Blisters and spoons

How dealing with severe hand eczema is a bit like juggling the ‘spoons’ in spoon theory.

I’m the kind person who is always in a rush. I have a certain amount of things to get done in a day, and I dart between one thing and the next. I hate it when I have to stop to search for a piece of essential equipment. I’m always racing against the clock. I squeeze as much as I can into a day.

All this changed about four years ago. Something happened that meant I had to slow right down. It wasn’t multiple sclerosis or chronic fatigue syndrome, lupus or cancer. It wasn’t any those high profile diseases that are well known for making people reappraise their whole lives. It was eczema.

I know that a lot of people have eczema. And that many parents are grappling right now with children who are terribly debilitated by it. I have had eczema in different forms all through my life, although there have been periods when it hasn’t really bothered me very much. Four years ago, the eczema appeared on my hands. This wasn’t the first time I had had eczema on my hands, but this time it was different.

Itchy-palms

Whereas before the eczema was on the sides of my fingers, on the backs of my hands, knuckles, and on my wrists, this time it appeared on the palms of my hands and on the surfaces of my fingers that I use to touch things. That changed everything. Suddenly, I experienced pain and soreness every time I touched anything. The inevitable itching that accompanied the eczema was all the more intense for being located on the parts of my body that were particularly dense with nerve endings. It seemed it could only get worse. Dense clusters of itchy blisters eventually gave way to peeling skin. Skin peeled and peeled, eventually leaving a fragile and terribly thin layer of parchment-like skin.

Now I lived in a very different world. I started wearing cotton gloves to protect my hands. It wasn’t long before I started turning the gloves inside out so that the seams were pointing outwards. I couldn’t even bear to have the seams pressing against my skin. When I needed to touch something wet, I had a choice. I could either remove the gloves, get my hands wet, dry them and put the gloves back on, or I could don waterproof gloves over the top so that I didn’t have to remove the cotton gloves. As my skin flaked and peeled, the razor sharp edges would snag on the fibres and made it increasingly difficult to keep on putting the cotton gloves on and off, so increasingly I opted to wear waterproof gloves over the top whenever I wanted to do anything wet. Wet hands were bad news anyway, as my wettened skin always became more sensitive afterwards.

Working in the kitchen was the most trying. Peeling and chopping vegetables was a challenge. Carrots and potatoes slipped through my fingers and sometimes shot across the kitchen. My disposable vinyl gloves usually managed to get nicked or torn. This meant my cotton gloves would get wet, so I would have to change into clean dry pair before I could continue. Forging ahead with wet gloves usually stored up trouble for later, as my skin would never forgive me for leaving it wet for any length of time. Wearing waterproof gloves did not guarantee dry hands, even if they didn’t leak. Eventually perspiration would build up inside waterproof gloves, which meant that my hands would get damp after a certain length of time anyway.

I entered the world of having to make a decision every time I began a new task. How much do I fear damp hands at this moment? Which gloves should I put on? What can I achieve before my hands start to sweat inside these gloves? Cotton gloves alone were also pretty useless for more heavy-duty work such as going shopping and driving a car, not to mention gardening. Cotton gloves are not designed for such wear and tear. They rub against the surfaces of your hand, get grubby very quickly, and look rather shabby. And of course they are not waterproof which means that going out in the rain with them makes me feel anxious and a bit silly.

I managed to find some variations on gloves by searching the internet. I invested in cycle gloves and hockey gloves that I could wear over the top of my cotton gloves. They offered some firmer support and also some grip, as well as being tough enough to manage driving a car, handing shopping bags and trolleys, freezer goods, tins, packets, and so on. Since those early days of my adventures with gloves, I have accumulated quite a store of them. I have a whole drawer in my bedroom dedicated to gloves. Next to my skin I now wear cotton, viscose, silk, and a whole range of highly engineered moisture wicking fabrics. I have discovered external coatings on gloves that allow me to grip the credit cards in my purse. Some gloves will allow me to use my smart phone, others won’t.

SmartphoneCamera-with-gloves

My main motivation for writing this blog post was not so much to discuss gloves, but to talk about spoon theory. Spoon theory is a neat metaphor for expressing the amount of energy you have to get through a day – the possibilities available to you. You start the day with a certain number of spoons, and once you have spent them all you are out of choices. I feel very much like that when my hands are bad. I can only achieve so much in one day. If I do house work, I can’t do the garden. I can’t go shopping AND prepare a meal. If I hang out the washing, get it in again later and put it away, I might not be able to read a book that evening. I might not put the washing away the same day, though, as it’s difficult for me to work out whether or not it is dry. Depending on where the blisters are on my fingers, reading a book might be off the agenda anyway.

Just by seeing the links between my own situation and spoon theory, I feel connected to a wider community. However, I can’t help feeling a bit like an impostor. I haven’t seen anyone else relate hand eczema to spoon theory. How can I think that what I have is equivalent to some much more serious chronic diseases? Nevertheless, I’m starting to see how it can be a useful way of explaining to other people the wide ranging impact of having severe hand eczema.

Related

The Spoon Theory by Christine Miserandino http://www.butyoudontlooksick.com/articles/written-by-christine/the-spoon-theory/

What is the Spoon Theory? http://thespoontheory.tumblr.com/post/44757754831/faq

Severe hand eczema: Major new clinical trial compares treatments “head to head”. http://www.bbc.co.uk/programmes/p03tqv2c

Author: Anthea

I enjoy writing about the intersection between people and the natural world. I also feel compelled to delve into human behaviour - philosophically and practically. With a background in further and higher education, plant science and healthcare, I like to apply my expertise in workplace learning, distance learning and e-learning. Mix it all up, and see what comes out!

15 thoughts on “Blisters and spoons”

  1. I wanted to add a comment here – i suffered from exactly what you have above. Tried evrerything until i got some Dermovate Cream. It literally cleared it up overnight.

    I now only have flare ups in extreme cold weather, and nowhere near as bad as the amount of blisters I used to get. Please try it, it is very good. There is another version called Betnovate, but it is more of a cream. The Dermovate is a bit like a waxy substance, like vaseline.

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    1. Hi Paul, thanks for your interest in my post, and I’m glad you have found Dermovate to be so helpful. I agree it is more potent than the other steroid creams and ointments available. I do use this myself now, but it has not proved to be such a success in my case. It definitely comes in handy, though, when things get particularly bad.

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  2. I just felt the need to drop in and say that your pictures (finger closeups) are *literally* the *only pictures* I’ve ever seen that show *exactly* what I suffer from on my hands–I was beginning to think I was the only one anywhere that had these microscopic sub-dermal blister clusters!! I’ve always felt alone because my dermatologists (such as they are…) never have any answers; they just hem and haw and call it ‘atopic dermatitis’ (which is just a cop-out way of saying ‘you’re probably just reacting to something you’re allergic to’) or stupid crap like that. So extremely frustrating. Glad to know I’m not the only one out there (although I’m *not* glad for the fact that you have to suffer, though, obviously). 😦

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    1. Hi Jess, it was lovely to receive your comment, and I similarly feel reassured that other people experience the same symptoms. It is incredibly frustrating, and difficult for other people to understand you can’t do certain things when it’s bad. I hope things are’t too distressing for you at the moment.

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  3. Hey mate, I have to add a comment here because I suffered with this for over a year and still 5 years later have wrinkled paper thin skin on my fingers I have to manage but something that worked for me was soaking my hands in a saturated salt solution (a heap of table salt stirred in warm water until it wont dissolve anymore then cooled) for 10 minutes at a time, then rinsing and patting them dry and once dry applying a small amount of sorbolene moisturizer to prevent the dry flaking skin from catching and ripping. Can be painful but it works. I would repeat this 2-3 times a day and the salt solution through osmotic pressure draws the liquid out of the blisters so they cant later burst and get infected, it also removes the itching. I spent a lot of time using steroids and they were never a long term fix. Turned out I was allergic to the antibacterial hand wash and my GP would get 2-3 nurses a week with the same sensitivity and reaction. I hope this helps someone.

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  4. Need help I have the same problem I been told it’s a fungal infecting and then scericces then I see this post pics are the same as my fingers my hand and feet start exactly the same then crack and bleed also wet when blisters burst it’s all over and very painful just as you say my nails also falling off.. skin very thin now even shocks me and not my wife when I try close the shower the taps shock me .. what is this exma fungus scerises or what.. is there a cure who can help it’s just started 6 months ago getting word no treatment is helping what do I do what works for you

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    1. Hi Jason, that sounds pretty bad. Have you seen a dermatologist? You might need to ask your family doctor to refer you, because in my experience they can let things drag on for quite some time before making a referral to a specialist. I hope it settles down.

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  5. Your fingertip picture looks *exactly* like mine. I hope you’re getting better now. I used to have eczema on my hands and feet but only lasts for a few days or a couple weeks. 5 months ago, it happened on my palm again. The difference is, this time, it won’t go away. The blisters keep popping up. The skin will peel off. New skin will form then blisters pop up again. I can feel your pain. I also have to have cotton gloves on so I can do some daily works. Did see a dermatologist. The only thing he can do is giving me steroids, which works a little bit but never can clean it up and certainly not a long term solution. I suspect fungal infection may be playing a role in my case. But my dermatologist says there’s no resource to do a fungal test (what?? he is working in a walk-in clinic, though). I tried to see another dermatologist. The appointment is usually 6 months later. I’m feeling hopeless. However, I did get some oral anti-fungal tables to try. After that, I think the condition on my feet and palms starts to improve. My feet are now a lot better. The skin still peels here and there, but no itching blisters. There are still blisters coming out on my palms and fingertips. They are not itching but causes the skin to peel. I don’t know what to do at this point…
    One thing I can think of might be interesting. One month ago, I got an allergy rash on my face and neck (later, I figured out it was a skincare product my wife just got. The product ended up on the pillow and contacted my face). I saw my doctor at that time. She gave me some oral tables to put the allergy off. I think it’s still steroids. During the days taking those medications, I found out that all blisters on my hands are gone. There’s NO blister at all. Even though the skin is still broken, but that takes time to heal. Maybe the steroid was just suppressing my immune system. Didn’t mean that it cured anything. Certainly, few days after finishing the medication, the blisters come out again, and everything starts happening as it was.

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  6. Hi, I’ve had standard dry itchy eczema on and off pretty much everywhere on my body at some point all my life, including on the outside of my hands and fingers. However, 4 years ago I suddenly developed bubbled, horrendously itchy eczema on my inner side of fingers and fingertips tips and palms, EXACTLY the same as the picture you have here, your hands could literally be my hands. I had to wear plasters on every single finger and bandages which meant doing pretty much anything was difficult and I would hold them under the hot tap to get rid of the itch. I totally get the getting hands wet dilema!. After much trial and error and elimination diets, I had a skin test for around 50 different substances and they still couldn’t find what was causing it. Anyway, one day I got a new mobile phone that had a clear plastic cover on the bottom of it (where my previous phone just had the bare underside of which I think had a metal look to it but not sure what the material was and it had been heating up with use). Within a few days of using the new phone with the cover on it, I noticed that the eczema on my palms had calmed right down and massively reduced on the fingers also. Few weeks later palms and fingers were weepy, bubble eczema- free but still a bit on the fingertips. Presently, about a year after getting the new phone, the skin on my fingers and palms are totally clear and the skin on on my fingertips are still much better but still very thin and sensitive and can flare up a little bit (still not sure why) but much more tolerable and dosn’t weep as soon as I touch something now. This is maybe because the skin was so damaged for so many years. Its worth also noting that the eczema appeared originally not long after getting the uncovered, metal-underside phone. The outcome is, I could be wrong, but I think that the nickel on the underside of that old phone (or whatever the material was) was causing the allergy and was particularly bad when the phone heated up with use. I’m commenting here because I know how utterly hideous having this type of eczema is (you don’t know till you have it) and if this can help anyone then it’s worth a try. So for anyone reading this with this type of eczema, it might be worth not using your phone (or any other type of technology like that) for a few days and see if that helps, if so, get a sturdy cover for it that completely covers all areas where you fingers and palms touch it and especially where it would heat up. Maybe this would be a good place to find out if we can get a cure and keep a track on how things are going for everyone. After all this condition is a disability that massively interferes with life but the treatment is just a matter of finding out whats causing it.

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    1. Hi Eve, that’s very interesting, and thank you for taking the trouble to share your experience. Good to know that you found a cause for the problem. I’ve had patch testing for contact allergy now and again, and am gradually finding ways to limit the impact of all the things I seem to be allergic to. I was thinking of writing a blog post about this.

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  7. My 9 year old has suffered on and off with this for years. He recently healed from a broken elbow and when they removed his cast within a week all his fingertips on that arm flared up again.
    I have been googling all day to help him and came across silicone fingertip protectors on Amazon (Jrery-Key Finger Protectors).
    They are stretchy, soft and like “an extra layer of skin.” There are thousands of reviews and I’m hoping they arrive within the next couple days. You can wear with or without gloves.
    Wanted to comment so if others stumble across your post like me they can try this too. I feel terrible I can’t make this go away. We have tried so many creams and doctors.

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  8. Literally this!!! Someone else being open about this. Thank you. Nurse, frequent hand washing, and my fingertips have been suffering from these symptoms for over 4 years now. No real answer yet, just eczema and use this or that.

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    1. I do feel for you. I used to be an intensive care nurse and had to give it up. Keep on asking for help – there are many treatment options nowadays.

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