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Bloody calluses on the legs and arms

Medical expert of the article

Dermatologist, onkodermatolog
, medical expert
Last reviewed: 06.09.2021

Calluses are lesions of the skin that are caused by simultaneous friction and pressure, and calluses of blood or blood are referred to as wet calluses with the formation of a blister containing fluid with blood (blister or bulla).

Causes of the bloody calluses

The key reasons for the appearance of bloody calluses on the feet are poorly fitted shoes: tight, squeezing toes or heels, with a rough heel and inner seams, or poorly sitting on the feet, with the movement of the foot inside the shoe when walking. The appearance of such calluses under the big toes is provoked by high heels. [1]

In addition, increased physical activity, which increases the friction of the skin, can also cause the formation of blood blisters. This applies, first of all, to wet  calluses on the heel .

So, runners can have a bloody callus on the heel: tension in the calf muscles transfers additional tension to the Achilles tendon, which pulls the heel bone of the foot more and faster (which leads to increased friction of the skin covering it).

And bloody calluses on the hands appear in the process of working with tools or during sports activities with shells, which are accompanied by repetitive (frictional) friction and mechanical pressure on the skin of the palms and / or fingers. [2]

Risk factors

In addition to unsuitable (or new, not yet worn out) shoes and overuse, risk factors for rubbing skin on feet, heels, or toes - resulting in blisters and calluses - include excessive  sweating of the feet  (wet skin is more likely to hurt because of increased sweating, friction increases) and various pathological changes in the anatomical structures of the feet, which lead to  disturbances in the movement of the foot , that is, its normal biomechanics. [3]

This refers to the presence of  flat feet , hallux valgus, deformity of Haglund (osteochondral growth on the back of the heel), Morton's toe (when the second toe is longer than the big one), incorrect union of an old fracture, etc.

The frequent appearance of bloody calluses under the first toe of the foot may be the result of a functional limitation of the joints of the big toes (hallux limitus) known to orthopedists, in which their flexibility during movement decreases and mechanical pressure on soft tissues increases.

Excess weight also significantly increases the pressure on the feet.

Pathogenesis

The skin of the foot is subjected to pressure, friction and shear when walking, which can ultimately lead to blistering damage to the skin.

Friction blisters are caused by excessive shear stress between the basal layer of the skin (lowest) and the stratum corneum (topmost). The layers of skin near the prickly layer of the epidermis (stratum spinosum) are most susceptible to shear. When this layer is separated from the underlying tissues, plasma (transparent liquid) diffuses from the cells. This is a common callus blister. [4]

The pathogenesis of blood blisters is associated with the fact that when the skin of the foot contacts the shoes, a shear force occurs, which, repeating cyclically during walking, affects the deeper layers of the dermis, damaging their cells. When the tissues of the zones of increased friction of the foot - on the joints of the toes, on the bony protrusions of the back of the heel, on the metatarsal pads - can no longer withstand the force of friction and pressure, microscopic ruptures (separation of skin cells) begin to appear in the basal layer of the dermis, leading to the formation of space, where the exudate is collected.

The presence of blood in it - a blood callus - indicates that the pressure led to a violation of the integrity of small blood vessels and venous anastomoses of the papillary and reticular layer of the dermis, the blood entered the epidermis (staining its cells due to local hemorrhage) and went out into the blister cavity, where it mixed with the usual exudate.

Symptoms of the bloody calluses

The first signs, more precisely, the predecessor of the blister, is a reddened, hot to the touch area of the skin in the rubbed place (on the leg or on the hands).

The main symptoms of a bloody callus are local swelling, pain, fluid buildup between the layers of the skin, and the appearance of a blood-filled blister.

Consequences and complications

The consequences of a blister bursting or trying to pierce it is infection with common obligate skin bacteria, for example, staphylococci, as well as all other microbes of the environment. The development of infection is manifested by the spread of hyperemia and increased edema (swelling) of the skin and subcutaneous tissue around the corn, the redness and soreness of which become more intense.

Complications of infection lead to purulent inflammation. In people with diabetes, it can lead to gangrene, with weakened immunity, to the development of sepsis.

Diagnostics of the bloody calluses

Diagnosis is limited to a physical examination of the limb, since callus is a clinical diagnosis.

Differential diagnosis

Differential diagnosis includes palmar-plantar erythrodysesthesia ( palmar-plantar syndrome ), which is a side effect of some cytostatic drugs used in cancer chemotherapy; heparin-induced bullous hemorrhagic dermatosis or bullous pemphigoid .

Who to contact?

Treatment of the bloody calluses

The most correct treatment for a blood callus is to allow it to heal within a few weeks: the conditions are sterile in the blister, the fluid is gradually reabsorbed, mitosis occurs with the formation of new skin cells, and the blister membrane gradually dries up and disappears over time. But while the blood callus heals in this way, it should be protected - with the help of a special hydrocolloid  plaster Compid  (Compeed), Reliance, Alpe, Corn Milplast, Septona, etc.

To reduce pain, it is recommended to apply ice to the callus or take pain relievers such as  ibuprofen  or other nonsteroidal anti-inflammatory drugs with pain relief.

If, as is often the case, the blister spontaneously bursts, its shell is by no means removed, since healing under it occurs faster and without complications.

Opinions about the puncture of a bloody blister - when it interferes with walking - are diametrically opposed. Some doctors consider attempts to open it as a risky procedure due to the threat of infection, therefore, they advise to consult a doctor.

If, nevertheless, it is decided to get rid of the pain of a pressing blister by puncturing it, then this should be done with a sterile needle from a syringe - in a horizontal plane in the lower part of the blister (without touching the damaged skin) - with preliminary treatment of its surface with medical alcohol or vodka and subsequent treatment with the same alcohol or alcohol tincture of propolis. From above, the corn is closed with a sterile bandage, or better with a bactericidal or colloidal plaster.

At the slightest signs of inflammation, the blood callus is lubricated with such ointments as tetracycline,  Levomekol  (Levosin), Baneocin, Oflokain or other  antibiotic ointment , as well as ointment or cream with silver sulfathiazole (Sulfargin, Argosulfan, etc.).

Prevention

In order not to rub your feet before the appearance of bloody calluses, the shoes should fit you, and it concerns not only its size and fullness. Read more in the publication -  How to choose the right shoes .

In addition, in any orthopedic salon you can purchase special silicone stickers on the heels of shoes to protect the heel from strong skin friction from the Achilles tendon and the occurrence of blisters and bloody calluses.

If your feet are sweating a lot, effective foot sweat  remedies can help .

And further. If calluses, including bloody ones, appear very often and no matter what shoes you wear, you should seek the advice of an orthopedist or  podiatrist , who will identify the problem and help solve it.

And so that bloody calluses do not appear on your hands, when starting to work with tools, you just need to put on gloves.

Forecast

The blood callus heals in a month or so, so the prognosis for this skin lesion is good. True, it is not excluded that over time, at this place, a site of hyperkeratosis (increased keratinization) with the formation of another skin callus, but already dry, is not excluded.


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