Table of Contents
Blisters
Synonym: Vesicle
Because of the condition of the skin and the swelling, it is fairly common for people with lymphedema to experience blisters. It is important to treat these correctly as they can be an opening for bacteria.
What is a blister?
A blister is a lfuid filled “bump” or “bubble on the skin. It is an inflammatory response to skin trauma, injury or damage and is your body’s way of helping protect the injured area and to help it heal.
This bubble is basically a thin-skinned sac of a blister contains fluid, and in most cases should not be ruptured, as rupturing can introduce infection and slow the healing process. Blisters that contain blood instead of fluid are aptly named blood blisters, and are caused by a rupture of blood vessels beneath the surface of the skin, usually due to trauma.
Causes of Blisters
Friction, constant rubbing and pressure are the most common causes of blisters. But there are many medical conditions that cause them as well.
These include:
- Allergic reactions to drugs
- (eczema)
- Chicken pox
- Contact dermatitis (may be caused by poison ivy)
- Herpes simplex (cold sores, genital herpes)
- Sunburn
- Allergic reaction
- Incontinentia pigmenti syndrome (IPS)
Other types of injuries to the skin that may cause a blister include:
- Burns from exposure to heat, electricity, chemicals, radiation from the sun, or friction.
- Cold injuries from being exposed to cold or freezing temperatures.
Some spider bites, such as a bite from a brown recluse spider . Symptoms of a brown recluse spider bite include reddened skin followed by a blister that forms at the bite site, pain and itching, and an open sore with a breakdown of tissue (necrosis) that develops within a few hours to 3 to 4 days following the bite. This sore may take months to heal.
Blisters and Infections
Important point (1) - for people with lymphedema to understand that blisters should not be popped if at all possible. Left alone, blisters will generally self heal. Popping them is dangerous as it provides anopen door to a bacterial infection.
Important point (2) - If you have diabetes and lymphedema, special care must be taken as you risk of an infection is dramatically increased. If the blister is large, sore or red, you should contact you doctor.
Important point (3) – Many of us because of other medical conditions, for example cancer, may have a suppressed immune system. It is even more critical for you to correctly treat the blister, prevent it from popping and becoming infected. Sepsis, a life threatening infection could result.
Signs of infection could include:
- pus draining from the blister
- very red or warm skin around the blister
- red streaks leading away from the blister
- extreme tenderness
- any rise in your body temp
If you have any indication of infection, contact your doctor immediately. Antibiotics need to be started immediately as well.
If the blister appears infected, it should be opened (preferably by a doctor) and drained entirely, an appropriate dressing and ointment applied, and the victim treated with antibiotics. Dicloxacillin, erythromycin, cephalexin, or augment are good antibiotics commonly used. The treatment needs to be for a miminum 5 days or until the skin appears normal. Complete the course prescribed by your doctor. Do not stop taking the antibiotic until the prescription is finished.
Treatment of Blisters
- Cleanse the area with a mild soap (I use an antibacterial soap).
- Apply a soft gause pad over it, especially if it is in an area that would be easy to bump or scrap.
- Do not pop the blister
How to Prevent Blisters
- Keep “skin friction” to a minimum.
- Wear work gloves. Jobs you do only occasionally, such as shoveling snow or raking leaves, are great for raising a blister or two
- Break in new shoes gradually and put petroleum jelly or an adhesive bandage on areas that take the rub – before the blister happens.
- Wear socks that have heels instead of tube socks (they bunch up and cause blisters)
- Use sun screen when outdoors
If you must pop a blister
Preferably this should be done by your doctor. I understand some of us hate going to a doctor or think we can handle it ourselves.
These guidelines should be followed: (1)
- Use a sterilized needle or razor blade (to sterilize it, put the point or edge in a flame until it is red hot, or rinse it in alcohol).
- Wash the area thoroughly, then make a small hole and gently squeeze out the clear fluid.
- Apply a dab of an antibiotic ointment with polymixin B and/or bacitracin to help protect against infection. Use caution with ointments that have neomycin in them because they are more likely to cause an allergic reaction.
- If the fluid is white or yellow, the blister may be infected and needs medical attention.
- Do not remove the skin over a broken blister. The new skin underneath needs this protective cover.
Look for signs of infection to develop. These include pus drainage, red or warm skin surrounding the blister, or red streaks leading away from the blister.(1)
Types of Blisters
Blood Blisters - contain small amounts of blood that have accumulated from small broken capillaries or vessels within the skin. These skin blisters are typically characterized by excess swelling. Most commonly created due to an injury surrounding the skin caused by impact, a blood blister will typically appear deep red in color.
Fever Blisters - occur on the mouth and may be accompanied by cold sores or develop on their own. This type of blister is caused by a virus and may be contagious. The herpes virus also causes fever blisters and cold sores and is actually quite common. Blisters of this nature may cause skin irritation and burning. Itching and peeling is also common. Fever blisters are best left to heal on their own without any intervention or treatment.
Water Blisters - contain clear liquid and are typically small in size. Most often, these types of blisters are caused by chafing and irritation against an area of the skin. May people suffer from water blisters due to wearing improperly fitted shoes, and runners and athletes are typically prone to this. Water blisters are generally harmless and mild and most require no treatment, other than to keep the area clean and free of friction.
References
Blisters – WebMd (1)
External Links
Blisters – First Aid – Mayo Clinic
Blisters and Vesicles – Medline Plus
Blisters, Calluses and Corns – Kidshealth
Bullae or Bulla are blisters larger than 1 centimeter wide. Bullae that are filled with clear fluid may occur on the skin.
Vesicle A vesicle is a small fluid-filled blister. A vesicle is small – it may be as tiny as the top of a pin or up to 5 or 10 millimeters wide.
In many cases, vesicles break easily and release their fluid onto the skin. When this fluid dries, yellow crusts may remain on the skin surface.
Codes and Classifications
ICD-10
T14.0
Superficial injury of unspecified body region
- Abrasion Blister (nonthermal) Bruise Contusion Haematoma Injury from superficial foreign body (splinter) without major open wound Insect bite (nonvenomous) Superficial injury
Excludes: multiple superficial injuries NOS ( T00.9 )
ICD-9-CM Diagnosis 910
Superficial injury of face neck and scalp except eye
- 910 is a non-specific code that cannot be used to specify a diagnosis
- 910 contains 32 index entries
ICD-9-CM Diagnosis 910.2
ICD-9-CM Diagnosis 910.0
Abrasion or friction burn of face neck and scalp except eye without infection
- 910.0 is a specific code that can be used to specify a diagnosis
ICD-9-CM Diagnosis 910.1
Abrasion or friction burn of face neck and scalp except eye infected
- 910.1 is a specific code that can be used to specify a diagnosis
ICD-9-CM Diagnosis 910.2
Blister of face neck and scalp except eye without infection
- 910.2 is a specific code that can be used to specify a diagnosis
ICD-9-CM Diagnosis 910.3
Blister of face neck and scalp except eye infected
- 910.3 is a specific code that can be used to specify a diagnosis
Lymphedema People Links
Lymphedema People Resources
Page Tools
