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Dr. Chrysoula I. Liakou MD, PhD
- Treated online: Yes, usually. Photo and video assessment, prescription when appropriate.
- Pompholyx (dyshidrotic eczema) causes crops of intensely itchy small blisters on the palms, fingers and soles; short courses of potent steroid creams are the usual first treatment.[1]
- Pompholyx is a form of eczema, not an infection, so it cannot be passed on by touch or shared towels.
- Leave blisters intact; the blister roof is the best dressing there is, and piercing it invites infection.
- Call 112 immediately for widespread blistering with mouth or eye involvement, facial swelling, difficulty breathing, or fever with confusion or rapid breathing.
Get in-person care instead if the blistered skin is weeping pus, crusting golden, increasingly painful or spreading hot redness up the hand or foot, especially with fever: infected pompholyx can escalate. Sudden widespread blistering beyond the hands and feet, blisters in the mouth, or blistering after starting a new medicine also need in-person assessment the same day.
Can an online doctor treat pompholyx?
Usually, yes. Pompholyx is visually distinctive: crops of small, deep-seated, intensely itchy blisters on the palms, sides of the fingers or soles. Clear photos plus a video consultation can often provide enough information to confirm it and prescribe treatment at the right strength. Infected, unusually severe or diagnostically unclear cases need in-person care, and prescribing rules vary by country.
It is also a condition where under-treatment is the norm. The skin of the palms and soles is the thickest on the body, so the mild hydrocortisone people buy first rarely touches it, and weeks of half-working cream erode confidence that anything works at all. A consultation with Mobi Doctor, an online healthcare service with licensed doctors, gets the strength and the plan right from the start.
How an online consultation helps with pompholyx
? Take daylight close-ups with the blisters in sharp focus: the sides of your fingers, the palm, and the soles if affected, plus one wider shot of both hands. Photograph early, because pompholyx changes stage: fresh blisters look different from the peeling, cracking phase that follows, and both stages inform the plan. Our guide to photographing a skin problem for an online doctor shows how to get usable close-ups.
? Take daylight close-ups with the blisters in sharp focus: the sides of your fingers, the palm, and the soles if affected, plus one wider shot of both hands. Photograph early, because pompholyx changes stage: fresh blisters look different from the peeling, cracking phase that follows, and both stages inform the plan. Our guide to photographing a skin problem for an online doctor shows how to get usable close-ups.
deep small blisters along the sides of the fingers and on palms or soles are exactly what a sharp close-up shows, and the pattern separates pompholyx from its look-alikes.
palm and sole skin usually needs a potent steroid, used properly for a short course, not a mild cream used timidly for months. The doctor explains the strength, the duration and the exit plan.
sweat, heat, stress, wet work, nickel contact and fungal foot infections all feed pompholyx. The consultation hunts your likely drivers instead of shrugging at bad luck.
blistered, cracked skin on working hands is a door for bacteria. You learn precisely which changes mean infection and what to do the same day.
What the doctor checks in an online pompholyx consultation
The assessment is built around confirming the diagnosis and finding what is driving the flares. The doctor will typically assess:
- The blisters themselves: size, depth and position, because small deep blisters on the sides of the fingers, palms and soles are the signature of pompholyx.[2]
- The stage: fresh crops, merging blisters, or the later peeling and painful cracking, which need different care.
- The rhythm: one-off flare or repeated crops, and whether they track heat, summer, stressful periods or particular work.
- Your feet, even if the problem is your hands: a fungal foot infection can drive blistering on the hands (an id reaction), and treating the feet is then part of curing the hands.[1]
- Contact with water and irritants: wet work, frequent hand washing, gloves worn for long shifts, solvents and soaps, the classic occupational load of nurses, hairdressers, cleaners, mechanics and kitchen staff.
- Nickel and cobalt exposure: jewellery, keys, coins, tools and some occupational materials, because metal allergy is a recognised trigger in some people.[2][4]
- What you have already used: which steroid, what strength, how long and how applied, since "treatment failure" is often a strength or duration problem rather than a wrong diagnosis.
- Infection signs: weeping, golden crusts, pus, spreading redness or pain out of proportion.
What does pompholyx look like?
Pompholyx starts with burning or intense itching, then crops of small, deep-seated, fluid-filled blisters, often compared to tapioca pearls, appear on the palms, the sides of the fingers or the soles. The blisters sit under thick skin, so they feel firm, resist bursting and are often maddeningly itchy rather than painful at first.[2]
The typical cycle of a flare
Over 2–3 weeks the blisters gradually dry and the skin peels, sometimes leaving tender, cracked, red areas that hurt more than the blisters did, particularly across finger creases and pressure points of the sole. Then the skin recovers, until, for many people, the next crop arrives. Doctors call the same condition dyshidrotic eczema or vesicular hand eczema; it is a form of eczema, it is not contagious, and scratching does not spread it, though it does invite infection.
Who gets it and why
Pompholyx most often starts in adults under 40 and is more troublesome in warm months. There is no single cause; instead a set of recognised triggers stack up: sweating and heat, emotional stress, prolonged contact with water and detergents, nickel or cobalt allergy, and fungal infection elsewhere, usually the feet.[1] Part of the consultation is working out which of those apply to you, because each one you can act on lowers the frequency of flares.
Is it pompholyx or something else?
Blistered, itchy hands and feet have several causes worth separating. Ordinary eczema tends to be dry, red and cracked rather than studded with deep blisters, and often lives in the elbow and knee creases too. A fungal infection usually scales and spreads at the edges, classically affecting both feet and just one hand, and needs antifungal rather than steroid treatment. Intense night itch with tiny bumps in the finger webs, and itchy people in your household, points to scabies rather than pompholyx. Yellowish pustules rather than clear blisters, above all in a smoker, suggest palmoplantar pustulosis, which belongs with a dermatologist. The close-up photos usually settle it, and honest uncertainty is itself an answer: when the picture does not fit, the doctor says so and arranges skin scrapings or in-person review instead of guessing.
Which pompholyx treatment might the doctor recommend?
Pompholyx treatment follows the stage and severity of the flare and what is driving it. This is the framework our doctors use, aligned with the cited guidance:[1]
Swipe sideways to compare →
| Presentation | Likely first step | Suitable for online care? | When referral or in-person care is needed |
|---|---|---|---|
| First or mild crop of itchy blisters on palms, fingers or soles | A potent topical steroid for a short defined course, plus generous emollients | Usually yes | Not settling after two weeks of correct treatment, or the diagnosis is unclear |
| Recurrent crops with an identifiable trigger pattern (sweat, wet work, nickel) | Treat the flare and build a trigger plan; consider patch-testing referral for suspected metal allergy | Usually yes | Patch testing for contact allergy is done in person |
| Weeping, crusting or increasingly painful blisters | Assessment for secondary infection; antibiotics only when there are signs of bacterial infection | Often yes | Spreading hot redness, fever or feeling unwell: same-day in-person care |
| Severe blistering making gripping or walking impossible | Potent or very potent treatment, sometimes a short oral steroid course, and early dermatology involvement | Case-dependent | Severe or repeatedly disabling flares merit dermatology referral |
| Blistering on one hand with scaly feet | Check for a fungal driver before steroids; antifungal treatment if confirmed | Assessment yes | Skin scrapings to confirm fungus are taken in person |
Availability of individual medicines and who may prescribe them vary by country; your doctor confirms what applies where you are.
Not sure which row fits your hands or feet? A doctor can tell you in one consultation. €47, exact price shown before payment.
See available times →Treatment options for pompholyx (dyshidrotic eczema)
What you can do yourself
Leave the blisters intact: the roof of a blister is the best dressing there is, and piercing it invites infection. Cool compresses calm the itch, and a plain, greasy emollient used several times a day, and always after water, supports the skin through the peeling phase. Cut the water burden where you can: lukewarm washing, pat dry between fingers, cotton gloves under waterproof ones for wet work, and a change of socks whenever feet get sweaty. If nickel is your suspected trigger, an honest audit of daily metal contact (keys, coins, tools, jewellery) is worth an afternoon. Pharmacy hydrocortisone 1% is usually too weak for palm and sole skin, which is not a reason to double up on it but a reason to get the right strength prescribed.[1]
Prescription treatment
A prescription is never issued without a consultation. After assessment, first-line pompholyx treatment is usually a potent topical corticosteroid for a short, defined course, long enough to clear the flare and short enough to keep thin-skinned areas safe; the doctor is explicit about where to apply it, for how long, and when to stop or step down.[1] Weeping blisters may earn drying soaks first, and a confirmed fungal driver is treated with antifungals, not more steroid. A sedating antihistamine for a few nights can rescue sleep while the itch peaks. Secondary bacterial infection is treated with antibiotics only when there are actual signs of it, such as spreading redness, pus or crusting; antibiotics do nothing for sterile blisters. For severe or constantly relapsing pompholyx, options such as short oral steroid courses, phototherapy or specialist tablets exist through dermatology referral, and who provides them varies by country.[3][5]
Living and working with pompholyx
Recurring pompholyx is, for many people, an occupational disease in all but name: wet work, gloves and detergents keep re-priming the skin. Small process changes carry real weight: cotton liners under occlusive gloves, swapping soap for a soap-free cleanser, moisturising at every break, and treating athlete's foot promptly so it cannot restart hand flares.[1] In pregnancy, topical steroid treatment is commonly still usable with adjustments the doctor explains, so mention pregnancy or breastfeeding at the start. For travellers, sweaty shoes and hot climates are classic flare setups; a consultation while away means a proper plan and, when appropriate, a prescription at a pharmacy near you rather than two weeks of guessing. Between flares, keep a tube of your prescribed treatment in reserve as agreed with your doctor, because starting on day one of a crop consistently beats starting on day five.
When we treat pompholyx online, and when we refer you
We treat online: typical pompholyx flares on hands or feet needing properly potent treatment; recurrent crops needing a trigger plan; early secondary infection suitable for tablets; flares where a fungal driver is suspected and treatable; and reviews when treatment is not tracking to plan.
We refer or redirect you: suspected contact allergy needing patch testing, which is an in-person investigation; severe or repeatedly disabling flares needing dermatology options such as phototherapy or specialist tablets; blistering with spreading redness and fever, the same day, because infected hands and feet escalate; blistering that does not fit pompholyx on photos, where scrapings or biopsy settle it; and widespread blistering beyond hands and feet or involving the mouth, urgently. Pompholyx is one of many skin conditions our doctors assess online, and the line between the two lists is applied honestly.
When to get in-person care
Get same-day in-person care if redness is spreading up the hand or foot, the skin is hot and increasingly painful, or you develop fever: an infected hand can deteriorate quickly (see our cellulitis page for what spreading skin infection looks like). Call 112 immediately for widespread blistering with mouth or eye involvement, facial swelling, difficulty breathing, or fever with confusion or rapid breathing.
From the Mobi Doctor podcast
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Listen · 23 Feb 2026 →How Mobi Doctor works
- Book a time that suits you: open daily 7am–11pm, often the same day, with the exact price, €47, shown before you pay.
- Upload your skin photos, then speak to a licensed doctor: a private video consultation, from anywhere in Europe.
- Leave with your plan the same day: everything agreed on the call, and if treatment is right for you, the prescription follows straight away, sent to a pharmacy near you in most EU countries. If we can’t help you online, you get a full refund.
Frequently asked questions about pompholyx (dyshidrotic eczema)
Can an online doctor prescribe pompholyx treatment in Europe?
Yes, after a consultation. A prescription is never issued without one: the doctor assesses your photos and history by video first, then prescribes a suitably strong topical steroid or other treatment when it fits. Prescriptions can be sent to a pharmacy near you in most EU countries, and your doctor confirms what applies in your country.
How much does a pompholyx consultation cost?
A video consultation costs €47. The exact price is shown before payment, and there is no subscription. If the doctor can’t treat you online, you get a full refund and clear directions to the right care.
How quickly can a doctor look at my hands?
Appointments are available daily from 7am to 11pm, often the same day. Pompholyx is distinctive in sharp close-up photos, so one consultation is usually enough for an assessment, a treatment plan at the right strength and, when appropriate, a prescription.
Is pompholyx contagious?
No. Pompholyx is a form of eczema, not an infection, so you cannot pass it on by touch, sharing towels or preparing food. The exception worth knowing: if the blisters become infected with bacteria, that infection needs treatment, though even then it is the infection, not the pompholyx, that poses any risk.
Should I pop the blisters?
No. The blister roof protects the raw skin underneath, and piercing it trades a few days of tightness for a real infection risk in skin you use all day. Very large, tense blisters that make gripping or walking impossible are the exception, and draining those is a job for a clinician, not a sewing needle.
Why didn’t hydrocortisone from the pharmacy work?
Because palm and sole skin is the thickest on the body, and mild hydrocortisone rarely penetrates it in useful amounts. Pompholyx usually needs a potent steroid used correctly for a short course. Under-strength cream used for weeks is the most common failed treatment story we hear, and it is fixable.
Is pompholyx the same as eczema?
It is a specific form of eczema, also called dyshidrotic eczema or vesicular hand eczema, defined by deep itchy blisters on the palms, fingers or soles. It behaves differently from ordinary eczema in one important way: the thick skin it occupies needs stronger treatment than eczema elsewhere on the body.
Why do my blisters keep coming back?
Because pompholyx is trigger-driven, and untreated triggers reload it: heat and sweating, stress, wet work and detergents, nickel contact, or a quietly persistent fungal foot infection. A review consultation that walks through those one by one, and fixes the ones that apply, is how recurrent pompholyx becomes occasional pompholyx.
- Pompholyx: Clinical Knowledge Summary, NICE Clinical Knowledge Summaries, revised 2023.
- Pompholyx (dyshidrotic eczema), DermNet New Zealand Trust, reviewed 2023.
- Hand dermatitis, DermNet New Zealand Trust, reviewed 2022.
- Contact dermatitis, DermNet New Zealand Trust, accessed August 2026.
- Interventions for hand eczema (CD004055), Cochrane, Cochrane Collaboration, 2019.
This page is for information only and is not a substitute for a medical consultation. Guideline links are provided for transparency; treatment decisions are made with your doctor.
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Listen · 23 Feb 2026 → Podcast · 13:26How to Stay Healthy on a Long Flight
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Listen · 23 Feb 2026 →Speak to a doctor about pompholyx today
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