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skin health

Bubbles on the skin - Cut bubbles by G.Bertelli

Generality

The blisters on the skin are lesions characterized by the collection of clear liquid (serous or serum-ematic), which arise below the outer layer of the epidermis. Compared to the skin surface, these signs appear to be detected and have dimensions varying between 5 and 10 mm in diameter.

The causes of blisters on the skin are numerous and include severe sunburn, exposure to extreme cold, intense friction or rubbing. The skin can react with the formation of bullous lesions even after contact with allergens or irritating substances (allergy or irritative contact dermatitis). The appearance of blisters on the skin can also occur in patients suffering from autoimmune diseases (such as pemphigus vulgaris), acne and various infections (including chickenpox, shingles and impetigo).

Bullous lesions can be associated with other symptoms, such as pain, redness or itching.

Treatment depends on the underlying cause and can include various strategies to facilitate healing and prevent the onset of infectious complications.

What are

The bubbles are among the elementary lesions of the skin, ie they are the direct expression of a pathological process that affects the skin surface. These are characterized by the collection of serous or serum-hematic fluid, typically in the epidermis or dermo-epidermal area. The bubbles on the skin have a rounded shape and a size between 5 and 10 mm in diameter.

On the skin surface, depending on the cause, bullous lesions can have a single or grouped spread.

How the skin is made (in short)

  • The skin is the largest organ and represents the largest part of the body in contact with the external environment.
  • The skin surface is not just a simple shell, but carries out a series of fundamental functions for the organism: it protects from external aggressions (such as traumas), regulates body temperature, promotes the absorption of important substances, etc.
  • The skin appears as a thin fabric, covered with hair and small imperfections. In reality, this is composed of three main layers, each of which performs different functions and, in turn, are divided into further zones:
    • Epidermis (most superficial layer): it is the external scaffolding of the skin and there are germinative cells, involved in the production of all the skin components;
    • Derma (intermediate part): it is formed by connective tissue, soft and elastic. The dermis is crossed by capillaries, lymphatic vessels and nerve receptors (papillary layer). Furthermore, this portion allows the skin to remain elastic and tight, allowing adequate protection of the whole body (reticular layer);
    • Hypoderm or subcutaneous (innermost layer): it connects the dermis and the epidermis to the internal tissues, allowing the anchorage on muscles and bones and favoring the adherence of the skin during body movements.

Bubbles on the skin: what are they?

A blister is a lesion detected on the skin level, characterized by the collection of fluid (serous or serum-ematic) in the thickness of the epidermis or located between it and the dermis.

Blisters or bubbles?

  • The blisters on the skin are lesions similar to the bladders, but they have larger dimensions (variable between 5 and 10 mm in diameter; for sizes greater than a cm one speaks instead of flittene ).
  • The bladders are defined, in fact, as circumscribed formations, with a diameter of less than 10 mm, measured with respect to the skin plane. These lesions are light in color and contain a clear serous or serum-ematic liquid (note: if the bladder contained pus, then a turbid liquid, it would be a pustule ).
  • The smaller blisters (less than 5 mm in diameter) are called vesicles .

Causes and Risk Factors

What causes blisters on the skin?

The blisters on the skin can be caused by different conditions. These include autoimmune skin diseases (eg pemphigus), herpetic infections and irritative or allergic contact dermatitis. The blisters on the skin can also appear in the case of insect bites or drug intolerance.

Friction or rubbing

The blisters on the skin can develop following friction (or continuous pressure ) exerted against a particularly sensitive portion of skin exposed to external aggressions. The appearance of this type of injury is, in fact, common on the hands and feet.

Bubbles on the skin can arise while repetitive movements are performed: when traveling long distances or when wearing a new pair of shoes or when using a tool all day without protective gloves.

The bubbles on the skin are more easily formed on the moist skin surface and are more common in hot seasons. Unlike calluses and corns, which develop as a result of prolonged (but less aggressive) rubbing, blisters and blistering lesions come from an intense friction, relatively short and located on a small area.

Blisters on the skin from friction can lead to more serious complications, such as ulceration and infection.

Severe burns and / or burns

Exposure to flames or steam or contact with a very hot surface can cause the appearance of bubbles on the skin, as well as radiation (for example, due to interaction of the skin with UV or X rays). In the context of severe burns, bubble assessment is one of the tools used to determine the degree of injuries sustained.

Did you know that…

Second-degree burns are associated with the immediate appearance of skin blisters, while in first-degree burns these can occur (possibly) even after a couple of days.

Extreme cold exposure

Rarely, blisters on the skin can form due to tissue damage sustained by freezing . Usually, this manifestation involves hands and feet, ie the body parts most easily exposed to the external environment.

Contact with irritants or allergens

The skin can react with the formation of blistering lesions when it comes into contact with irritating chemicals, cosmetics, solvents and aggressive detergents (bleach, formaldehyde, denatured alcohol, etc.). This condition is known as allergic contact dermatitis .

The blisters on the skin can also develop as a result of an allergic reaction to an insect bite or following contact with natural stinging substances (as happens, for example, in the case of a close encounter with jellyfish or nettles). The phenomenon can develop even after contact with allergens (pollen, dust mites, spider bites etc.).

Allergic reactions to drugs

Many people develop blisters on the skin as an allergic reaction induced by some medicines.

Therefore, before resorting to the use of new drugs, it is advisable to inform your doctor about any adverse effects that may have occurred previously with similar products.

In any case, if during a drug therapy blisters appear on the skin, it is useful to immediately contact your doctor.

Autoimmune diseases

Among the various autoimmune diseases that cause the onset of blisters on the skin, the most common conditions are:

  • Pemphigus vulgaris : is a potentially fatal skin disorder. The elementary lesions of the disease are intraepidermal blisters containing serous fluid, of varying sizes, which originate at the level of the mucous membranes and on the skin. If pressure is applied to the skin, the bubbles tend to spread and can break easily, causing painful ulcers that become chronic and potentially lead to infection.
  • Bullous pemphigoid : causes less severe eruptions of pemphigus vulgaris, as the bubbles on the skin heal faster and do not cause life-threatening complications. This pathology occurs mainly in the elderly.
  • Herpetiform dermatitis : it is a chronic dermatological disease, which manifests itself with the appearance of small, intensely pruritic vesicles, usually located on the elbows, knees, back and buttocks. The bubbles on the skin develop into patches of the same shape and size, on both sides of the body.

Other pathological conditions

The blisters on the skin are a common symptom that characterizes many infectious diseases and a series of other diseases of different origins.

The most common conditions that cause the development of blisters include:

  • Acne;
  • Chickenpox ;
  • Herpes simplex (herpetic infection that occurs most frequently around the lips);
  • Shingles ( shingles );
  • Impetigo ;
  • Dyshidrosis (a particular form of eczema ).

Rare diseases that can occur with the appearance of blisters on the skin are:

  • Psoriasis (pustular form);
  • Erythema multiforme (or polymorphic);
  • Epidermolysis bullosa (a hereditary disease, in which the slightest disturbance to the skin causes the appearance of infected bubbles);
  • Porfiria cutanea tarda (condition associated with liver damage, which often originates from an abuse of alcoholic beverages).

Symptoms and Complications

The bubbles are a collection of liquid between different layers of skin: almost always, these lesions originate in the intraepidermal area (in the thickness of the epidermis) or between the epidermis and the dermis. On observation, the bubbles on the skin appear as a bulge of various shapes and sizes (diameter between 5-10 mm).

What symptoms are associated with the appearance of a blister on the skin?

The blisters on the skin can be accompanied by various other signs and disorders, local or general.

Depending on the cause that causes the onset of the skin lesion, the following can occur:

  • Ache;
  • Local redness or surrounding skin;
  • Swelling;
  • Itch;
  • Stinging or burning sensation;
  • Localized skin irritation and tingling;
  • Oil bleeding;
  • flaking;
  • Scab formation.

Diagnosis

If the blisters on the skin recur or appear in large numbers, a dermatologist should be consulted.

The evaluation includes, first of all, the medical history and the physical examination of the affected area.

To define the severity of the blisters on the skin, the doctor will evaluate the following aspects:

  • Extension of the bubbles on the skin surface;
  • Possible involvement of delicate parts of the body (such as eye, nose and mouth);
  • Signs of infection (eg formation of purulent material, itching, swelling or severe redness).

Acute pathological processes that cause the onset of blisters on the skin should be investigated by taking microbiological samples using a swab (culture test); this makes it possible to establish an infectious etiology. Furthermore, a skin biopsy may be useful to make the diagnosis.

Treatment

In most cases, blisters on the skin do not require specific medical care, but only precautions to avoid infectious complications or other disorders.

Clearly, cases in which blistering lesions are an exception:

  • They manifest themselves in a recurrent way;
  • They are related to serious pathological conditions;
  • They are caused by burns;
  • They signal the presence of an underlying underlying infection.

These situations require, in fact, a targeted treatment, indicated by the doctor after a careful evaluation.

How to heal blisters on the skin

  • The course of the blisters on the skin can take from a few days to a month. Their evolution is directed towards erosion (through exudation and crusting), pustules and / or desquamation (due to reabsorption of the same bullous lesions).
  • The natural physiological process of healing of the blisters on the skin will restore the skin surface below the affected area; the liquid contained in the lesion will simply be reabsorbed.
  • In the event of accidental breakage, the bubbles on the skin let the liquid contained in them escape and remain in ulcers that are covered by a crust, and then heal gradually. This process takes about a week. If they become infected, however, the liquid takes on a purulent appearance and, after breaking, the lesion is ulcerated and exuding.

Warning! No bubbles should be punctured on the skin, except in the event that the lesions are very large, painful or susceptible to further irritation (in this case, however, it would be advisable to contact the doctor first to obtain the most appropriate indications).

To remember

An intact bubble allows the skin to be kept clean, promoting healing; for this reason, it is important to resist the temptation to break the wound, pierce it or incise it: in this way, the natural process of repairing the skin or causing an infection could be hindered.

What are the treatments planned for blisters on the skin?

Most blisters on the skin are caused by minor friction or burns that do not require medical attention.

Measures for managing a simple friction or rubbing bubble include:

  • Frequently wash the area where the lesion is located and the surrounding skin with soap and water to keep it free from dirt or irritants.
  • If the blister on the skin has burst (for example, a bladder on the foot may break due to friction with socks or shoes): do not detach the skin dome covering the lesion, as the best protection against infections remains. Cover with a sterile dressing to protect the area.
  • If a bubble is close to breaking, sterilize the part and puncture the lesion near the margin with a needle (like a disposable syringe). Press gently to allow the liquid to escape and apply an antiseptic to reduce the risk of infection. A slight pressure will allow the liquid to escape. The superficial skin must be left in place and must be covered with a soft and sterile dressing, making sure that the central part of the dressing does not stick to the bubble itself. Change the dressing daily.

When to contact the doctor

Consult your doctor to define a specific treatment, if the blisters on the skin are caused:

  • From burns or severe burns;
  • From contact with a chemical substance;
  • From a full-blown illness;
  • From allergic reactions.

Even when it is suspected that the blisters may be caused by some type of infectious skin disease (viral, fungal or bacterial) it is essential to discuss with a specialist the medical measures to be taken.

Skin blisters must be treated with a suitable therapy even if signs of a secondary infection develop ( infectious complications, for example, due to the incorrect management of the lesion), ie:

  • Presence of purulent exudate (yellow or green pus, fluid, sometimes smelly);
  • The area becomes increasingly swollen or inflamed (the skin surrounding the vesicle is red, hot or painful).

Furthermore, it is necessary to consult the doctor if the blisters on the skin tend to recur or appear in large numbers .

drugs

The medical treatment of blisters varies depending on the cause and may include:

  • Drainage and sterile dressings ;
  • Local application of antiseptics to facilitate healing and prevent the onset of infectious processes;
  • Antibiotics, in the case of a bacterial infection;
  • Antifungal preparations, in case of fungal infection;
  • Antiviral therapies, in the case of viral infection.

Prevention

How can bubbles be prevented on the skin?

The main strategies that can be adopted to avoid the appearance of bubbles on the skin include:

  • Wear shoes of a suitable size and breathable socks to limit the friction of the foot. Apply locally protective gel pads to prevent blister formation on skin susceptible to rubbing.
  • When using work tools such as shovels and pickaxes with your hands, be sure to wear protective gloves.
  • Use a suitable sunscreen to avoid burns. Use clothes and hats during the hottest hours of the day and do not expose yourself excessively to the sun.
  • Be careful when using heat or steam sources.
  • Avoid skin contact with substances that can be potentially irritating, such as detergents, cleaning products, solvents and other chemicals.

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