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Bladder (bulla, skin blister)

A Bladder (bulla, skin blister) is a cavity which is filled with tissue fluid. This fluid-filled space is usually within the different layers of the skin and has a raised appearance. In the case of skin vesicles, it is medically a skin rash (exanthem).

What is a blister (bulla, skin blister)?

Some skin blisters indicate an illness. Herpes zoster can be recognized here.

A blister (bulla, skin blister) is a pathological, fluid-filled change (efflorescence) above the skin level that is at least five millimeters in size.

Skin vesicles (exanthema) can have different characteristics. The rash can manifest itself in the form of smaller or larger spots, pustules or wheals. Blisters on the skin can occur locally or over a large area over the entire body.

Medicine distinguishes between three types of skin blister. The subcorneal blisters lie below the horny layer, intraepidermal blisters are inside the epidermis and the subdermal bladder (bulla, skin blister) lies below the dermis. The skin blister can be caused by very different reasons.

Burns can cause skin blisters filled with fluid.

causes

Some infections, allergies as well as skin diseases and internal diseases cause a rash, which is noticeable with skin blisters or exanthema.

Furthermore, blisters occur in the case of cold damage or frostbite, burns and photodermatitis (light damage on the skin). A viral infection can also be responsible for skin blisters.

On the one hand, it can specifically be herpes simplex type 1 (cold sores) and herpes simplex type 2 (genital herpes). Other viral infections include herpes zoster (shingles) and chickenpox (varicella). On the other hand, a blister or vesicles can be caused by bacterial infections such as bullous erysipelas (wound rose).

Diseases

When to the doctor

Normally, you do not need to see a doctor if you have a skin blister. If there are no other symptoms, the bladder will burst on its own after a few days. You can burst it yourself at any time with a sterile needle. A visit to the doctor is not necessary for this.

If the bursting of the bladder leads to severe pain or the formation of pus, see a doctor. There is inflammation that needs treatment before it can spread or become chronic. If the bladder is in a position that is uncomfortable or causes severe pain, it is advisable to seek outside help. If this is not available, a doctor can be consulted.

If the blistering occurs over a longer period of time and regardless of the shoes you are wearing, a doctor can find out the more precise causes of the symptoms. This can hide bad posture of the body or malformations, which a doctor can clarify.

Under normal circumstances, there is a clear liquid in the bladder that can be moved around with your finger. If you can see through the skin that the liquid is dark in color or if the filling in the bladder feels unusually hard, it is advisable to consult a doctor for a closer examination.

Diagnosis and course

If skin vesicles or a blister appear all of a sudden, those affected should consult a specialist or their family doctor to clarify the exact cause. In order to determine the cause of the blister, questions are asked which, for example, narrow down the beginning and the affected skin area as precisely as possible.

In addition, complaints such as nausea and itching, runny nose and cough and fever are queried. Information about previous illnesses, existing allergies and medication taken are just as important for the attending physician in order to make a diagnosis. If you have had contact with infected people (for example chickenpox), additional information is crucial.

If appropriate measures such as cooling or an ointment are taken directly when a blister (bulla) is detected, the subsequent size can be positively influenced. However, if the blister is there, it will take some time to heal. Usually the skin area will regenerate within a few days.

However, if the skin blister has burst, it will take a little longer to heal. However, most skin blisters recede completely so that no scars whatsoever. By examining a bladder, as well as allergy tests and blood samples, the doctor can usually make a diagnosis and thus initiate the appropriate treatment.

Complications

The formation of a skin blister is classified as of little concern. For this reason, you can often wait until it bursts open by itself. In this case, clear liquid emerges, which can be perceived as unpleasant for a short time. In addition, it can lead to contamination that creates a risk of infection. Since new skin forms under the bladder, it can initially be sensitive to pain when pressure is applied. If the bladder itself is opened, there is a higher risk of infection, but this usually goes away within a few days.

In most households, opening the bladder cannot be done in a sterile manner. Even if the advantage is that the escaping liquid can be collected in a controlled manner, it must be ensured that it is a wound that needs to be treated accordingly. If the blister bursts itself, the skin underneath is usually even more sensitive to pain.

Depending on the location of the blistering, it can be perceived as uncomfortable when performing activities or moving. Particularly when moving, it is important to ensure that there is no bad posture that could cause further tension and uncomfortable physical strain. Regardless of whether the bladder is opened by yourself or by a doctor, you should pay more attention to your posture in the following days.

Treatment and therapy

Quite a few people simply puncture the bladder. However, it is advisable to leave the bladder in its shape, as its tight skin protects against bacteria. In the course of healing, the bladder usually goes back on its own. However, the healing process of a blister (bulla, skin blister) can be supported and even accelerated with the help of various ointments.

It may be necessary to pierce a skin blister if it is located below the sole of the foot or in areas of the body where it is not possible to heal in peace. In principle, only a sterile and pointed object may be used for this. If the wound water has drained from the skin blister, a blister plaster is stuck over it, which replaces the blister skin. This will usually avoid infections.

If the blister bursts on its own, a doctor does not always have to be consulted. However, if it catches fire, medical care must take place. Since wound water forms on the exposed dermis (light and reddish), bacteria of all kinds can settle unhindered.

If the doctor, based on his diagnosis, attributes the skin blister to a bacterial infection such as a wound rose, he will usually prescribe antibiotics (penicillin). Skin blisters, which are caused by frostbite or burns, also require special wound treatment. Since a blister often shows symptoms such as itching, antihistamines (drugs to relieve itching) can be an essential part of treatment.

You can find your medication here

Outlook and forecast

Depending on the cause, a blister has a different prognosis for the course of the disease. The prognosis is generally very good for uncomplicated individual blisters that occur, for example, during exercise or when wearing unsuitable shoes. The bladder heals by itself and, in the worst case, can become inflamed, but this can be treated very well with various creams using medication.

Blisters can also be the result of an allergy. Contact with an allergen triggers inflammation and the typical blisters and wheals develop. An allergy usually lasts for a lifetime and varies in extent, as those affected react differently to the substance. Usually such blisters heal within the next two to three weeks if contact with the allergen is avoided. If contact is avoided for the next few years, the further prognosis is good.

In addition to allergies, autoimmune diseases can also cause an inflammatory reaction with the formation of blisters. The prognoses here are also very different depending on the extent of the disease and the amount of autoantibodies.

A distinction is made between two major autoimmune blistering diseases: pemphigoid disease and pemphigus disease, whereby pemphigoid disease is more serious and has a worse prognosis because it occurs in deeper layers of the skin than pemphigus disease. Both diseases can lead to death if left untreated. However, the therapy is very appealing, so that both diseases have a good prognosis when treated.

prevention

Before a classic blister (bulla, skin blister) develops, it already causes pressure pain. Burn blisters can be reduced in size if the skin areas are immediately and extensively cooled. Blister plasters, for example, are not only suitable for treating, but also for preventing a blister.

However, the formation of bubbles can only be completely counteracted if the causes can be absolutely avoided. These include, for example, socks and shoes made of synthetic materials (increased sweating of the feet) and poorly fitting shoes (pressure points).

Moisture inside the shoes can be avoided, for example, with antihidrotics (pharmacy). These are applied to the skin and reduce perspiration. In order to avoid smaller burn blisters, oven gloves that are already lined are often sufficient.

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  • Furter, S., Jasch, K.C .: Dermatology crash course. Urban & Fischer, Munich 2007
  • Dirschka, T., Hartwig, R., Oster-Schmidt, C. (Ed.): Clinical Guide Dermatology. Urban & Fischer, Munich 2010
  • Rassner, G .: Dermatology - Textbook and Atlas. Urban & Fischer, Munich 2009
  • Abeck, D .: Common skin diseases in general medicine: Clinic, diagnosis, therapy, Springer Verlag, 2nd edition, 2011
This article has been written using the latest medical literature and sound scientific sources.
Quality assurance by: Dr. med. Nunmaker
Last updated on: December 29, 2018
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