Eczema is not just one condition — the term covers several distinct disorders. Dyshidrotic and atopic eczema are often confused, even though they differ in appearance, location and typical age of onset. This article clearly explains how they differ, where they overlap and when it is worth seeing a doctor.
Atopic and dyshidrotic eczema are two different types of eczema. Atopic eczema is a chronic, intensely itchy condition linked to atopy (asthma, hay fever) that usually begins in childhood and affects the creases of the elbows and knees, the face and other areas of the body. Dyshidrotic eczema (pompholyx) appears as small, deep-seated blisters on the palms, sides of the fingers and soles, typically in adults under 40. Neither is contagious, and both are linked to an impaired skin barrier. About half of people with dyshidrotic eczema also have atopic eczema or a family history of atopy.
What is the main difference?
The main difference lies in location, appearance and typical age of onset. Atopic eczema is a chronic, recurrent itchy condition that appears mainly in the skin creases (elbows, knees), on the face and neck and is linked to atopy — the tendency toward asthma and hay fever [4][5]. Dyshidrotic eczema, by contrast, is a specific eruption of small blisters confined to the palms, sides of the fingers and soles [1][3]. Both are types of eczema (dermatitis), neither is contagious and both are linked to an impaired skin barrier — but they differ in how they look and in who typically gets them.
What atopic eczema is
Atopic eczema (atopic dermatitis) is a chronic, intensely itchy inflammatory skin condition with an impaired skin barrier [4][5]. It usually begins in childhood — most often in the first year of life and rarely after the age of five [5]. It is part of so-called atopy — an inherited tendency toward allergic reactions that often runs in families alongside asthma and hay fever [4][5]. It appears as dry, red, scaly and itchy patches; typically in the creases of the elbows and knees, on the face in infants, and in older children and adults also on the hands, neck and around the eyes [4][5]. The course is chronic and fluctuates between worsening (flares) and calmer periods.
What dyshidrotic eczema is
Dyshidrotic eczema (pompholyx) is an itchy, chronically recurring eruption of small, deep-seated blisters 1–2 mm in size on the palms, sides of the fingers and soles [1]. The blisters usually persist for several weeks and then peel [1]. It typically appears in adults, usually under 40, and is more common in women [2]. The exact cause is unknown; triggers include stress, excessive sweating, and contact with nickel and irritants [1][3].
Key differences at a glance
Location: atopic eczema mainly affects the creases, face and body areas; dyshidrotic is confined to the palms, sides of the fingers and soles [1][5].
Appearance: atopic eczema forms dry, red and scaly patches; dyshidrotic small fluid-filled blisters [1][5].
Typical age: atopic usually begins in childhood; dyshidrotic more often in adults under 40 [2][5].
Link to atopy: in atopic eczema, atopy (asthma, hay fever) is a defining feature; in dyshidrotic, atopy is present in only some patients [2][4].
Where the two conditions overlap
Although they are distinct conditions, they can be related. According to the National Eczema Society, about half of people with dyshidrotic eczema also have atopic eczema or a family history of atopy [2]. At the same time, DermNet notes that the evidence for a link between dyshidrotic eczema and atopy is mixed [1]. Both conditions also share an impaired skin barrier — both have been linked to the protein filaggrin, which is key to barrier function [3]. One person may therefore have both types at once — dyshidrotic on the hands or feet and atopic elsewhere on the body [2].
Different types of eczema are not mutually exclusive. The precise diagnosis — and which type (or combination) is present — is determined by a doctor based on location, appearance and personal and family history [4][5].
How to care for sensitive skin
Whichever type it is, the foundation is gentle daily care and protection of the impaired skin barrier: regular moisturising (emollients), avoiding irritants and harsh soaps, and protecting the hands [4][5]. Diagnosis and treatment are always determined by a doctor according to severity and symptoms. EPIDERMA® offers cosmetic products for the daily care of sensitive skin — gentle, moisturising and dermatologically tested. They do not replace medical treatment but complement everyday care.
For supporting the skin from within: DermBalance Complex® — a food supplement with zinc, omega-3, turmeric and probiotics. Zinc contributes to the maintenance of normal skin.
Learn more about DermBalance Complex®Food supplement. Not a substitute for a varied diet. Not suitable for pregnant or breastfeeding women or children under 12.
Frequently asked questions
No. They are two different types of eczema. They differ in location, appearance and typical age of onset, even though both are inflammatory skin conditions linked to an impaired skin barrier [1][4][5].
Yes. Some people have them at the same time — about half of people with dyshidrotic eczema also have atopic eczema or a family history of atopy [2].
No. Neither atopic nor dyshidrotic eczema is contagious — they are not passed on by touch or close contact [1][5].
Location and appearance are a guide — dyshidrotic forms blisters on the palms and soles, atopic dry patches in the creases and on the face. A definitive diagnosis, however, is made by a doctor based on symptoms and history [4][5].
References
[1] DermNet (Jain MA, Jarrett P; rev. Coulson I). Dyshidrotic eczema (Pompholyx, Vesicular Hand Eczema). dermnetnz.org/topics/dyshidrotic-eczema
[2] National Eczema Society. Pompholyx (dyshidrotic) eczema. eczema.org
[3] Medscape / eMedicine. Dyshidrotic Eczema (Pompholyx): Background, Etiology. emedicine.medscape.com/article/1122527-overview
[4] DermNet. Atopic dermatitis. dermnetnz.org/topics/atopic-dermatitis
[5] NHS. Atopic eczema. nhs.uk/conditions/atopic-eczema
MUDr. Jiří Skalický
Founder of EPIDERMA®
This article is for educational purposes and does not replace medical consultation. Have an unclear or persistent outbreak assessed by a dermatologist.