Dyshidrotic Eczema: Causes, Symptoms, Treatments & Natural Remedies That Work in 2025

Have you ever dealt with stubborn, itchy blisters on your hands or feet that just won’t go away? You’re not alone. Dyshidrotic eczema—also known as pompholyx or vesicular eczema—is a lesser-known but deeply frustrating skin condition. Affecting around 5–20% of people with hand eczema, this chronic condition causes intense flare-ups of fluid-filled blisters that can disrupt daily life.

In this guide, we’ll explore what dyshidrotic eczema is, how to recognise its symptoms, what triggers dyshidrotic eczema flares, and the most effective ways to manage it in 2025, primarily focusing on natural remedies. You’ll also find helpful advice on supporting the skin barrier, reducing flare frequency, and maintaining healthy skin function.

What Is Dyshidrotic Eczema?

Dyshidrotic eczema is a chronic inflammatory skin condition marked by small, itchy blisters on the sides of the fingers, palms, soles, and toes. These dyshidrotic eczema blisters often appear in clusters and resemble tapioca pearls trapped beneath the skin. The affected areas may burn, tingle, or feel sore.

After the blisters heal, the skin can crack or peel, leading to secondary symptoms like scaly skin, discomfort, and even skin infection. Although dyshidrotic eczema is not contagious, its recurring nature makes it challenging to manage, especially in individuals with compromised immune systems or pre-existing skin conditions such as atopic dermatitis or palmar dermatitis.

Dyshidrotic eczema tends to follow a cyclical pattern, characterised by blistering, drying, peeling, and then recovery, over a few weeks. This form of hand eczema may occur independently or in conjunction with other types of eczema, such as contact dermatitis or palmoplantar eczema.

What Causes Dyshidrotic Eczema?

The cause of dyshidrotic eczema remains complex, with both genetic and environmental factors playing a role. Individuals with a history of eczema, hay fever, asthma, or allergic reactions are more susceptible due to an overactive immune system.

Possible causes of Dyshidrotic Eczema

From our clinical experience, these include:

• Poor/compromised gut health, such as gut microbial dysbiosis, inflammation and intestinal permeability (more on this below)
• Dietary factors: gluten, dairy, sugar, histamine-rich foods, fried and processed foods (See what foods to avoid to prevent eczema flare ups)
• Emotional stress or anxiety
• Excessive sweating (sweaty hands and feet) and/or poor hygiene
• Infections from pathogens such as bacterial/viral/fungal infections
• Chemical exposure, such as detergents and soaps (e.g., washing dishes frequently)
• Contact allergens: nickel, cobalt, fragrances, and preservatives
• Seasonal changes (especially warmer, humid months or cold weather)

In many cases, flare-ups occur when multiple triggers converge

Spotting a Flare

The earliest sign of a flare is often a tingling or burning sensation, followed by sudden itching and the appearance of small, fluid-filled blisters. These watery blisters commonly affect the hands and feet and may merge into large blisters in severe cases. Common symptoms include intense itching, pain, and cracking or peeling skin once blisters recover. Symptoms like itching tend to get worse at night.

The Gut–Skin Axis: How Digestive Health Affects Eczema

Many people with eczema are now exploring how their gut health might be influencing their skin. This connection—known as the gut–skin axis—has been the focus of growing research, revealing that the health of your digestive system can have a direct impact on inflammatory skin conditions, such as eczema.

1. Gut Microbiome Imbalance (Dysbiosis)

Your gut houses a complex ecosystem of trillions of bacteria that help regulate immune responses and inflammation. When this balance is disrupted—known as gut dysbiosis—it can lead to systemic inflammation, which may manifest as eczema or exacerbate existing symptoms.

Studies have found that individuals with eczema often have lower levels of beneficial bacteria, such as Lactobacillus and Bifidobacterium, compared to those without the condition [1]. This microbial imbalance can compromise the gut’s ability to regulate immune function, increasing the risk of chronic skin inflammation.

You can find out more about your gut health and how its ecology affects your skin, mental health, immunity, etc., with a simple BIOMA gut test. 

Learn more  – MyBioma Gut Test Kit. The test is available in our clinic.Reference: Petersen, E. B., et al. (2021). The role of the gut microbiome in atopic dermatitis: A systematic review. International Journal of Molecular Sciences.

2. Leaky Gut and Intestinal Permeability

A healthy gut lining forms a protective barrier that prevents harmful substances from entering the bloodstream. When this barrier is compromised—a condition known as leaky gut syndrome—undigested food particles, toxins, and bacteria can pass through, triggering immune reactions and systemic inflammation.

This immune activation can exacerbate eczema, particularly in individuals with an already overreactive immune system. Nutrients like zinc, glutamine, and collagen are often used to help restore mucosal integrity and reduce inflammatory skin responses.

Reference: de Punder, K., & Pruimboom, L. (2015). The dietary intake of wheat and other cereal grains and their role in inflammation. Nutrients.

3. Autoimmune-Like Responses and Immune Dysregulation

While eczema isn’t classified as an autoimmune disease, it involves immune system dysregulation, which can resemble autoimmune patterns. Poor gut health can disrupt immune signalling and increase the likelihood of the body attacking its tissues, including the skin.

The gut–immune connection plays a critical role in modulating inflammation and teaching the body to distinguish between harmful and harmless triggers. A healthy gut microbiome supports immune tolerance, which may help reduce eczema flare-ups over time.

Find how you can know about your gut flora – https://leaftolife.com.sg/product/mybioma-gut-test-kit-leaf-to-life/

Reference: Belkaid, Y., & Hand, T. W. (2014). Role of the microbiota in immunity and inflammation. Cell.

4. Inflammatory Foods That Trigger Gut and Skin Reactions

What you eat can have a direct impact on both your gut health and eczema symptoms. Common inflammatory foods, such as gluten, dairy, refined sugar, soy, and ultra-processed snacks, are known to damage the gut lining, feed harmful bacteria, and trigger immune responses. Our naturopath and medical herbalist can advise you on the foods that are commonly associated with allergies.

For many eczema sufferers, switching to an anti-inflammatory or elimination diet has provided noticeable relief from symptoms. Diets rich in whole foods, fibre, parent essential fatty acids, fermented vegetables, and polyphenols can help reduce both gut and skin inflammation.

Reference: Venter, C., et al. (2020). Role of diet in the prevention and management of atopic dermatitis. The Journal of Allergy and Clinical Immunology: In Practice.

How can Naturopathy and Herbal Medicine (Phytotherapy) Support Healing?

For optimal results, individuals require a comprehensive assessment and a tailored treatment plan.

Our Naturopathic Holistic Assessments

During the 1st consultation (45-60 minutes), our Naturopaths and Medical Herbalists will conduct a thorough case-taking and holistic assessment. This includes

• Examining presenting symptoms
• Noting any pertinent health/family history
• Assessment of the individual’s tissue state and constitution (tongue and pulse diagnosis)
• Review any medical reports.
• Any possible stress factors?
• Recommend any further testing as needed, such as EPI-MAPPING and Gut Bioma Analysis (available in the Sebastian Liew Centre).

Many people wonder how dyshidrotic eczema is diagnosed. Although there is no single definitive test, the combination of symptoms, triggers, and visual examination helps our Naturopaths assess all possible contributing factors and support the healing.

Naturopathic Treatment Plan

Following the consultation, our practitioners may advise and coach on various aspects of health that the individual can change. These may include:

• Dietary changes (see our Holistic Vitality Diet)
• Lifestyle modifications such as a healthy sleep routine, exercise, and nature time
• Learning how to manage stress

They will also come up with a customised treatment plan consisting of natural remedies, which may include remedies such as

• Phytolec+® to support the health inflammatory response
• Phyto-EFA for healthy plant-based omega-3s and 6s
• Phyto-GIH to heal the gut and treat the root cause
• Balanced Synbiotic for prebiotics, probiotics and gut health
• Spore Renew – also for creating an optimum environment for the growth of good bacteria
• PhytoXin® to support stress management.
• Customised Herbal Remedies for the skin: depending on the presenting skin condition, the Naturopath and Medical herbalist may blend on the spot either one or a combination of the following:
  • a moisturising and non-steroidal herbal cream for dry eczema
  • a herbal oil to apply to dehydrated skin
  • a herbal spray for eczema that is oozing fluid, and to promote healing of open wounds

Examples of Western herbs that a Naturopath and Medical Herbalist may incorporate into the above are German chamomile, Liquorice, St. John’s wort, and Cleavers.

It is not advisable to self-medicate with health supplements without professional supervision by a qualified and experienced naturopath or herbalist (view supplement options for guidance)

To know more about Phytotherapy and how it can help you, visit this link.

Preventing Dyshidrotic Eczema Flares

To help prevent dyshidrotic eczema, it’s essential to reduce exposure to triggers and adopt consistent skin-supportive habits:

• Use fragrance-free, hypoallergenic skincare (such as our customised herbal creams and Eco-Soap bars)
• Wear protective gloves (e.g., cotton gloves) when washing/cleaning or gardening
• Apply cool compresses during itchy episodes
• Avoid sudden temperature shifts, prolonged sun exposure or excessive sweating
• Manage stress through relaxation, exercise, or counselling
• Maintain skin moisture with natural moisturisers like our herbal creams, oils and balms
• Keep wounds sterile – use a sterile dressing to cover up open wounds or oozing patches
• Prevent scratching with nails as much as possible by dressing open wounds well, trimming nails, using ice packs to numb itchy areas, and applying our herbal creams or sprays whenever you feel itchy.

Lifestyle Tips for Managing Dyshidrotic Eczema

Managing dyshidrotic eczema goes beyond physical symptoms—it also includes mental well-being. Stress and anxiety can worsen skin flare-ups.

Self-Care and Support:

• Maintain a regular skincare routine, such as applying herbal remedies at least 3x/day and before bed
• Prioritise rest and emotional balance
• Avoid scratching to lower the risk of secondary irritation (see the above)
• Keep hands and feet clean and dry
• Use wearable cotton gloves overnight to retain moisture

Engaging with healthcare professionals and support communities can offer emotional reassurance and practical advice.

Conclusion

Managing dyshidrotic eczema requires patience, consistency, and collaboration with your healthcare provider. While no single approach suits all, adopting a holistic and natural approach can be highly beneficial for various skin conditions.

From managing dyshidrotic eczema symptoms to protecting the skin barrier and understanding common triggers, many tools support your comfort. Relief is possible—and so is feeling more confident in your skin.

Disclaimer: Leaf to Life® products are not intended to diagnose, treat, cure, or prevent any disease. Content on this website is for general informational purposes only and is not medical advice or a substitute for a healthy lifestyle or professional care.

Always inform your primary healthcare provider about any supplements or complementary medicines you use. For personalised guidance, consult a qualified naturopath or medical herbalist.