A Solution for Dyshidrosis

Is soaking the feet in an aluminum salt solution an effective therapy for dyshidrosis?
—John Mosby, MD
  Corpus Christi, Tex
The first objective in the treatment of dyshidrosis is to establish the cause. A number of factors can cause or exacerbate dyshidrosiform eruptions on the hands and/or feet. Primary irritants, as well as contact dermatitis, can provoke a vesicular reaction. Ingested metals- such as nickel, chromium, and cobalt-may have a causative role. Fungal infections (particularly dermatophyte infections) and bacterial infections elsewhere in the body have been implicated. The role of stress has been difficult to determine; however, some patients believe that recurrences are associated with stressful life events. If the underlying causes of dyshidrosis are not addressed, no symptomatic treatment will be effective.
Astringent soaks still have a role during the acute phase in cases in which no obvious cause can be found.¹ Aluminum salt solution is available under the trade names Bluboro's, Domeboro's, and Burow's. Alternatively, a compounding pharmacy can make up a 10% solution of aluminum subacetate. Other astringents that can be used include Castellani paint (either clear or gentian violet) and potassium permanganate( solution (1:8000 dilution); however, these are not as cosmetically acceptable.
—David L. Kaplan, MD
  Clinical Assistant Professor of Dermatology
  University of Kansas School of Medicine
  Kansas City
  University of Missouri Kansas City School of Medicine