Hand Eczema

Q:  Aside from dry skin all over my body. The main place I get eczema is on my hands. When I have a flare up it seems to start with small (1-2 centimeter), clear-fluid, blister-type bubbles on my hands. The bubbles pop, the skin underneath is exposed, and the eczema starts. It takes about 7 to 10 days to heal—sometimes more, sometimes less. This depends on how much care I give it. That clear fluid blister that formed comes from something inside my body. Can you help me understand this? What is that clear fluid? I think it may be histamine. What causes it to come out on my hands? And how can I prevent it?

A:  The fluid is serum, which comes in when the skin is inflamed and forms the tiny blisters (eczema is from the Greek word “to boil over or effervesce”). The inflammation must be stopped quickly using potent topical steroids applied to wet, hydrated skin. Hand dermatitis is the hardest of all the eczemas to treat. If it is caused by a contact allergy, dermatologists can do patch tests to detect the offending chemicals.