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Skin Blister - Types, Causes, and Management

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A blister, also known as a vesicle, is a circular, fluid-filled, raised portion of the skin. The fluid can either be clear or blood-filled. This article is a brief on blisters.

Medically reviewed by

Dr. Dhepe Snehal Madhav

Published At November 18, 2022
Reviewed AtAugust 3, 2023

What Are Blisters?

The skin consists of the epidermis, dermis, and subcutaneous tissues. A blister develops as a fluid-filled sac under the epidermis of the skin. Blisters are generally circular in shape, painful, or itchy. The blister may be blood-filled or transparent, depending on the extent of the injury. When the blister gets infected, the fluid turns into milky white pus. Blisters are often seen on the hands or feet but can appear on any body part. In most cases, a blister is mild and heals on its own. But in some conditions, it may result from an underlying condition that may require immediate intervention.

What Are the Types of Blisters?

  • Blood Blisters: When the injury extends to the dermis, the blood starts pooling in the blister space resulting in a bloody blister.

  • Friction Blisters: Friction blister occurs due to the friction caused when rubbing the skin. Here, the blisters are filled with clear fluid as only the superficial layer of skin is involved.

  • Heat Blisters: Heat blisters occur due to burns or sunburns. They may also happen after a warm-up from frostbite. Skin blistering is a form of second-degree burn.

What Are the Conditions That Cause Blisters?

Burn is the only blistering condition that can occur through injury, infection, or friction.

Burns:

  • Burn is a medical emergency condition requiring immediate care.

  • Burns are classified based on depth, size, and severity.

  • In first-degree burns, red, tender skin turns white when applying pressure with minor swellings and dryness.

  • Second-degree burns are excruciating, clear, oozing blisters and skin with red or patchy color.

  • Third-degree burns are white, dark brown, or tan in color, leathery appearance, have little or no touch sensitivity.

Blisters due to injury, infections, or allergic reactions are as follows:

Cold Sore:

  • Red, painful, fluid-filled blisters occur near the mouth and lips.

  • It starts with a tingling or burning sensation before the sore appears.

Herpes Simplex:

  • Herpes simplex virus causes oral and genital blistering lesions. Genital herpes is a sexually transmitted disease (STD).

  • The blisters are painful and occur alone or in clusters and discharge clear yellow fluid forming a scab.

Impetigo:

  • They are commonly seen in babies and children.

  • Rash and fluid-filled blisters that break easily, forming a honey-colored crust, are seen around the mouth, chin, and nose.

Stomatitis:

  • Stomatitis is a sore or inflammation on the lips or inside the mouth caused by infection, stress, injury, sensitivity, or other diseases.

  • Stomatitis can be herpes stomatitis, cold sore, aphthous stomatitis, or canker sore.

  • Herpes stomatitis presents as fever, body pain, swelling of lymph nodes, and painful fluid-filled blisters on the lips or mouth that ooze out and form ulcers.

  • Aphthous stomatitis is an oval or round, yellow or white center with an inflamed border.

Shingles:

  • Shingles appear as linear striped rash, fluid-filled blisters commonly present on the torso but may occur anywhere in the body.

Dyshidrotic Eczema:

  • These form itchy blisters on the soles or palms.

Pemphigoid:

  • Pemphigoid is an uncommon autoimmune disorder resulting in skin rash and blisters on the mucous membranes, arms, legs, and abdomen. When the blister ruptures, the skin becomes sensitive and painful.

  • There are different types of pemphigoid based on the location and time the blistering occurs.

Pemphigus Vulgaris:

  • Pemphigus vulgaris is a rare autoimmune disease where painful or itchy blisters are seen on the skin and mucous membranes of the eyes, nose, mouth, throat, lungs, genitals, and anus.

  • When blisters are present in the mouth and throat, there may be pain when swallowing and eating.

Erysipelas:

Erysipelas is a bacterial infection caused by Streptococcus affecting the superficial skin.

Dermatitis Herpetiformis:

  • Dermatitis herpetiformis is a gluten-related disorder associated with celiac disease.

  • They form an itchy and burning rash that turns into blisters that recur and regress on the scalp, elbows, knees, back, and buttocks.

Hand-Foot-and-Mouth Disease:

It is named so as the blisters are present on these parts of the body. It is commonly seen in children below 10 years. The virus spreads when there is contact between the saliva, mucus, feces, and blisters of the affected person. The condition starts with a low-grade fever, sore throat, and runny nose. But the presence of blisters helps in diagnosing the disease.

Blisters caused by friction are as follows:

Allergic Eczema:

  • Allergic eczema resembles a burn.

  • These are red, itchy blisters on the hands and forearms.

Chickenpox:

  • Clusters of itchy, red, fluid-filled blisters in various stages of healing all over the body.

  • It remains contagious until all blisters have crusted over.

Contact Dermatitis:

  • Occurs hours to days after contact with an allergen.

  • The rash is itchy, with visible borders that appear for hours to days and are localized to the area of allergen contact.

  • These rash turn into blisters that ooze out and become crusty.

Frostbite:

  • Frostbite is an emergency condition and requires immediate intervention.

  • Frostbite occurs when extreme cold temperature damages the body part.

  • Frostbite is commonly seen in fingers, toes, nose, ears, cheeks, and chin.

  • The exposed area becomes numb, skin turns white or yellow ,and feels waxy or hard.

  • In severe cases of frostbite, the skin completely blackens, and loses sensation with fluid or blood-filled blisters.

A blister can also be short-term or long-term. It depends on the underlying cause of the blister.

cause-of-the-blister

These blistering conditions are also accompanied by headache, fatigue, fever, body pain, swollen glands, sore throat, and dry and scaly skin with deep cracks.

How Are the Blisters Treated?

Blisters mostly do not require any treatment. It fades over in a period.

Management is based on making the lesion more comfortable:

  • Preserve the area dry and clean.

  • Wash the area gently using mild soap and water.

  • Apply antibacterial ointments or cream.

  • Apply ice packs to reduce swelling.

  • Do not break or peel off the blister.

  • Cover the blister with gauze or bandage if the blister breaks. Change the gauze or bandage daily.

  • In case the blister gets infected, antibiotic coverage may be required.

Blisters triggered by friction, allergens, and burns are short-term. Therefore, treatment is to avoid the stimulus causing the blister. Some medical conditions, such as pemphigus, where blisters are seen, do not have a cure. Hence, the aim is to manage the symptoms using steroid creams or antibiotics to relieve skin infections.

How to Prevent a Blister?

There are different methods to prevent blisters, and it depends on the type of blister:

1. Friction Blisters: Friction blisters are caused by repeated rubbing. It can be prevented by:

  • Wear well-fitting shoes that do not rub.

  • Avoid wearing new shoes for long periods.

  • Protect hands with gloves when doing manual work.

2. Blood Blisters: These blisters develop when there is a deep injury. They mainly occur on the hands. It can be prevented by:

  • Staying alert when using sharp tools or instruments.

  • Wear gloves while working with strong pliers or with other tight instruments.

3. Heat Blisters: Heat blisters can happen from a burn or when recovering from frostbite. It is prevented by:

  • Use sunscreen when moving out in the sun for a long time.

  • Be careful while handling hot items or with fireworks.

  • Wear weather-appropriate clothes to avoid frostbite. Raise body temperature gradually with lukewarm water.

What Is the Prognosis of a Blister?

The prognosis for a blister is usually good. Blisters are not a life-threatening condition and fade over time but may cause pain and discomfort in their course.

Conclusion:

Blisters are fluid-filled lesions on the superficial skin surface. They can occur due to any injury, allergy, friction, or underlying condition. They usually regress over time. But treatment involves only managing the disease when a systemic condition is involved and no permanent cure is present.

Dr. Dhepe Snehal Madhav
Dr. Dhepe Snehal Madhav

Venereology

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