Blister: Causes, Conditions that cause blisters with symptoms, Treatment, Prevention and Prognosis


Blister also called a vesicle is a pocket of fluid between the upper layers of skin because of friction, freezing, burning, infection, and chemical burns. Blisters are also a symptom of some diseases.

May 14, 2018

Blister: Causes, Conditions that cause blisters with symptoms, Treatment, Prevention and Prognosis

Blister also called a vesicle is a pocket of fluid between the upper layers of skin because of friction, freezing, burning, infection, and chemical burns. Blisters are also a symptom of some diseases.
Epidermis is the uppermost layer of skin whose purpose is to protect and cushion the layers below. The blister bubble is formed from the epidermis. Blisters can be filled with serum, plasma, blood or pus depending on how and where they are formed. Wearing ill-fitting shoes for too long can cause a blister when friction between your skin and the shoe results in layers of skin separating and filling with fluid. Blisters are often annoying, painful, or uncomfortable. But in most cases, they aren't serious and will heal without any medical intervention. However, if you have unexplained blistering on your skin, you should see your healthcare provider for a diagnosis.

Causes of blisters:

There are many activities and ailments that can cause a blister. Some of the more common ways that blisters can form include:

Friction:

Most commonly blisters are formed due to excess friction, often caused by repetitive actions such as playing a musical instrument. Friction occurs when something rubs against your skin for a prolonged period of time.
Any repetitive friction or rubbing can cause blisters. These blisters will usually appear on the hands or feet. These are the areas that most often gets effected by friction whether due to walking, running or playing any musical instruments. Blisters are more likely to occur in areas of skin with a thick horny layer, attached tightly to underlying structures such as palms of hands and soles of feet. It occur more readily if the conditions are warm, for example, inside a shoe. They also form more easily in damp conditions, compared with wet or dry environments. Blisters can lead to more serious medical issues such as ulceration and infection of skin.

Temperature extremes:

Temperature extremes such as burns, if severe enough, can produce blistering. This includes burns from heat, chemicals, and sunburns. A second degree burns will blister immediately,while a first degree burns blister a couple of days after the incident.
Frostbite also can produces blisters when exposed to extreme cold for a prolonged period of time. In both cases, the blister works as a defense mechanism to protect lower levels of skin from temperature related damage.

Chemical exposure

Skin can occasionally blister because of certain chemicals known as contact dermatitis. This is a skin reaction to allergens, like poison ivy, latex, adhesives, or irritants like chemicals or pesticides which can cause red, inflamed skin and blistering.
It can affect some individuals on contact with the following:

  • cosmetics
  • detergents
  • solvents
  • balsam of Peru, a flavoring
  • nickel sulfate, used in electroplating
  • pesticides
  • insect bites and stings
  • chemical warfare agents, including mustard gas

Crushing and pinching:

A blister filled with blood can be formed if a small blood vessel near the surface of the skin is ruptured. When blood leaks into the gap between the layers of skin, it can cause a blood blister to form.

Medical conditions:

A number of medical conditions can cause blisters.
These include:

Chickenpox:

This is an infection caused by a virus, produces itchy spots and often blisters on the skin. The rash forms small blisters that eventually scab over.The same virus that causes chickenpox also causes shingles, or herpes zoster. The virus reappears in some people later in life and produces a skin rash with fluid vesicles that can rupture.

Herpes:

The cold sores produced by the herpes simplex virus are clusters of blisters.

Bullous impetigo:

This is a bacterial infection of the skin that can occur in both children and adults which may cause blisters. But mostly this is seen in children under 2 years and blisters can form on the arms, legs, or trunk.

Eczema:

This is a skin condition that is caused or worsened by allergens and can produce blisters. Blistering can occur along with a number of other skin symptoms such as cracking, crusting, and flaking.

Dyshidrosis:

This is a skin condition characterized by a rapid occurrence of many small, clear blisters.

Bullous pemphigoid:

An autoimmune disease that affects the skin and causes blisters, this is most common in older patients.

Pemphigus:

A rare group of autoimmune diseases which affects the skin and mucous membranes. The immune system attacks an important adhesive molecule in the skin, detaching the epidermis from the rest of the layers of skin.

Dermatitis herpetiformis:

This chronic blistering skin condition is unrelated to herpes but similar in appearance.

Cutaneous radiation syndrome:

These are the effects of exposure to radiation.

Epidermolysis bullosa:

This is a genetic disease of the connective tissue that causes blistering of the skin and mucous membranes.

Stomatitis:

It is a sore inside the mouth that can be caused by herpes simplex 1.

Genital herpes:

This can also result in blisters around the genital region.

Erysipelas:

This is an infection caused by the Streptococcus group of bacteria, which produces skin blisters as a symptom.

Conditions that cause blisters with symptoms:

Friction, infection, or a skin condition can cause a blister. The conditions include:

Cold sore:

Red, painful, fluid-filled blister that appears near the mouth and lips.
Affected area will often tingle or burn before the sore is visible.
Blister may also be accompanied by mild, flu like symptoms such as low fever, body aches, and swollen lymph nodes

Genital herpes:

This sexually transmitted disease (STD) is caused by the HSV-2 and HSV-1 viruses.
It causes herpetic sores, which are painful blisters often fluid filled bumps that can break open and ooze fluid.The infected site often starts to itch, or tingle, before the actual appearance of blisters.Symptoms include swollen lymph nodes, mild fever, headache, and body aches.

Impetigo:

Common in babies and children. Rash is often located in the area around the mouth, chin, and nose. Irritating rash and fluid-filled blisters that pop easily and form a honey colored crust

Herpes simplex:

The viruses HSV-1 and HSV-2 cause oral and genital lesions.These painful blisters occur alone or in clusters and weep clear yellow fluid and then crust over. Signs also include mild flu like symptoms such as fever, fatigue, swollen lymph nodes, headache, body aches, and decreased appetite. Blisters may reoccur in response to stress, mensturation, illness, or sun exposure

Contact dermatitis:

This appears hours to days after contact with an allergen. Rash has visible borders and appears where your skin touched the irritating substance. Skin is itchy, red, scaly, or raw. Blisters that weep, ooze, or become crusty.

Burns

This condition is considered a medical emergency which requires urgent medical attention. Burn severity is classified by both depth and size.

  • First-degree burns: minor swelling and dry, red, tender skin that turns white when pressure is applied
  • Second-degree burns: very painful, clear, weeping blisters and skin that appears red or has variable, patchy coloration
  • Third-degree burns: white or dark brown/tan in color, with leathery appearance and low or no sensitivity to touch

Stomatitis:

Stomatitis is a sore or inflammation on the lips or inside of the mouth that can be caused by infection, stress, injury, sensitivity, or other disease.The two main forms of stomatitis are herpes stomatitis, also known as a cold sore, and aphthous stomatitis, also known as a canker sore.
Herpes stomatitis symptoms include fever, body aches, swollen lymph nodes, and painful, fluid-filled blisters on the lips or in the mouth that pop and ulcerate.
With aphthous stomatitis, ulcers are round or oval with a red, inflamed border and yellow or white center.

Shingles:

Very painful rash that may burn, tingle, or itch, even if there are no blisters present
Rash comprising clusters of fluid-filled blisters that break easily and weep fluid
Rash emerges in a linear stripe pattern that appears most commonly on the torso, but may occur on other parts of the body, including the face. Rash may be accompanied by low fever, chills, headache, or fatigue

Frostbite:

This condition is considered a medical emergency which requires urgent medical attention. Frostbite is caused by extreme cold damage to a body part.Common locations for frostbite include fingers, toes, nose, ears, cheeks, and chin
Symptoms include numb, prickly skin that may be white or yellow and feel waxy or hard. Severe frostbite symptoms include blackening of the skin, complete loss of sensation, and fluid- or blood-filled blisters.

Dyshidrotic eczema:

Itchy blisters develop on the soles of the feet or the palms of the hands with this skin condition.The cause of this condition is unknown, but it may be related to allergies, like hay fever. Itchy skin occurs on the hands or feet and fluid-filled blisters appear on the fingers, toes, hands, or feet. Other symptoms include dry, red, scaly skin with deep cracks.

Pemphigus vulgaris:

Pemphigus vulgaris is a rare autoimmune disease which affects the skin and mucous membranes of the mouth, throat, nose, eyes, genitals, anus, and lungs. Painful, itchy skin blisters appear that break and bleed easily. Blisters in the mouth and throat may cause pain with swallowing and eating

Pemphigoid:

Pemphigoid is a rare autoimmune disorder caused by a malfunction of the immune system that results in skin rashes and blistering on the legs, arms, mucous membranes, and abdomen. Based on where and when the blistering occurs there are multiple types of pemphigoid that differ. A red rash usually develops before the blisters.
The blisters are thick, large, and filled with fluid that is usually clear but may contain some blood. Skin around the blisters may appear normal, or slightly red or dark.
Blisters that are ruptured are usually sensitive and painful.

Allergic eczema:

This may resemble a burn and are often found on hands and forearms. Skin is itchy, red, scaly, or raw. Blisters may weep, ooze, or become crusty.

Chickenpox:

Clusters of itchy, red, fluid-filled blisters occurs in various stages of healing all over the body. Rash is accompanied by fever, body aches, sore throat, and loss of appetite.
Remains contagious until all blisters have crusted over.

Dermatitis herpetiformis:

Dermatitis herpetiformis is an itchy, blistering, burning skin rash that occurs on the elbows, knees, scalp, back, and buttocks.The symptom are similar to that of autoimmune gluten intolerance and celiac disease. Symptoms include extremely itchy bumps that look like pimples filled with clear liquid that form and heal in waxing and waning cycles. Symptoms can be controlled by following a gluten free diet.

Erysipelas:

This is a bacterial infection in the upper layer of the skin which is usually caused by the group A Streptococcus bacterium. Symptoms include fever, chills, a red, swollen, and painful area of skin with a raised edge, blisters on the affected area and swollen glands

Treatment for blisters:

Most blisters will heal without any medical treatment by its own if you leave them for some days. The fluid will slowly disappear and the skin will naturally dry and peel off as the new skin grows beneath the blister.
You may be able to treat it by covering it with bandages to keep it protected. Covering the blister with a band-aid or gauze can help protect it from additional trauma while it heals. Eventually the fluids will seep back into the tissue, and the blister will disappear.
As the bubble is a protective layer that protects you from infection, popping blisters is not recommended unless it is very painful. Once the barrier is removed, the wound is open to bacteria and can become infected.
If the blister bursts, allow the fluid to drain away naturally and carefully wash it with mild soapy water. Be patience to peel off any dead skin on the top.
Cover the blister and the surrounding area with a sterile, dry dressing. Avoid the known cause of blister such as blisters caused by friction, allergens, and burns which are temporary reactions to stimuli.
The blisters caused by infections are also temporary, but they may require treatment. You should see your healthcare provider if you suspect you have some type of infection.
Some over-the-counter (OTC) medications, such as hydrocolloid dressings, can help prevent further discomfort and help the healing process. Allow the blood blisters to heal under in their own time. They can be more painful than standard blisters. Often an ice pack can offer some relief. Place a towel over the affected area, ensuring that the ice pack does not come into contact with the skin directly.
Some conditions such as pemphigus that can cause blisters, don't have a cure. Treatments can prescribed by your healthcare provider that will help you manage symptoms. This may include steroid creams to relieve skin rashes or antibiotics to cure skin infections.

Prevention for Blisters:

Friction blisters are best prevented by removing the cause of the friction. This can be done in a number of ways.

Avoiding blisters on the feet:

You should wear well fitted, comfortable footwear and clean socks. Badly fitted or stiff shoes, such as high heels will have a higher risk of blistering. Moist skin blisters more easily. Therefore, socks that manage moisture or changing socks frequently can be helpful. Specially designed sports socks can reduce the amount of available foot sweat during exercise and sports. Tape, padding or moleskin can be applied to the affected spots to help prevent blisters from appearing. Friction management patches can be applied to the inside of shoes which will remain in place longer, throughout many changes of socks or insoles.

Avoiding blisters on the hands:

Wearing gloves will prevent the majority of blisters while using tools, carrying out manual work or playing a sport where holding a bat is necessary.Taping up the hands is good practice in case of some sports, such as gymnastics, weightlifting or rowing. As talcum powder acts to reduce friction, can be used in combination with gloves and tape, or as a stand alone option. However, it will not work well for long duration of activity because talcum powder absorbs moisture.
Most common of blisters those caused by friction on the skin of your feet and hand can be prevented by practicing the above basic preventive measures.

Prognosis for Blisters:

Mostly blisters aren't part of a life-threatening condition and will go away without treatment, but may cause you pain and discomfort in the meantime.
The outlook of your condition depend on:

  • The quantity of blisters you have
  • whether these have ruptured
  • Weather these have become infected

Your outlook is good if you treat an infection that is causing blisters. How well the treatment work will depend on the individual situation or rare skin conditions.