What Is Pustular Eczema?

Pustular eczema is a noncontagious inflammatory skin condition characterized by itchy pustules that form into a rash. Pustules are small pus- or fluid-filled blisters. Typically, pustular eczema affects only the hands and the feet. In some cases, though, it can also affect the limbs.

This article discusses the causes, treatment, and ways to cope with pustular eczema.

Types of Pustular Eczema

Three types of eczema can present with blisters. They include:

• Dyshidrotic: Dyshidrotic eczema appears as tiny fluid-filled blisters on the hands and feet and includes a rash that resembles tapioca pudding.
• Nummular: Nummular eczema begins as tiny sores similar to blisters that can spread and blend into larger lesions. They tend to occur after an injury to the skin.
• Weeping: Weeping eczema can develop in any type of eczema but is more likely to occur with specific types, such as dyshidrotic or nummular. The blisters that appear with this eczema can expand into crusty yellow-beige sores.

Pustular Eczema Symptoms

The main symptom of pustular eczema is the appearance of fluid- or pus-filled blisters.

Other symptoms associated with pustular eczema include:

• Intense itch
• Blisters that feel tense to the touch or are difficult to pop
• Burning or pain where the rash occurs
• Dry and peeling skin
• Cracks in the skin
• Bumps that eventually form into larger lesions

Causes

As with all types of eczema, the cause isn’t well understood. Various factors play into the development of the skin condition, including:

• A family history of eczema or allergies
• A dysregulated immune system (when the body can't control or turn off an immune response)
• Gene mutations
• A person’s environment (climate, exposure to pollutants)

Diagnosis

Diagnosing pustular eczema relies heavily on a physical examination, and specific characteristics must be present. The essential features include the following:

• Itching sensation
• The location of the rash on the body
• The frequency of the rash

Other features used in the diagnostic process include:

• Age of onset: Typically, eczema develops in early childhood.
• History: A person with pustular eczema is likely to have a family history or personal history of the condition.
• Immunoglobulin E (IgE) levels: Eczema is affected by the immune system, so levels of a specific antibody known as IgE may be increased in people with the condition.
• Skin health: People with pustular eczema usually have excessively dry skin.
• Appearance: Different types of eczema present differently on the skin. For example, one type may not cause blisters, whereas pustular eczema does. The appearance helps determine the type of eczema as opposed to a simple eczema diagnosis

Treatment

The treatment for pustular eczema varies depending on the severity and type.

Coping

Coping with pustular eczema can be difficult. However, many people can manage their symptoms effectively with available treatments. By doing so, having the condition is that much easier to deal with.

Tips for coping with the various types of pustular eczema include:

• Moisturize regularly and more often if your skin is dry.
• Avoid flare-ups by reducing the use of harsh chemical products such as detergents and fragrances.
• Test new skin products before using them.
• Limit the time spent in water to avoid drying out the skin.
• When in a flare-up, refrain from trying to pop or scratch the blisters, as this will make things worse.
• On top of medications, using a cold compress can help with the itch sensations.

Summary

Pustular eczema is a group of skin conditions that present with pus- or liquid-filled bumps. Three types of eczema—dyshidrotic, nummular, and weeping—all present with the same blister-like lesions.

The symptoms most associated with the condition are intense itchiness, pain and burning sensations, and dry and peeling skin. The cause of pustular eczema isn’t well known, but family and personal health history, genetics, and environmental factors all play a role in its development.

Treating pustular eczema revolves around the severity and type. However, the most common treatment for all types of eczema is topical corticosteroids or topical calcineurin inhibitors. To cope with your eczema, you can find a treatment that works, identify and avoid triggers, and keep your skin healthy through regular moisturizing and avoiding irritating products.

A Word From Verywell

Pustular eczema can be unsightly, uncomfortable, and hard to deal with when you’re in a flare-up. The good news is that, although the condition can be severe, it is more likely to be moderate or mild and easy to treat.

There is no cure for eczema. Still, there are remedies that can help. Speak to your healthcare provider for advice and treatment options if you have pustular eczema and want to improve your symptoms.