Almost everyone knows skin blisters from minor burns or after wearing new shoes. If you know the causes for the development of a skin blister, it can be easily treated and in many cases even prevented in advance.
What is a skin blister?
A skin blister, also called a bulla, is a pathological skin condition in which fluid accumulates due to skin irritation and causes the skin area to visibly bulge outward. A skin blister, also called a bulla, is a pathological skin change in which fluid accumulates due to skin irritation and visibly bulges the skin area outward. Thus, skin blisters belong to the so-called efflorescences in dermatology. If blisters are at least 5 mm in size, they are called skin blisters or bullae. Smaller fluid accumulations are called vesicles or vesicles in dermatology. In medicine, three types of skin blisters are distinguished. Subcorneal blisters are those that lie under the stratum corneum, intraepidermal blisters lie in the so-called epidermis, and blisters lying under the dermis are called subdermal.
Causes
Blisters occur as a result of excessive skin irritation. A particularly typical cause of a skin blister is friction, such as from footwear that does not fit properly or is too moist. The friction generates heat that burns the skin. However, skin blisters also occur after any other type of second-degree burn. This does not only apply to physical sources of heat, such as the sun, fire or the like. Causes of skin blisters may well be chemical as well. In addition to burns, bullae can also result from second-degree frostbite or infection. Typically, a blister does not develop immediately, but develops over a period of time, sometimes after several hours.
Diseases with this symptom
- Impetigo contagiosa
- Herpes simplex
- Shingles
- Polymorphous light dermatosis
- Allergy
- Pemphigus foliaceus
- Acne
- Rosacea
- Pemphigus vulgaris
- Labial herpes
- Dermatitis herpetiformis Duhring
- Bullous pemphigoid
- Anthrax
- Burn
- Blistering autoimmune dermatoses
Diagnosis and course
A skin blister is painful, as long as it affects comparatively small areas of skin, but usually harmless from a health point of view. Therefore, treatment by a physician is usually not necessary. Since the occurrence of a blister is announced in advance by pain, the cause of the skin irritation can be eliminated in many cases and the development of the blister can be prevented. When a blister can no longer be prevented, the uppermost skin layers detach and protein-poor tissue fluid is deposited. If direct measures are taken in the case of blisters, such as cooling or ointments, it is possible to influence their formation and subsequent size. Once a blister has formed, it takes time for it to disappear. As a rule, the skin recovers after a few days. Burst skin blisters usually take a little longer to heal. Nevertheless, skin blisters usually recover completely and do not leave scars.
Complications
A skin blister is usually harmless and will burst on its own. However, those who do not wait for it and open it themselves at home expose themselves to the risk of infection. This complication occurs when sterile cutlery has not been used – which, in turn, is not easy to do at home. Boiling the tool in salt water or exposing it to a sufficiently high heat source can kill germs, but if this is not done thoroughly, when the bulla is opened, the germs are placed exactly where they have an especially easy time triggering infections. The opened blister becomes infected and since the affected area is already weakened anyway, such infections usually do not clear up on their own after a short time. If the skin blister is located in an unfavorable place that normally has to be loaded, this can also lead to complications. Blisters on the foot are particularly common; they occur precisely at the points of stress. If the skin blister is not opened, the affected person may no longer be able to step properly and risks tension and incorrect strain on the muscles he or she uses for substitute movement.Since these muscles are not made for this, they react with pain and subsequent overload. To avoid this type of complication, opening the bladder by a doctor is often considered better.
When should you go to the doctor?
Blistering of the hand and arm after pouring boiling water over them after an accident. People who notice skin changes with blisters should always consult a doctor (e.g., dermatologist). It could be due to a bacterial or viral skin infection, an autoimmune disease, or a food allergy. Immunodeficiency skin diseases that are accompanied by blistering are called bullous dermatoses and are very rare. In bullous dermatoses, the organism forms antibodies against cell components of its own skin. As a result, the uppermost layer of skin becomes detached and small or large blisters form. The antibodies massively interfere with the skin stability, destroying not only the epidermis but also deeper skin layers. There are several diseases that belong to the group of blistering dermatoses. They are all similar. If a blister can be moved laterally within healthy tissue, it indicates a certain autoimmune disease. The doctor tests for antibodies (immunofluorescence), which can be detected in the skin cells and blood. If the blisters developed due to a bacterial infection, treatment with antibiotics is advisable. Sun or cold can damage the skin to such an extent that fluid-filled blisters form. A common vesicular skin disease caused by viruses is herpes simplex type 1, which occurs primarily on the lips and can be very painful. Herpes simplex type 2 manifests in the genital area and is also caused by viruses.
Treatment and therapy
Many people tend to prick a blister. However, it is better to leave the blister as it is. The skin of the blister, which stretches over the wound, protects it from bacterial invasion. As the healing process continues, the blister also recedes. The healing process can be accelerated with various ointments from the pharmacy. However, if you decide to puncture a blister, you should use a pointed and, above all, sterile object. Puncturing a blister may be necessary if the blister is located, for example, under the sole of the foot or in other parts of the body where a blister cannot heal at rest. After the wound water has drained from the lanced blister, a blister patch is placed over the wound to take over the function of the blister skin and protect the wound from possible infection. In some cases, the skin blisters may also burst open on their own. This is also not atypical and usually does not require treatment by a trained medical professional. However, it can become problematic if the wound becomes infected. If blisters burst open, they reveal the dermis. Compared to the epidermis, the dermis is much lighter and redder and releases wound water. This is the ideal breeding ground for bacteria of all kinds, which have easy access through the unprotected and exposed wound. If the wound becomes infected, a doctor must be consulted to provide medical care.
Outlook and prognosis
The outlook for the further progression of a blister varies depending on the cause. Blisters caused by mechanical stress usually resolve on their own over time and heal without scarring. Nevertheless, inflammation can also develop, especially if the outer skin of the blister is damaged. If the blisters are detected early, they are usually well treatable with medicinal ointments. Scars can usually only remain if blisters are caused by intense radiation, burns or frostbite. If allergies are triggers, the course depends on the severity of the allergic reaction. Since allergies usually persist throughout life, the recurrence of blisters in this case can only be prevented by avoiding future contact with the allergenic substance. Even when autoimmune diseases cause blistering, the prognosis varies greatly, depending on the extent of the immune response. Treatment is essential, as these diseases can lead to death if left untreated. Most often, the therapy used is medication that curbs the immune activity that causes symptoms such as blistering.These immunosuppressants usually must be taken for life because the underlying autoimmune disease usually cannot be completely cured.
Prevention
Before a blister develops, the affected area is already painful. For blisters that occur due to mechanical friction, skin blisters can be prevented by directly eliminating the circumstance that causes the friction. Blisters caused by burns can also be prevented or at least the size of the blister can be reduced by directly cooling the affected area extensively. Blister plasters are also suitable not only for the treatment of blisters, but also for prevention. Blister formation can also be completely prevented by avoiding the causes of skin blisters. In many cases it is enough to change a few everyday things. For example, only suitable footwear with synthetic and also well-fitting socks should ever be worn. Socks should also be changed regularly to avoid moisture in the shoe. Anyone who can foresee that hiking or running will increase the strain on the feet should slowly accustom them to this strain in order to prevent skin blisters. To reduce moisture caused by sweating, there are also so-called antihidrotics available in pharmacies that can be applied to areas of the skin to reduce the release of sweat. Anyone handling fire or hot objects should wear protective clothing and be especially careful around heat sources. In the home, oven mitts or the like are often sufficient to prevent minor burns.
What you can do yourself
Everyday and self-help is usually very possible when skin blisters occur. If the skin blister forms on the foot due to new footwear, preventive measures can be taken in advance. For example, the development of a blister on the foot is announced by pain in the affected area, and skin redness appears. One preventive measure is to apply a plaster with soft padding to the reddened area or to apply a small padding in the shoe itself. Better than a normal wound plaster are special blister plasters. They are specially designed for pressure relief, pain relief and sterile covering. If skin blisters are expected to form after scalding by hot or boiling water, cooling the scalded skin will help to contain the inflammatory reactions initiated by the immune system. Existing skin blisters that can no longer be prevented in advance should, if possible, be given the opportunity to heal on their own without opening them. If the blister is very bothersome, it can also be opened carefully with a pointed object, such as a sewing needle. It is advisable to sterilize the needle tip beforehand by alcohol or by heating in the lighter flame, because the tissue fluid in the bladder is an ideal breeding ground for many pathogenic germs.
