney function.
Light therapy is another treatment option
"Light therapy" is another option. Zhu Jianhe said that light therapy uses ultraviolet light of a specific wavelength to irradiate the affected area. , to achieve the effect of anti-inflammatory on the skin. There are also case reports abroad that point out that ultraviolet rays in the sun also have certain curative effects. For example, when the sun is strong at noon, you can bask in the palms and soles of your feet for 12 minutes, lasting 10 to 15 times. For some patients with sweat herpes, it has an inhibitory effect. effect.
However, some patients may have symptoms that become more serious. Therefore, Zhu Jianhe suggested that if you feel counterproductive after sunbathing for a few days, you should not continue to do it; and it is recommended that other parts of the body should still wear sunscreen. , to avoid sunburn, the gain outweighs the loss.
If you are a patient with hyperhidrosis and also have sweat herpes, it is recommended to treat the hyperhidrosis first. You can use "ion electrophoresis" or "botulinum toxin injection". After the hyperhidrosis is treated, Clinically, it has been found to have a certain effect on improving sweat herpes.
Sweat herpes in the chronic phase will become more difficult to treat due to thick skin, repeated itching and scaling. Zhu Jianhe suggested that once the disease becomes chronic, "sealed therapy" can be used, that is, after applying steroid ointment, put on gloves or cover it with plastic wrap for 5 to 10 minutes. In a closed and humid environment, it will help to cure the disease. Improve efficacy.
Comprehensive prevention of sweat herpes
Sweat herpes is a skin disease that is difficult to eradicate and can only be prevented based on the "possible" causes. Zhu Jianhe said that because some patients with sweat herpes are exposed to allergic substances, such as common heavy metals such as nickel, cobalt, and chromium, especially nickel, they can take a trace amount of "nickel sulfate" orally to see if it will induce Sweat herpes outbreak; or through "skin test", 20 to 30 kinds of allergens are applied to the back, and the patient returns to the hospital on the 2nd, 4th and 7th day for allergen analysis.
Once contact allergies are confirmed to be the cause of sweat herpes, these sources should be avoided. For example, people who are allergic to nickel should eat less canned food, chocolate, cocoa, nuts, oats and beans, and wear less earrings and necklaces with unknown metal content.
You should also pay attention to your daily life. Huang Yuhui recommends that your hands should be exposed to water and detergent as little as possible, and you should wear gloves when doing housework; your feet should be kept ventilated and cool, and you should apply lotion appropriately to help the skin repair. But if the disease occurs, to suppress the inflammatory response, drug treatment is still needed to be effective.
Zhu Jianhe suggested that timely release of stress, maintaining exercise habits and emotional calm, and normal work and rest can help reduce the recurrence of sweat herpes. He also reminded that if there are abnormal small blisters on the skin, it is best to seek medical examination, especially "hemorrhagic blisters", which may not just be simple sweat herpes, but may be autologous "cutaneous lymphoma" or "pemphigoid" For immune diseases, skin biopsy must be done to make a clear differential diagnosis and then treat the symptoms accordingly, otherwise the condition will be delayed.
Is sweating herpes related to sweating?
Although sweat herpes has the word "sweat", the cause is not directly related to abnormal sweat glands or sweating. Zhu Jianhe pointed out that some patients will suffer from hyperhidrosis of the hands and feet, but it has nothing to do with the sweating itself. However, there are more eccrine glands in the hands and feet. It may be due to eating allergic substances. The allergic substances are excreted from the eccrine glands in the hands and feet and come into contact with the skin of the hands and feet. What causes sweat herpes is not caused by abnormal sweat or sweat glands, but only indirectly causes the disease.
In addition to medicine, you should also pay attention to your daily life!
Huang Yuhui said that in addition to using topical or oral medications, in daily life, you should also pay attention to touching less water and washing your hands less frequently. Try not to use cleaning products frequently on the affected skin, and wear gloves to protect your hands in a timely manner. Moderate use of hand lotion and hand cream can help maintain and repair the skin.
How to distinguish between sweat herpes and athlete’s foot?
Like sweat herpes, athlete's foot may also cause blisters. The clinical manifestations are difficult to distinguish. Even dermatologists have difficulty in completely distinguishing them with the naked eye. However, there are good tools that can detect the lesions from Scrape off the skin flakes and go under a microscope to see if there is mold. If there is mold, it is athlete's foot. It is also possible that athlete's foot and sweat herpes coexist at the same time. The two diseases are very different in terms of medication. Antifungal drugs are required for athlete's foot, while steroids are used to treat herpes. If the wrong medicine is used, it will be ineffective.
Content source: Changchun Monthly Issue 424