DermTV – Very Itchy Fingers, a.k.a. Dishydrosis [ Epi #396]

“Hello, I’m Dr. Neal Schultz [pause] And welcome to DermTV. This may be the season for itchy skin, but chances are if itu2019s your fingers that are itching, itu2019s not because theyu2019re dry. Most of the time, itchy fingers are caused by a condition called Dishydrosis and the itch it causes can really drive you crazy. And itu2019s not just itching that Dishydrosis causesu2026 You actually get little bumps on the bottom and sides of your fingers.

And the bumps are actually tiny blisters. Dishydrosis literally means, bad sweating, and it used to be thought that these crazily itchy bumps were filled with sweat. Thats why it was named Dishydrosis. But the fluid isn’t sweat i9s actually serum, which is the clear fluid in your blood. The most common cause of Dishydrosis is extreme stress, although not every outbreak can be linked directly to a stressful situation. On a personal note, I can tell you that Ive only experienced Dishydrosis once in my life. It was early in my medical training after a very stressful night of being up all night taking care of a lot of very sick patients. The next morning the hospital dermatologist was making rounds and I showed him my hands, and he said, “Boy you must have had a really rough night.” So… The itching and bumps both finally go away after a few days. As it gets better, there are these really interesting telltale little collars of dead flaky skin that peel off. Those tiny match-head size collars of dead skin get larger…

And then smaller… over a few days and are caused by the bubble of serum as it rises through the higher levels of the epidermis. Itu2019s like taking horizontal slices through a sphere starting tiny at the bottom, then getting larger, and finally smaller again. To treat the itching and bumps, topical cortisone creams and anti-itch lotions with menthol are best. If that doesn’t stop the itch, cold water can usually give temporary relief, but never try to stop the itching with hot water. Even though hot water feels good and stops the itch, it also causes the itch to come back worse a few minutes later. After the itch and bumps are gone, the flaking skin can continue for a week. It can be camouflaged with a moisturizer, but finally goes away by itself.

And donu2019t ever pull off the dead skin. That’s a great way to get an infection, and then you’ll have to visit your dermatologist!