5d • General discussions
Dyshidrotic Eczema (Pompholyx) or Interdigital Dermatitis
Today, my cousin came to my house, and I noticed she was constantly scratching between the fingers of her hands to the point they were very red.
I asked her whats happening.
She told me that she has had this itchy feeling between her fingers for the past few hours.
I asked her if she wouldn't mind me taking a look, which she was fine with me doing so.
I donned a pair of latex gloves and inspected her hands.
Her hands were not only very dry, with white, peeling skin, but the insides of her fingers were red, with tiny-looking blisters, some of which looked to have burst, with fluid, as well as small cuts.
My cousin works in an aged care facility's kitchen, where she is constantly washing dishes, having to sanitize her hands, and wearing gloves.
My immediate thought was that this is Dyshidrotic Eczema (Pompholyx) or possibly Contact Dermatitis, also known as hand eczema. As it was located specifically between the fingers, this type of contact dermatitis is specifically called Interdigital Dermatitis, as it refers to inflammation occurring in the webs of skin between the fingers.
Remember, as Aromatherapists, we do not diagnose, but we can make an educated guess based on our knowledge.
Dyshidrotic Eczema (Pompholyx): Causes tiny, deep, fluid-filled blisters that look like small bumps or tapioca grains. They are intensely itchy and can be triggered by stress, sweating, or contact with metals like nickel.
Contact Dermatitis: An allergic reaction or irritation from soaps, cleaning supplies, lotions, or jewelry. It causes a red, bumpy, itchy rash in the exact areas that touched the irritant.
What Not to Do:
I asked my cousin if she has been applying anything to her hands, and she said she was using a moisturizer. I asked her what kind, and she had it in her purse, and it was one of those drugstore brands with a heavy fragrance.
With this skin condition, you shouldn't be using ANY fragrance-based product on the skin, which also includes most essential oils, as this can cause more issues than anything. Essential oils, by their very nature, are drying, with some of them, like Eucalyptus or the Citruses, being skin penetrating enhancers.
You also want to avoid the use of scented or harsh soaps when you have this skin condition. In fact, if needing to wash hands, mild, unscented soap-free cleansers are your best option, and when washing dishes, clean gloves should be worn.
Never scratch or pop the area, as you could break the skin and increase the risk of secondary bacterial infection.
My Treatment Protocol:
I first got a large, deep stainless steel bowl and poured very cold water from my refrigerator into it. I added to this 50mls of German Chamomile Hydrosol (which I keep in my fridge).
I had my cousin place her hands into this very cold water so that the water reached past her wrists.
I got her to keep her hands in the water for about 1 minute before taking them out for 1 minute, putting them back in, taking them out, etc. She continued to do this until the water wasn't as cold.
Cold water soothes contact dermatitis by instantly numbing nerve endings and interrupting the itch-scratch cycle. The cold temperature naturally constricts blood vessels, which reduces local blood flow, swelling, and redness. It also provides temporary relief from burning sensations without stripping the skin of protective lipids as hot water does.
I gave her a clean, dry towel to pat dry her hands, and then I grabbed some brand new sterile gauze, which I soaked in pure Chamomile Hydrosol, which was then placed between her fingers for 10 minutes.
Afterwards, I mixed up a 200g jar with a good natural and unscented Water Cream.
Water cream works by acting as an artificial barrier to lock in moisture, soothe inflammation, and protect damaged skin from further irritants. They relieve contact dermatitis through targeted hydration, physical protection, and cooling.
To this water cream, I added 0.5% of German Chamomile essential oil, which is roughly 20 drops or 1ml per 200g of water cream.
I only added the German Chamomile essential oil after asking my cousin if she has any sensitivities to chamomile, ragweed, or any plant in the Asteraceae family, as between 1-2% of the population have allergic reactions to chamomile, with 3.4% having a skin reaction to it when applied to contact dermatitis skin.
If you are already allergic to ragweed or have a history of ragweed-induced hay fever, up to 14% of these individuals may experience chamomile sensitivity.
If this is the case or it's unknown, either leave out the Chamomile essential oil or do a small patch test first.
The reason why I used German Chamomile Hydrosol and its essential oil.
Not only did I have them in my kit, but I also traditionally, when people have contact dermatitis, doctors will commonly recommend the use of over-the-counter hydrocortisone cream, usually starting at a low dose of 1%, or the use of calamine lotion.
Hydrocortisone is used because it reduces inflammation, redness, and swelling.
German Chamomile and even Roman Chamomile are not only great anti-inflammatories and cooling similar to Hydrocortisone, it is also antihistamines.
An antihistamine is used to help manage the itching aspect of contact dermatitis
German Chamomile works because of its high a-bisabolol, Chamazulene, and (E)-b-farnesene, which inhibit the release of histamines from mast cells and reduce inflammation. This makes them useful for soothing allergic reactions, nasal inflammation, and itchy skin, and greatly helps alleviate the resulting itch-scratch cycle.
Chamazulene and alpha-bisabolol penetrate deeply into the skin layers to calm inflammation and reduce redness.
Research indicates that chamomile volatile oils inhibit pathways like NF-κB, suppressing pro-inflammatory cytokines such as TNF-alpha and IL-6.
Though it is still early, my cousin felt immediate relief when doing this protocol, which I told her to repeat the cold water bath (I gave her 200ml of hydrosol) every 3 hours and to apply the water cream often.
Safety & Contraindications:
- Generally non-toxic, non-irritating unless oxidized.
- Generally considered safe, even for babies when kept diluted well.
- The Hydrosol is considered 100% safe with no contraindications.
- However, essential oils containing farnesene and alpha-bisabolol inhibit some metabolizing enzymes (CYP2D6) and could potentiate the actions of some antidepressants such as quinidine, fluoxetine, and paroxetine, though this is more likely to be an issue with the internal usage of chamomile.
- Used topically or orally, German Chamomile could also have drug interactions with codeine and tamoxifen.
- Can trigger underlying allergies in some. 1-2% of the population have allergic reactions to chamomile, with 3.4% having a skin reaction to it when applied to contact dermatitis skin, and 20% - 30% of those with ragweed allergies will react/be sensitive to chamomile.
- Not to be used during any stage of pregnancy if there has been a history of miscarriage or breakthrough bleeding.
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Dyshidrotic Eczema (Pompholyx) or Interdigital Dermatitis
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