Blisters

Definition

• A blister is a small pocket of fluid that forms under the skin.

• Friction blisters usually occur on the palms, fingers, heels, or toes

• For Newborn rashes and blisters, please see The Newborn Rash article

What Does a Blister Look Like?

• Raised, fluid-filled bubble

• Clear fluid (most common)

• May look cloudy or yellow if irritated

• Skin around it may be red or tender

Symptoms

• Blisters cause mild to moderate pain.

• The amount of pain depends on where and how large they are.

• They can interfere with work or sports.

Cause

Blisters in children are common and can happen for several reasons:

• Friction

  • Shear forces on the skin separate the top layer of skin from the lower layer.

  • This forms a cushion (blister) of fluid over the spot of friction

  • Hand blisters are often caused by friction from using a tool (shovel, pick, or rake).

  • They can also be caused by sports equipment such as a tennis racquet or boat oars.

  • Gymnastics equipment (high bars) may also cause hand blisters.

  • Foot blisters are usually caused by friction from activities such as hiking or running.

• Burns – from heat, sun, or hot liquids

• Irritation – from chemicals or soaps

• Allergic Reactions- from plants like poison ivy

• Infections – such as Impetigo or Hand, Foot, and Mouth Disease

  • Viral Infections

    • Herpes Simplex Virus (HSV)

    • 

      This is a very serious and dangerous newborn infection

  • • Varicella Zoster Virus (VZV) causes Chickenpox and Shingles

      

    • Coxsackie and other Enteroviruses cause Hand, Foot, and Mouth Disease

    • 

  • Bacterial Infections

    • Staphylococcus aureus or Streptococcus pyogenes may cause Impetigo.

      

Prevention of Blisters

• Foot Blisters

  • Shoes.

    • Buy shoes that fit.

    • Do not wear shoes that are too tight or too loose.

    • New hiking boots are often somewhat stiff. Break them in by wearing them in the house and on short walks.

  • Socks.  

    • Use socks to reduce friction.  

    • Do not use cotton socks. They tend to stay damp when wearing.

    • Instead use synthetic (acrylic) or wool socks.

    • Some people prefer to wear two socks at a time.

    • You can wear a thin inner liner (‘wicking’) sock and a thicker outer sock.

  • Lubricants.

    • If your child often gets blisters at the same spot, use a lubricant.

    • You can use petroleum jelly.

    • Cover the area with a small amount of the lubricant before sports.

    • This will help to reduce friction on the spot.

  • Taping Pressure Points.

    • If a lubricant doesn’t stop blisters, taping is the next step.

    • Taping is a very good way to treat hot spots for friction blisters.

    • Many hikers and runners use taping.

    • Use moleskin or duct tape.

    • Cut a piece into a shape slightly larger than the pressure point.

    • Put it on the pressure point.

    • Smooth it from the center outward so that there are no wrinkles.

• Hand Blisters

  • Gloves:

    • Wear heavy-duty work gloves when working with your hands.

    • Use gloves when working with tools such as shovels and rakes.

    • Use sports gloves for rowing, paddling, weight lifting or cycling.

  • Lubricants. Lower friction at pressure points by covering them with a lubricant such as petroleum jelly.

• Sun Blisters

  • Apply sunscreen to prevent sunburn

• Irritant and Allergy Blisters

  • Avoid known irritants and allergens

How to Care for Blisters at Home

With home care, blisters usually dry up and peel off without any treatment in 1-2 weeks.

• Do:

  • Wash gently with soap and water

  • Keep the area clean and dry

  • Cover with a bandage if needed

  • Use comfortable, well-fitting shoes

  • Give acetaminophen (such as Tylenol) or ibuprofen. Use as needed.

• Don’t

  • Pop the blister (this helps prevent infection)

  • Rub or put pressure on the area

What if the Blister Breaks?

If the blister opens:

• If the blister breaks open, let it drain.

• Leave the roof of the blister in place to protect the raw skin underneath.

• If there are any loose flaps of skin, trim them with a fine pair of scissors.

• Gently clean the area with warm water and soap.

• Use an over-the-counter antibiotic ointment twice a day.

• Cover it with a Band-Aid.

When Should I Call CPCMG?

Contact your child’s healthcare provider if:

• The blister is very large or painful

• There is severe pain, and you want your healthcare provider to drain the blister

• There are many blisters, or they keep coming back

• There are signs of infection:

  • Increasing redness

  • Warmth or swelling

  • Pus (yellow/green fluid)

  • Fever

• Blister is from a burn

• Blister is near the eyes, mouth, or genitals

• Your child has a condition like eczema and the skin is worsening

• You think your child needs to be seen

• Your child becomes worse