Blisters

Blisters (Overview)

Blisters
Skip to content

A blister is a bubble of fluid under the skin. The clear, watery liquid inside a blister is called serum. It leaks in from neighboring tissues as a reaction to injured skin.

If the blister remains unopened, serum can provide natural protection for the skin beneath it. Small blisters are called vesicles. Those larger than half an inch are called bullae.

A blood blister is filled with blood, rather than serum.

There are many causes of blisters, including:

  • Irritation — Blisters can be caused by physical factors that irritate the skin, such as friction (rubbing the skin), irritating chemicals or extreme cold or heat. Blisters on the feet can result from shoes that are either too tight or rub the skin in one particular area. Blisters also can be caused by contact dermatitis, a skin reaction to some type of chemical irritant. Intense cold can trigger frostbite, which often leads to blisters once the skin is rewarmed. Any type of burn, even sunburn, also can cause blisters.
  • Allergies — Allergic contact dermatitis, a form of dermatitis or eczema, may result in blisters. Allergic contact dermatitis is caused by an allergy to a chemical or poison, such as poison ivy, poison oak or poison sumac.
  • Infections — Infections that cause blisters include bullous impetigo, an infection of the skin caused by staphylococci (staph) bacteria; viral infections of the lips and genital area due to the herpes simplex virus (types 1 and 2); chickenpox and shingles, which are caused by the varicella zoster virus; and coxsackievirus infections, which are more common in childhood.
  • Skin diseases — Numerous skin diseases cause blisters. Examples include dermatitis herpetiformis, pemphigoid and pemphigus. There also are inherited forms of blistering skin conditions, such as epidermolysis bullosa (in which pressure or trauma commonly leads to blisters) and porphyria cutanea tarda (in which sun exposure provokes blisters).
  • Medications — Many medications, such as nalidixic acid (NegGram) and furosemide (Lasix), can cause mild, blistering skin reactions. Others, such as the doxycycline (Vibramycin), can increase the risk of blistering sunburn by increasing the skin's sensitivity to sunlight. In more dramatic cases, medications can trigger more severe, even life-threatening, blistering disorders, such as erythema multiforme or toxic epidermal necrolysis, also known as TEN, an illness that causes severe skin damage and typically involves 30% or more of the body's surface.

Symptoms

There are many causes of blisters, including:

  • Irritation — Blisters can be caused by physical factors that irritate the skin, such as friction (rubbing the skin), irritating chemicals or extreme cold or heat. Blisters on the feet can result from shoes that are either too tight or rub the skin in one particular area. Blisters also can be caused by contact dermatitis, a skin reaction to some type of chemical irritant. Intense cold can trigger frostbite, which often leads to blisters once the skin is rewarmed. Any type of burn, even sunburn, also can cause blisters.
  • Allergies — Allergic contact dermatitis, a form of dermatitis or eczema, may result in blisters. Allergic contact dermatitis is caused by an allergy to a chemical or poison, such as poison ivy, poison oak or poison sumac.
  • Infections — Infections that cause blisters include bullous impetigo, an infection of the skin caused by staphylococci (staph) bacteria; viral infections of the lips and genital area due to the herpes simplex virus (types 1 and 2); chickenpox and shingles, which are caused by the varicella zoster virus; and coxsackievirus infections, which are more common in childhood.
  • Skin diseases — Numerous skin diseases cause blisters. Examples include dermatitis herpetiformis, pemphigoid and pemphigus. There also are inherited forms of blistering skin conditions, such as epidermolysis bullosa (in which pressure or trauma commonly leads to blisters) and porphyria cutanea tarda (in which sun exposure provokes blisters).
  • Medications — Many medications, such as nalidixic acid (NegGram) and furosemide (Lasix), can cause mild, blistering skin reactions. Others, such as the doxycycline (Vibramycin), can increase the risk of blistering sunburn by increasing the skin's sensitivity to sunlight. In more dramatic cases, medications can trigger more severe, even life-threatening, blistering disorders, such as erythema multiforme or toxic epidermal necrolysis, also known as TEN, an illness that causes severe skin damage and typically involves 30% or more of the body's surface.

Diagnosis

If the cause of your blisters is not obvious, your doctor will ask about your family history and your personal medical history, including any allergies you have and any medications you take, including over-the-counter medications. You also will be asked about any recent exposure to irritating chemicals or allergens.

Source: https://www.health.harvard.edu/a_to_z/blisters-overview-a-to-z

Articles

Blisters
ABOUT CAUSES DIAGNOSIS TREATMENT

A blister is a bubble on the skin containing fluid. Blisters are often shaped a circle. The fluid that forms below the skin can be bloody or clear.

Injury, allergic reactions, immune diseases, or infections can cause blisters. These include:

  • Burns or scalds
  • Sunburns
  • Rubbing (friction), such as from shoes rubbing against the skin
  • Atopic dermatitis
  • A contagious skin infection (impetigo)
  • Allergic reactions such as poison ivy
  • A rare, blistering skin disease that often occurs in middle-aged and older adults (pemphigus)
  • A blistering autoimmune disorder that is more common in older adults (pemphigoid)
  • A blistering autoimmune disorder linked to gluten sensitivity that often first appears in adults between ages 30 and 50 (dermatitis herpetiformis)
  • Viral infections such as chickenpox and herpes zoster

Blisters caused by injury or rubbing (friction) will appear in that one area as a bubble filled with either clear or bloody liquid. Blisters that are due to another condition may appear in one area of your body. Or they may be all over your body. Blisters may be painful or itchy.

In some cases the blister may be caused by something that affects the whole body, such as an infection. Then you may also have whole-body symptoms such as fever, pain, or extreme tiredness (fatigue). The symptoms of a blister may look other skin conditions.

Always see your healthcare provider for a diagnosis.

Healthcare providers can often diagnose blisters by looking at your skin. If your provider thinks you may have an infection or a skin disorder, a blister biopsy may be done. A piece of the blister is removed and checked under a microscope. Or a skin culture may be needed.

Blisters often heal on their own without treatment.  If needed, treatment will vary, depending on the cause. Some general guidelines for first aid may include:

  • Wash the area with soap and water.
  • Apply a cold or ice pack which may help reduce swelling and discomfort.
  • Keep the area clean and dry. Don't burst or puncture the blister.
  • If the blister bursts, place a bandage or dressing on the area to keep it clean.
  • Watch the area for signs of infection such as increased warmth, swelling, redness, drainage, pus formation, or pain. If you notice any signs of infection, call your healthcare provider. You may need antibiotics.

Key points about blisters

  • A blister is a bubble on the skin containing fluid.
  • Blisters are caused by injury, allergic reactions, or infections.
  • The symptoms of a blister may look other skin conditions.
  • If you have whole-body symptoms, such as a fever, talk with your healthcare provider.
  • Blisters often heal on their own.
  • It is important to keep the area clean and dry.

Tips to help you get the most from a visit with your healthcare provider:

  • Know the reason for your visit and what you want to happen.
  • Before your visit, write down questions you want answered.
  • Bring someone with you to help you ask questions and remember what your provider tells you.
  • At the visit, write down the name of a new diagnosis, and any new medicines, treatments, or tests. Also write down any new instructions your provider gives you.
  • Know why a new medicine or treatment is prescribed, and how it will help you. Also know what the side effects are.
  • Ask if your condition can be treated in other ways.
  • Know why a test or procedure is recommended and what the results could mean.
  • Know what to expect if you do not take the medicine or have the test or procedure.
  • If you have a follow-up appointment, write down the date, time, and purpose for that visit.
  • Know how you can contact your provider if you have questions.

Source: https://www.cedars-sinai.org/health-library/diseases-and-conditions/b/blisters.html

Blisters

Blisters

Most blisters heal naturally and don't require medical attention.

As new skin grows underneath the blister, your body slowly reabsorbs the fluid in the blister and the skin on top will dry and peel off.

When to seek medical help

See your GP if you have blisters that:

  • you think are infected – an infected blister will be filled with yellow or green pus and may be painful, red and hot
  • are very painful
  • keep coming back
  • are in unusual places, such as on your eyelids or inside your mouth
  • are caused by severe sunburn, burns or scalds or an allergic reaction

Antibiotics may be prescribed to treat an infected blister.

If you have a large or painful blister, your GP may decide to decompress the blister under sterile conditions.

If your blisters are caused by a medical condition, such as chickenpox, herpes or impetigo, your GP will be able to advise you about how to treat the underlying condition.

Friction blisters

The unbroken skin over a blister provides a natural barrier to infection. It's important that the skin remains intact to avoid infection.

As tempting as it may be, try not to pierce a blister with a needle because it could lead to an infection or slow down the healing process. Allow the skin to peel off on its own after the skin beneath has healed.

You may choose to cover small blisters with a plaster. Larger blisters can be covered with a gauze pad or dressing that can be taped in place.

Painful blisters, or those in positions where they're ly to burst, such as on the sole of your foot, can be covered with a soft dressing to cushion and protect them. It may help to cut the dressing into a 'doughnut' shape to fit around the blister and avoid placing pressure directly on it.

Change the dressing daily and wash your hands before touching the blister to avoid infection.

Burst blisters

If a blister has burst, don't peel off the dead skin on top of the blister. Allow the fluid inside to drain and wash it with mild soap and water. Cover the blister and the area around it with a dry, sterile dressing to protect it from infection until it heals.

Hydrocolloid dressings, available over the counter from pharmacies, have been shown to help prevent discomfort and encourage healing.

If the top layer of dead skin from a burst blister has already rubbed off, don't pick at the edges of the remaining skin. Follow the advice above to protect it from infection.

If the blister is on your foot, avoid wearing the shoes that caused it, at least until it heals.

Blood blisters

Blood blisters should be left to heal naturally. If a blood blister bursts, keep the area clean and dry. Protect it with a sterile dressing to prevent infection.

Blood blisters are often painful. Applying an ice pack to the affected area immediately after the injury can help relieve the pain (a bag of frozen vegetables works just as well). Between 10 and 30 minutes should help.

To stop the ice touching your skin directly, place a towel over the affected area before applying the ice pack.

Source: https://www.nhsinform.scot/illnesses-and-conditions/injuries/skin-injuries/blisters

Diagnosing blistering skin conditions

Blisters

A blister describes any raised, fluid-filled skin lesion. Small blisters under 0.5cm are called vesicles, while larger blisters are known as bullae.

Insect bites

Insect bites frequently blister, probably as a result of being scratched. Such blisters are often formed on the lower legs and should be treated in the same way as friction blisters, along with oral antihistamines and topical steroids to stop irritation. Insect bites are often grouped or linear.

Scabies

Un scabies in an adult, scabies in a small child or infant can present with small blisters on the base of the feet and the palms. This is often mistaken for eczema.

Both conditions can coexist and when this occurs, making a correct diagnosis can be a challenge. Using a dermatoscope greatly assists this process, because the head parts of the scabies mite can be seen as a dark triangle under the skin and the burrows of the mite become much more obvious.1

Treatment for scabies should involve not only the infant, but all members of the household (older children and adults). A topical scabicide should be used over the entire skin surface of the infant, and from the neck down for the others. Ideally, everyone should be treated on the same day and the process repeated a week later.

Infective causes of blistering

Herpes simplex and herpes zoster

Herpes simplex and herpes zoster cause painful blisters. Both start as a red macule, which soon becomes raised and forms a vesicle. Pain preceding the appearance of the skin lesions is a very important clue to this diagnosis.

Herpes simplex causes small, closely grouped vesicles on a red base and these can be located anywhere on the body, not just the most common sites (lips or genitals).

Herpes zoster lesions are more linear and restricted to one side of the body following a dermatome. In immunosuppressed people or patients on chemotherapy, this condition can involve several dermatomes.

Herpes simplex can be treated with either topical or oral aciclovir. Frequent recurrences may need an extended course of oral aciclovir. In immunosuppressed patients, herpes simplex can become generalised and may be life-threatening. In this situation, hospital admission and IV antivirals will be necessary.

Treating herpes zoster with antivirals has been shown to reduce the acute pain, virus shedding, rash and the incidence and severity of post-herpetic neuralgia.2

Eczema herpeticum

Eczema herpeticum is a condition with a somewhat misleading name, as it suggests there has to be eczema, but any skin problem that breaches the skin barrier can be complicated by herpes simplex (although eczema is the most common cause of barrier dysfunction). Often mistaken for impetigo, it consists of small, very even, punched-out blisters, which look as if someone has tried to take shallow punch biopsies.

It can become secondarily infected with bacteria. If a skin problem suddenly deteriorates, especially if the patient is complaining of pain, it is important to consider giving oral aciclovir – topical treatment will not be enough.

Herpetic whitlow

A herpetic whitlow is a vesicular infection around the nail fold caused by herpes simplex. This is a painful condition and causes swelling of the digit. The thumb and index finger are most commonly affected. It requires topical antivirals if mild or oral antivirals if more severe, very painful or recurrent.

Chickenpox

Chickenpox initially presents with fever and crops of red macules that progress over a matter of hours to papules and then vesicles, which take a few days to dry up and form a scab.

Hand, foot and mouth disease

Hand, foot and mouth disease is a mild, short-lasting viral infection mainly affecting young children. It gives small, oval-shaped pearly grey blisters on the hands and feet and in the mouth, and is very infectious. It is caused by an enterovirus, usually Coxsackie A16. These small blisters resolve within a week, without leaving scars.

Orf

Orf is a parapoxvirus contracted from goats and sheep. It is common in sheep farmers and those working in the meat industry. Children can acquire it from bottle-feeding lambs or playing in an infected field.

It presents with a small, firm, red or bluish-red papule, usually on the hand, which progresses into a blister that is often quite purple. This can grow to a large lesion 2-3cm in diameter. It is self-healing in about six weeks but there may be a need to treat any secondary bacterial infection.

Orf: papule progresses to a blister, which can be quite large (Photograph: ISM/Science Photo Library)

Cellulitis

Cellulitis can present with blistering of the affected skin along with the classic signs, which are sudden development of fever, feeling unwell, one-sided redness, swelling, tenderness and increased warmth.

The usual causative organism is Streptococcus, and penicillin V and clarithromycin are the antibiotics of choice, at higher doses than normal. Severe cases will require hospital admission.

If the redness is bilateral, has been developing slowly and is not acute, it is more ly there is another diagnosis, such as infected eczema, which is a frequent cause.

Bullous impetigo

Bullous impetigo is a less common form of impetigo that can affect intact skin and is caused by exfoliative toxins of Staphylococcus aureus. The exotoxins produce loss of adhesion in the superficial dermis, causing fragile blisters that often rupture to give superficial erosions.

Coagulase-positive group II Staph aureus, most often phage type 71, is the predominant causative organism and is the same strain that causes staphylococcal scalded skin syndrome.

Bullous impetigo is treated in the same way as non-bullous impetigo, with the use of antiseptics, topical or oral antibiotics and dressings.

Bullous impetigo: blisters may rupture to give superficial erosions (Photograph: Dr P Marazzi/SPL)

Eczema and dermatitis

Pompholyx eczema

Eczema on the palms and soles is more ly to blister and the classic presentation of pompholyx eczema is small, extremely itchy vesicles along the sides of the fingers.

The differential is palmoplantar psoriasis, which gives bigger, yellow pustules with some older brown ones that are painful rather than itchy. The patient with psoriasis is ly to be a smoker or ex-smoker.

Pompholyx eczema requires potent topical steroids. Dilute potassium permanganate soaks can be very useful in the acute stage to calm the itch and prevent bacterial infection. The skin peels after the vesicles dry up.

Discoid eczema

This type of annular eczema is often mistaken for psoriasis because it has a well-demarcated border that is more pronounced than is usual in eczema.

It is more common in winter, often affects the lower legs and can be triggered by an insect bite or minor injury. There can be grouped vesicles and it can be very itchy. Strong topical steroids may be required to bring this condition under control.

Allergy

Nickel allergy can be acute and may present with small blisters, especially on the ears from wearing earrings, or around the umbilicus from belt buckles. Hair dye allergy can cause dramatic blistering on the face. Avoidance of the allergens will prevent recurrence. This is particularly important for hair dyes, where repeat eruptions can be extremely severe.

Plant dermatitis

Plant dermatitis can be due to direct contact with a plant, or after sun exposure on the area of skin that touched the plant.

The distribution of the blisters in plant-induced dermatitis is usually linear or streaky and asymmetrical.

Plants that can cause photocontact dermatitis are the citrus family, celery, parsnip, fig and giant hogweed, which all have high levels of furocoumarins, a naturally occurring psoralen. Squeezing limes outside on a sunny day can cause very dramatic blistering. Phytophototoxic reactions have occurred after eating parsnip or celery soup and then being out in the sun.

Oedema blisters

This type of blistering is underdiagnosed but is a common cause of lower leg blistering and is due to the rapid development of oedema. These can be large, unilocular, clear blisters and are associated with heart failure and venous insufficiency. It is most important to determine and treat the underlying cause, as well as to protect the blisters to prevent secondary infection.

Nutritional causes

Rarely, blisters can be caused by nutritional deficiency. Acrodermatitis enteropathica is a genetic disorder that causes malabsorption of zinc. In the infant, a perioral and perianal rash develops, plus blistering of the fingers, toes and ears, along with diarrhoea. Oral zinc improves the skin within days.

In adults, zinc deficiency can occur as a result of alcoholism, severe inflammatory bowel disease and after bariatric surgery.

Drug-induced blisters

Drug eruptions come in many different forms, including bullous eruptions. Drugs that can cause blistering are barbiturates, furosemide, nalidixic acid and penicillamine.

Fixed drug eruption

Fixed drug eruption is an uncommon condition where dusky red or purple plaques occur when the causative drug is taken. The timescale between taking the drug and the lesion flaring up is 30 minutes to eight hours.

Initially, there is a single plaque, but with repeated episodes, the plaque expands and can multiply. The lesions tend to blister, with pigmentation on clearing.

Many drugs can cause this, but oral antifungals, paracetamol, NSAIDs, aspirin and antibiotics are the most common. Sites affected are the mouth, anogenital region, hands and feet.

CAUSES OF BLISTERING, MAIN FEATURES, SITE AND TREATMENT
Cause    Features Site Treatment
Friction blisters Often due to footwear, gripping tools or sports equipment Soles and palms Drain fluid from blister with sterile needle if large or bothersome, leaving roof of skin to protect the base
Insect bites Linear or grouped Limbs Antihistamines and topical steroids
Scabies in babies and infants Itchy vesicles, can look eczema Hands and feet Topical scabicide all over; repeat week later; treat all household contacts on same day
Herpes simplex Pain precedes small groups of vesicles Lips, genitals and buttocks most common Topical aciclovir if mild; if recurrent, widespread or other health problems, use oral aciclovir
Herpes zoster Pain precedes vesicles Any dermatome  Oral antivirals
Chickenpox Macule to papule to vesicle within hours Most prominent on trunk and face  Consider prompt oral antivirals in those aged over 14 years, especially if other health problems, and in newborns or pregnant women
Hand, foot and mouth disease Small, oval, pearly grey blisters Acral distribution Analgesics, keep the blisters intact to prevent viral spread
Orf Farm workers, vets, meat industry workers Hand or arm, occasionally face Treat if secondary bacterial infection; usually resolves within six weeks 
Pompholyx eczema Very itchy Hands and feet Potent topical steroids, potassium permanganate soaks; may require oral antibiotics
Discoid eczema Very itchy Limbs, especially legs Potent topical steroids
Plant dermatitis Linear Arms, legs, trunk Topical steroids or oral steroids if severe
Oedema blisters Unilocular, clear blisters Lower legs Treat oedema; bed rest
Zinc deficiency Infants, adults with alcoholism, after bariatric surgery or severe inflammatory bowel disease Perioral/perianal rash, blisters on fingers, toes and ears, diarrhoea Oral zinc supplementation
Fixed drug eruption Annular  Lips, genitals, lower abdomen common Exclude most causative drug 
  • Dr Elizabeth Ogden is associate specialist in dermatology, Lister Hospital, East and North Herts NHS Trust

Click here to take a test on this article and claim a certificate on MIMS Learning

References

1. Dupuy A, Dehen L, Bourrat E et al. Accuracy of standard dermoscopy for diagnosing scabies. J Am Acad Dermatol 2007; 56: 53-62.

2. Pavan-Langston D. Herpes zoster antivirals and pain management. Ophthalmology 2008; 115(2 Suppl): S13-20.

Further learning
These action points may provide opportunities for further CPD on this topic
  • Present a summary of blistering conditions to colleagues
  • Look up photographs of blistering conditions to familiarise yourself with the different presentations
  • Produce a patient factsheet on blistering conditions

Source: http://www.gponline.com/diagnosing-blistering-skin-conditions/dermatology/article/1392625

Blisters – Symptoms, Causes, Treatments

Blisters

A blister is a collection of clear fluid trapped between or beneath the top layer of skin, the epidermis. Blisters, which are often called “water blisters,” often break open and the fluid inside is released onto the skin. Blisters, also known as vesicles, can occur in all age groups and populations.

A blood blister is a specific type of blister that is due to damage to blood vessels and tissues just under the skin, which causes blood and other fluids to pool and form a bump. Blood blisters typically form after a strong pinch of the tissues, but there are other causes as well.

In contrast to a blister, an abscess is a collection of pus, a thick, cloudy, white or yellow-colored fluid that contains white blood cells and dead tissue. An abscess is caused by the body’s response to an infection (usually a bacterial infection). A blister that becomes seriously infected can develop into an abscess.

Blisters can be caused by a wide variety of mild to serious diseases, disorders and conditions including infection, inflammation, autoimmune disorder, trauma, allergy, adverse drug reaction, and other abnormal processes.

Blisters can form anywhere on the body, including inside the mouth, nose and genitals. Blisters can occur in isolation or you may develop hundreds of tiny blisters that affect several areas of the body.

Blisters can be very tiny and hardly noticeable or quite large, reaching a quarter inch in diameter or larger.

Depending on the cause, a blister can go away suddenly, such as a friction blister that develops from wearing a new pair of shoes. Blisters that occur unexpectedly, worsen over time, or occur in large numbers may be a sign of a more serious condition, such as an autoimmune or infectious disease. Diseases that cause blistering of the skin are called bullous skin diseases.

Because a blister can be a sign of a serious disease or condition, you should seek prompt medical care and talk with your medical professional about a blister or blisters that are persistent or occur with swollen lymph nodes, fever, pain, joint achiness, or the development of pain, redness or pus. If you have diabetes, you should seek prompt medical care to evaluate any blisters on the feet or legs, even if they are small.

Seek immediate medical care (call 911) If you have blisters with a high fever (higher than 101 degrees Fahrenheit), difficulty breathing, a severe or electrical burn, or you have been exposed to cold temperatures or toxic chemicals, such as lye or acids.

What other symptoms might occur with blisters?

Blisters may occur with other symptoms, which vary depending on the underlying disease, disorder or condition. Common symptoms can include a burning sensation, pain, rash and itching. Potential symptoms that may accompany a blister include:

  • Burning sensation
  • Flu- symptoms (fatigue, fever, sore throat, headache, cough, aches and pains)
  • Itching
  • Joint pain
  • Loss of appetite
  • Pain or tenderness around the blister
  • Rash
  • Swollen lymph nodes
  • Tingling sensation before visible blister

Serious symptoms that might indicate a life-threatening condition

In some cases, a blister or group of blisters can indicate a serious or life-threatening condition that should be immediately evaluated in an emergency setting. Seek immediate medical care (call 911) if you, or someone you are with, have blisters with any of these life-threatening symptoms or conditions including:

  • Change in level of consciousness or alertness, such as passing out or unresponsiveness
  • Difficulty swallowing
  • Electrical injury
  • Exposure to a toxic chemical, such as lye or acids
  • Exposure to cold temperatures (possible frostbite and hypothermia)
  • High fever (higher than 101 degrees Fahrenheit)
  • Joint pain and swelling
  • Redness, increased pain, pus, and warmth of affected area
  • Respiratory or breathing problems, such as shortness of breath, difficulty breathing, labored breathing, wheezing, not breathing, or choking
  • Sudden swelling of the face, lips, tongue or mouth

In addition, if you have diabetes, seek prompt medical care to evaluate and treat any blister on the feet or legs, even a small blister, because of a high risk of serious infection.

What causes blisters?

A blister can be a symptom of a variety of disorders, diseases or conditions including infection, inflammation, trauma, allergic reaction, and other abnormal processes.

Some causes may be relatively mild, such as blisters on the feet from ill-fitting shoes or blisters on the hands from working with garden tools.

Other conditions require prompt medical care, such as an infectious disease or scalding from boiling water.

Infections that cause blisters

Blisters can be caused by infectious diseases including:

  • Bacterial skin infection, such as cellulitis or impetigo, which are commonly caused by staphylococcal or streptococcal bacteria
  • Chickenpox (varicella-zoster virus infection)
  • Herpes simplex virus infection, which causes cold sores (fever blisters) and genital herpes
  • Infected hair follicle
  • Shingles (reactivation of the chickenpox virus)
  • Syphilis
  • Yeast (fungal) infection

Trauma or injuries that cause blisters

Blisters can be due to irritation of the skin or trauma including:

  • Chafing or friction, such as from ill-fitting shoes
  • Chemical, electrical or heat burn
  • Frostbite
  • Insect bites, such as chigger bites
  • Radiation burn
  • Sunburn

Other disorders that cause blisters

Blisters can be due to a variety of other diseases, disorders, and conditions including:

  • Adverse drug reaction
  • Allergic skin reaction
  • Atopic dermatitis (eczema)
  • Bullous pemphigoid (a possible autoimmune disorder)
  • Contact dermatitis, such as a reaction to poison ivy
  • Dermatitis herpetiformis (no known cause, but this disorder is linked to gluten sensitivity)
  • Erythema multiforme (allergic reaction in response to a drug, infection, or other illness)
  • Paraneoplasia (benign skin changes indicating cancer elsewhere)
  • Pemphigus vulgaris or other bullous (blistering) diseases
  • Porphyria cutanea tarda (an enzyme deficiency)
  • Scabies (mite infestation)

Questions for diagnosing the cause of blisters

To diagnose the underlying cause of blisters, your doctor or licensed health care practitioner will ask you several questions about your symptoms. Providing complete answers to these questions will help your provider in diagnosing the cause of your blisters:

  • When and where did the blisters first appear?
  • Have you had similar blisters before?
  • Do the blisters seem to be spreading? Where?
  • Do you have any other symptoms, such as fever or body aches?
  • Have you been in recent contact with any unusual substances or environments, such as exposure to allergens, chemicals, or poison ivy, or are you taking new medications or supplements?

What are the potential complications of blisters?

Complications associated with a blister can be progressive and vary depending on the underlying cause. Because blisters can be due to a serious disease, failure to seek treatment can result in complications and permanent damage.

It is important to contact your health care provider when you develop an unexplained blister or group of blisters, even if you do not have other symptoms.

Once the underlying cause is diagnosed, following the treatment plan outlined by your doctor can help reduce any potential complications including:

  • Bacterial or fungal infection of the skin (cellulitis) or spread of an existing infection
  • Chronic pain or discomfort
  • Open sores and lesions
  • Permanent change in skin texture and scarring
  • Permanent skin discoloration

Source: https://www.healthgrades.com/right-care/skin-hair-and-nails/blisters

Blister Treatment | How to Get Rid of a Blister

Blisters

SrisakornGetty Images

  • To prevent blisters, ensure you are wearing properly fitting shoes and socks.
  • Yes, you can run with blisters, but you should make sure they are protected with a clean bandage and dry socks.
  • Proper blister treatment will ensure your wounds heal quickly.

Annoying and painful, blisters are caused by friction, usually your shoes or socks rubbing against your skin.

Anything that intensifies rubbing can start a blister, including a faster pace, poor-fitting shoes, and foot abnormalities such as bunions, heel spurs, and hammertoes.

Bad blisters, and improper blister treatment, can cut into your training. During race prep and racing, proper blister treatment—including prevention—is key.

Additionally, heat and moisture, which can cause your feet to swell, can also intensify friction.

That explains why many of us only suffer blisters during races, especially marathons, during which you perspire more, run faster and longer, and slosh through aid stations.

The body responds to this friction by producing fluid, which builds up beneath the part of the skin being rubbed, causing pressure and pain. When the friction is so bad that it ruptures tiny blood vessels, that causes a blood blister.

While most blisters don’t pose a serious health risk, they should be treated with respect. “A painful blister can sideline a runner,” says Letha Griffin, M.D., an orthopedic surgeon in Atlanta, and sports physician for Georgia State University.

But more importantly, “a blister also can get infected. And those infections can put you in the hospital,” she adds. “A lot of people will pop a blister with a dirty needle, and the area will get infected.

Then, all of a sudden, you’ve got a severe problem.”

To avoid landing in the emergency room due to an issue as small as a blister, here is what you should keep in mind for at-home blister treatment.

Blister Treatment

If you have a large, painful blister, drain it. If you don’t drain it, your blister will hurt, and it could puncture on its own, says Sheldon Laps, D.P.M.,podiatrist and foot surgeon in Washington, D.C.To drain the blister, wash your hands, then wipe a needle with alcohol to sterilize it.

“Don’t put the needle in a flame; you’ll get carbon particles in your skin,” Laps says. The carbon can further irritate the wound.Once you’ve punctured the blister, carefully drain the liquid by pushing gently with your fingers near the hole. Then cover the blister with a tight, clean bandage to keep bacteria from getting in.

You can take the bandage off periodically and soak your foot in Epsom salts (follow package directions) to draw out the fluid. After soaking, dry the skin thoroughly, and put on a fresh bandage. “It’s a good idea to keep a bandage on until the skin tightens up again,” Laps says.

If you have a small blister that isn’t bothering you, leave it intact. The skin acts as a protective covering over a sterile environment. Furthermore, if the fluid amount is small and you try to pop it, you could cause additional problems by making it bleed. Leave small blood blisters intact, too.

Otherwise, you risk getting bacteria into your bloodstream.For small blisters, cut a hole the size of the blister in the middle of a piece of moleskin, then place it over the blister and cover it with gauze. The blister will dry out and heal on its own.

A blister under a nail is best treated by a professional.

“If it’s under the base of the toenail, we take an electric file and drill a hole,” Laps explains, adding, “You never want to deliberately remove the toenail.”

Blister Prevention

While it’s good to know what to do with a blister once you have one, it’s even better to stop one from forming before it starts. Here are so expert tips for preventing blisters from sidelining your run.

Hydrate Your Feet

Just sweaty skin, dry skin is also more prone to friction. Use skin creams and lotions liberally on a daily basis to maintain proper moisture and skin barrier function.

Choose the Right Socks

Synthetic socks wick moisture away from the skin. Cotton may be lighter, but it retains fluid. Socks with reinforced heels and toes also help reduce friction.

Run with Slick Skin

Coat your feet with Vaseline or another lubricant before you run. Or try Second Skin, a padded tape that stays on even when wet. Both methods form a protective shield between your skin and sock.

Get the Best Fit

Shoes that are too small will cause blisters under the toes and on the ends of the toenails. There should be a thumb’s width of space between the toes and end of the toe box. Your socks should also fit smoothly, with no extra fabric at the toes or heels.

Anti-Blister Tips from Real Runners

Every runner has at least one anti-blister secret. Here are some tips and tools the Runner’s World staff swears by.

  • No cotton socks! But Body Glide is a lifesaver if you’re doing a longer run. —Derek Call, video producer
  • Body Glide always works for me and I also size up a half size in my shoes. —Kathryn Steinhauer, Scrum Master
  • I use Band-Aids, Scotch tape, Kinesio tape, moleskin—anything that’s sticky and will protect the skin from rubbing. Try to avoid wearing wet socks if you can. If it’s raining before a race, pack a dry pair to put them on right before the gun. —Hailey Middlebrook, Digital Editor
  • Vaseline! —Amanda Furrer, Test Editor
  • It’s all about the right socks. I tend to get blisters when I run in socks that are too loose and bunch up in the front of shoes, especially when I’m racing. —Dan Roe, Test Editor
  • Lace-locking shoes ensure your heels don’t slip. —Gabrielle Hondorp, Editorial Fellow
  • I use diaper rash cream for long ultra trail runs. —Pat Heine, Video Producer

Source: https://www.runnersworld.com/health-injuries/a20802798/banishing-blisters/

What causes blisters?

Injury, allergic reactions, or infections can cause blisters. These include:

  • Burns or scalds
  • Sunburns
  • Friction (from a shoe, for example)
  • Atopic dermatitis
  • Impetigo (a contagious infection of the skin)
  • Pemphigus (a rare, blistering skin disease that often occurs in middle-aged and older adults)
  • Pemphigoid (a blistering autoimmune disorder, more common in older adults)
  • Dermatitis herpetiformis (a blistering autoimmune disorder that usually affects adults between 20 and 60 years old) 
  • Viral infections (including chickenpox and herpes zoster)

What are the symptoms of a blister?

Blisters causes by injury or friction will appear as a localized bubble filled with either clear or bloody liquid. Blisters that are the result of another condition may appear in one area of your body or may be all over your body.

Blisters may be painful or itchy. If there is a systemic cause, an infection, you may also have whole-body symptoms such as fever, pain, or fatigue. The symptoms of a blister may look other skin conditions.

Always see your health care provider for a diagnosis.

How are blisters diagnosed?

Doctors can usually diagnose blisters by looking at your skin.

How are blisters treated?

Blisters often heal on their own without treatment.  If needed, treatment will vary, depending on the cause. Some general guidelines for first aid may include:

  • Wash the area with soap and water.
  • A cold or ice pack may help reduce swelling and discomfort.
  • Keep the area clean and dry. Do not burst or puncture the blister.
  • If the blister bursts, place a bandage or dressing on the area to keep it clean.
  • Watch the area for signs of infection such as increased warmth, swelling, redness, drainage, pus formation, or pain. If you notice any signs of infection, call your doctor. You may need antibiotics.

Key points

  • A blister is a bubble on the skin containing fluid.
  • Blisters are caused by injury, allergic reactions, or infections.
  • The symptoms of a blister may resemble other skin conditions.
  • If you have whole-body symptoms, such as a fever, talk with your healthcare provider.
  • Blisters often heal on their own.
  • It is important to keep the area clean and dry.

Next steps

Tips to help you get the most from a visit to your health care provider:

  • Before your visit, write down questions you want answered.
  • Bring someone with you to help you ask questions and remember what your provider tells you.
  • At the visit, write down the names of new medicines, treatments, or tests, and any new instructions your provider gives you.
  • If you have a follow-up appointment, write down the date, time, and purpose for that visit.
  • Know how you can contact your provider if you have questions.

Source: https://www.hopkinsmedicine.org/health/conditions-and-diseases/blisters

healthnewschronicle.com