You notice bumps on your hands or feet. They itch or hurt, and you probably want to know what they are right away so you can treat them. Are they symptoms of dyshidrotic eczema, or are they warts?

Although only a healthcare provider can make a clear diagnosis, there are ways to tell the difference between dyshidrotic eczema and warts. These two skin conditions can look alike at first, but they have different causes — and need different treatments.

What Is Dyshidrotic Eczema?

Dyshidrotic eczema is a type of eczema that affects the palms of the hands, soles of your feet, and sides of the fingers and toes. It’s most common in people aged 20 to 40, and according to Cleveland Clinic, females are most likely to develop it.

A dyshidrotic eczema flare often starts with small blisters, filled with fluid, that may look like little bubbles. That’s why the condition is also called “pompholyx,” a Greek word that means “bubbles.” These blisters can itch, burn, sting, and feel painful or scaly. As they heal, the skin underneath may crack or become discolored, appearing red or pink on lighter skin tones and purple, gray, or darker brown on deeper skin tones.

“My hands are still sore and splitting,” one MyEczemaTeam member described.

What Causes Dyshidrotic Eczema?

Dyshidrotic eczema is an inflammatory condition that stems from an overactive immune system response. Flare-ups (periods when symptoms appear or get worse) are often triggered by something in your environment or lifestyle.

Researchers suspect that around half of dyshidrotic eczema cases result from exposure to an allergen — a substance that causes an allergic reaction — through direct skin contact. Common examples include metals like nickel and cobalt, or household products like laundry detergent.

Other triggers can include:

• Stress
• Heat and humidity
• Sweat on the palms or feet
• Seasonal allergies (like hay fever)
• On-the-job exposures, especially in industries like metalworking, construction, or hairstyling
• Certain medications (e.g. aspirin, oral contraceptives, or intravenous immunoglobulin)
• Tobacco use

Some fungal skin infections, including tinea pedis (athlete’s foot), can trigger dyshidrotic eczema. In addition, dyshidrotic eczema can mimic athlete’s foot.

Determining what sets off your flare-ups can be helpful. As one MyEczemaTeam member said, “Get a list of triggers. I have decreased my exposure, and my outbreaks are better.”

How Is Dyshidrotic Eczema Treated?

Treatment for dyshidrotic eczema often includes at-home skin care. Using cool or lukewarm water to wash the affected areas can help relieve discomfort. Cool compresses or short soaks may also reduce itching and inflammation.

“I find running cold water and keeping your hands under it helps. It cools the skin,” said one member.

After washing or soaking your hands or feet, gently pat them dry — and, if possible, leave the skin uncovered to air out. Apply a fragrance-free, rich moisturizer right away to help restore your skin’s barrier and prevent dryness, which can make symptoms worse.

To avoid irritating the skin on your feet, try loose-fitting footwear, such as flip-flops or sandals. If you wear socks, choose soft, breathable materials like cotton. Some people find merino wool helpful, but wool may trigger eczema symptoms in others — so be mindful of how your skin reacts.

Other treatment options include over-the-counter topical corticosteroid treatments and oral antihistamines, which help ease the itching and discoloration associated with dyshidrotic eczema. Medium- to high-potency topical corticosteroids are the main treatment for dyshidrotic eczema. For more severe cases, a dermatologist might suggest stronger steroids, immunosuppressants, or phototherapy (ultraviolet light). Topical calcineurin inhibitors (TCIs) can be used in place of steroids, especially for sensitive skin. Your dermatologist might prescribe short-term oral steroids for severe blisters. They may recommend phototherapy if your dyshidrotic eczema doesn’t respond to other treatments or is particularly long-lasting.

In recent years, some dermatologists have prescribed dupilumab or Janus kinase (JAK) inhibitors off-label for dyshidrotic eczema that’s severe or doesn’t respond well to other treatments. In some regions, the oral medication alitretinoin is approved to treat hand eczema, including dyshidrotic eczema.

Alongside medications, your dermatologist might recommend supportive therapies like potassium permanganate soaks to reduce dyshidrotic eczema blisters. They may also drain larger blisters, but you shouldn’t try to pop a dyshidrotic eczema blister on your own.

Patch testing and fungal cultures can guide treatment by helping you learn more about your dyshidrotic eczema, especially in areas where it flares up often.

What Are Warts?

Common warts are round, rough bumps that often develop where the skin is broken, such as near a bitten fingernail or a picked hangnail. Warts often develop on the hands and feet but, unlike dyshidrotic eczema blisters, can appear on other parts of the body.

Whereas dyshidrotic eczema appears on the palms, warts usually develop on the fingers, around the nails, and on the backs of the hands. In addition, warts on the hands — called common warts — look different from dyshidrotic eczema symptoms.

Warts that appear on the soles of the feet are also quite different from dyshidrotic eczema. Called plantar warts, they’re often flat or grow inward due to pressure from being walked on.

What Causes Warts?

Warts result from a human papillomavirus (HPV) infection. Because they’re caused by a virus, they can be contagious.

In contrast, dyshidrotic eczema stems from the immune system and can’t be spread to other people. Anyone can get warts, although they’re more likely to affect children, teens, and people with weakened immune systems.

How Are Warts Treated?

There’s no cure for an HPV infection, but warts may go away on their own as the immune system clears the virus. If they don’t, a dermatologist can freeze or burn them away or remove them chemically. Stubborn warts can be treated with lasers, medication injections, or immunotherapy.

Warts are usually benign (harmless). However, you should speak with your dermatologist or healthcare provider if you have one that:

• Becomes painful
• Undergoes changes in color or appearance
• Becomes a nuisance
• Keeps returning over time

Can Eczema Cause Warts?

Although warts and dyshidrotic eczema are different conditions, there’s a link between the two. Because eczema can cause breaks and wounds in the skin, skin affected by eczema can be more vulnerable to HPV — and therefore, to warts. Talk to your doctor for information about how to control your eczema to reduce the chances of getting warts.

Talk With Others Who Understand

On MyEczemaTeam, the social network for people with eczema and their loved ones, members come together to ask questions, give advice, and share their stories with others who understand life with eczema.

Have you had dyshidrotic eczema outbreaks or warts? How did you treat them? Share your experience in the comments, post to your Activities page, or connect with others in Groups.