Struggling with severe Atopic Dermatitis turning into Dyshidrotic Eczema on feet – Need advice on prevention and medication

Hi everyone,

I’m reaching out because I’ve been dealing with a frustrating and painful skin condition, and I could really use some advice from those who have been through something similar.

It all started small. About a year ago, I noticed a tiny patch of dry, itchy skin on the sole of my left foot, near the arch. I didn’t think much of it at first—maybe just dry skin. But over time, it didn’t go away. Instead, it slowly started spreading. First, it covered more of my left foot, and then, eventually, it appeared on my right foot as well. Now, both of my feet are affected.

At first, it looked like typical Atopic Dermatitis—red, inflamed, and extremely itchy skin. But recently, it has evolved into something more intense. Small, deep-seated blisters started appearing, especially along the sides of my toes and the soles. They itch like crazy, and when they dry out, the skin peels off in layers, leaving raw, painful areas. From what I’ve read, this sounds exactly like Dyshidrotic Eczema (people here call it "pompholyx"). It has gotten to the point where walking has become difficult—every step hurts, and the cracks in my skin make it feel like I’m walking on glass.

I’ve tried a few things, but I’m not sure if I’m on the right track. I’m currently using a mild corticosteroid cream (Hydrocortisone) on the really bad spots, and I moisturize religiously with a thick emollient. But the moment I stop the cream, the blisters and itching come back within days. I haven’t started any oral medication yet because I’m worried about side effects.

My questions are:

1. Prevention: What are the best ways to prevent flare-ups? I’ve heard about triggers like sweat, stress, and certain foods. What has worked for you in keeping this condition under control for longer periods?
2. Topical treatment: Is Hydrocortisone enough for this level of severity, or should I ask my doctor for something stronger (like a stronger steroid or even a calcineurin inhibitor)?
3. Oral medication: Have any of you taken oral meds (like antihistamines for itching, or even immunosuppressants) for severe eczema/dyshidrosis? Did it help, and were the side effects manageable?
4. Daily routine: Any tips on how to manage daily life—like walking, wearing socks/shoes, or showering—without making it worse?

I’d really appreciate any advice, personal experiences, or even just words of encouragement. This condition has been taking a toll on my physical comfort and mental health lately.

Thanks in advance for reading and helping out!