Pompholyx.co.uk

This week we were lucky enough to be able to interview Dr Anne Farrell. Dr Farrell has been a leading dermatologist for over 15 years in the UK and in the US. She has had more than 40 scientific articles on dermatology published and holds a consultant contract at St George’s Hospital Medical School and has a practice in Tunbridge Wells in Kent.

Having "face time" with such an expert, we took the chance to clear up some of the key issues that surround pompholyx and to bust a few myths.

Is pompholyx hereditary No. Pompholyx is like all eczemas, it's an heredited tendency. In effect this means that if your parents suffer from pompholyx then you may have a predisposition, but it is not hereditary.

We were recently asked if you can pass on pompholyx to your children. Can this happen? If the question is about heredity, then the answer is no. If you are asking can it be passed on by being in contact with someone who has pompholyx, the answer is also no.

So is pompholyx contagious? No. It's a condition that you suffer from or you don't. It can lie dormant in someone for a long time until it is triggered but it is not contagious.

What about the fluid in the blisters? This is called oedema fluid and it is totally sterile. It is exactly the same type of fluid that you get in a blister on your heal. But it is not a good idea to burst the blisters associated with pompholyx.

It's probably obvious, but why not? If you burst the blisters you won't spread the condition - the fluid is sterile. But you will be creating a wound. The skin is naturally covered in bacteria which can cause the wound to become infected. This in turn can cause complications, so no matter how itchy they get, don't pop the blisters. [Editor - we all do it - now you've been told by an expert - DON'T!]

Many people believe that stress causes pompholyx. Is this true? Pompholyx is not caused by stress. An episode can be brought on by stress because the bodies resistance to illness is reduced, but stress does not cause the pompholyx. Pompholyx is a pre-disposition, becoming stressed will not cause the condition.

So why do so many people associate stress with pompholyx? Stress can reduce the body's ability to cope with all sorts of illness. The reason pompholyx sufferers sometimes get bouts of the condition when they are stressed is that the body is less able to fight it off.

Can you tell us what does trigger pompholyx? There are many things that can cause pompholyx to occur in a sufferer but we know that the triggers are rarely dietary. Most triggers of pompholyx are environmental.

What is an environmental trigger? These are things that occur around you. In most cases environmental triggers are things that come into contact with your skin. It's no surprise that a skin condition is primarily affected by the things that touch the skin really.

That makes sense! What sort of thing are we talking about? The biggest trigger of eczema in the UK is perfume. Not just the expensive stuff in a tiny bottle, but the perfume that is added to so many products such as detergents, creams, beauty products and soaps.

Are there any other environmental triggers that we should look out for? There are many. But common triggers include nickel (found in coins) and leather.

Many contributors tell us that certain foods trigger their outbreaks. Are certain foods triggers? Pompholyx is rarely triggered by dietary triggers, it's a contact eczema. If readers have found changing their diet to be effective it might just be coincidence or it might be that they have changed removed some other environmental triggers without realising it.

So diet doesn't affect pompholyx? Possibly in some cases, but it is principally a contact eczema, so most episodes are triggered contact with the skin.

We spend a lot of time talking about living with pompholyx on pompholyx.co.uk perhaps we should think more about identifying triggers? Absolutely. You need to reduce the effect of the symptoms when they break out but it's far better to avoid the things that might be triggering the outbreak. Find out what is causing the episodes and remove that from your life and you'll have less need to treat the symptoms.

How can we find out if an environmental factor is triggering pompholyx? I recommend patch testing. Dermatologists use this as their primary means of assessing a patient.

What is patch testing? It sounds a bit "new age". Patch testing is a scientific process where pure chemicals are applied in small amounts to the skin in a systematic way. There is nothing "new age"about it.

Is it understandable that sufferers are a bit sceptical? Yes and no. A qualified dermatologist is a medical professional, so you should not be worried about patch testing. But I do agree that there are non-qualified "experts" who offer all sorts of odd techniques that they claim to be able to determine the cause of pompholyx.

Does patch testing always find the cause? No, not always. But it's the logical place to start because we know that pompholyx is a contact eczema and in most cases the trigger is environmental.

So what about dietary tests. Are they worth trying? Speak to a qualified dermatologist. If the patch testing does not identify the environmental triggers that cause your pompholyx to flare up, they will help you decide what to do next. I can't emphasise enough that pompholyx is a skin condition and that environmental triggers are generally the primary reason for episodes to occur.

Thank you very much for your time Dr Farrell, you've cleared up a lot of issues there. You're welcome.

About Dr Anne Farrell: She graduated from Oxford University Medical School in 1989. She gained extensive general medicine experience at the Queens Medical Centre, University Hospital of Nottingham, where she obtained Membership of the Royal College of Physicians and in the Department of Paediatrics, where she obtained the Diploma in Child Health.
She has been involved in dermatology full time since 1992, training as a Dermatology Registrar at the Chelsea & Westminster Hospital and Charing Cross Hospital, and Senior Registrar in Oxford, and entered the specialist register of consultant dermatologists in 1999.

She also undertook a graduate fellowship in cosmetic dermatology at the University of Miami as well as attachments with leading cosmetic dermatologists in New York, Philadelphia, Washington, Utah and California.

She was appointed as Consultant Dermatologist in 1999, initially in Tunbridge Wells, and then as Consultant Dermatologist at the University of Wales, Cardiff.

Throughout her 15 years in dermatology she has been active in teaching and research which has led to her publishing more than 40 scientific articles and book chapters on a variety of dermatology subjects. During her time in Oxford she was awarded a Doctor of Medicine Degree for a published research thesis. She currently holds a consultant contract at St George’s Hospital Medical School where she continues her research interests. She continues to participate in regular international conferences and visits overseas centres to enable her to apply the most advanced techniques currently available in dermatology including cosmetic dermatology.

Dr Farrell works in Tunbridge Wells in Kent. More information about her practice can be found at www.dermatologyconsulting.co.uk. Please note, Dr Farrell cannot provide advice by email. If you live in the Kent area, she would be happy for you to call to make an appointment.

This site provides you with some basic information about Pompholyx and the issues that arise from living with the ailment. If you want to do more research or if you want to know about treatments for Pompholyx and eczema we recommend searchig on Google.

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