Water callus in children and adults

A painful water callus is a limited area on the skin in the form of a bubble of fluid that forms in an area of repeated pressure or friction. The problem is superficial in nature, can cover differently sized areas of the skin, causes pain and some temporary discomfort. The diagnosis is established by external signs. Treatment in most cases consists in providing the necessary care for the callus, using disinfectants and healing agents. [1]

Causes of the water blister

A water blister is the appearance of a skin blister with a watery interior. Such a bubble can have a whitish, yellowish, reddish or grayish color. It is not only an aesthetic defect, but also a source of painful and quite unpleasant sensations.

In general, the water callus acts as a kind of protective reaction of the skin to mechanical irritation. It develops in the area of friction, prolonged pressure. Most often the problem appears on the lower extremities (in the area of the feet, fingers, shins) and upper extremities (in the area of the fingers, palms and elbows). Other parts of the body suffer from water blisters much less often.

The most common causes of this problem are considered to be:

• Improperly fitted or poor quality shoes that constantly damage (rub) your feet. In most cases, it is about the wrong size, shape, rough tailoring of shoes, uncomfortable soles, synthetic and poorly processed material. In addition, water corns on the toes can appear due to the lack of insoles or socks.
• Uncomfortable items of clothing, not fitting properly, containing synthetic materials. For example, women often complain about the appearance of water blisters due to the use of uncomfortable and low-quality underwear.
• Foreign objects that get inside your clothes or shoes (sand, small twigs, lint, pebbles).
• Foot disorders (clubfoot, flatfoot), a gait pattern in which the foot feels increased pressure in a particular place.
• Excessive sensitivity of the skin (for example, against the background of hypovitaminosis or dermatologic diseases).
• Insufficient air exchange inside shoes (leatherette shoes, synthetic socks, etc.), excessive sweating of the feet or body in general.
• Increased strain on certain parts of the body (during sports, dancing, or other physical activities).
• Failure to maintain body hygiene.
• Fungal or other dermatologic diseases.

Water calluses on the fingers and palms of the hands and palms can occur after a long bike ride, exercises on the staircase, work with a hammer or axe, shovel or other gardening tools, as well as when playing stringed musical instruments.

Risk factors

Among the risk factors that increase the likelihood of water blister formation, these are particularly common:

• Early childhood and old age (young children and the elderly have more vulnerable and sensitive skin);
• Presence of pathologies associated with bone and skin deformities (bursitis, arthritis, gout, heel spurs, flat feet, clubfoot, etc.);
• Diseases of internal organs, chronic pathologies that negatively affect the condition of the skin and the quality of blood circulation;
• Varicose veins;
• Overweight, obese;
• Dermatologic diseases (eczema, psoriasis, etc.);
• Diabetes;
• Hyperhidrosis.

Most often with the appearance of water calluses are faced by people who by occupation spend most of the time on their feet, as well as women who prefer to wear shoes with high heels, athletes, dancers.

Pathogenesis

As a result of prolonged squeezing or friction against the superficial tissues of the skin, there is a rush of blood to the damaged area, increased vascular permeability, tissue edema, and detachment of the epidermal layer. A cavity is formed, which is quickly filled with moisture - intercellular fluid. Such a process is a natural reaction of the body in response to external irritation and protection against the penetration of infectious agents through the traumatized skin.

An inflammatory process develops, which is accompanied by local fever and pain. If the external damaging effect continues, the bladder fills and spontaneously opens (bursts), and in its place a sharply painful wet wound is exposed.

The subsequent stages may be different: the wound heals, or it becomes infected, which is manifested by the following pathologic symptoms:

• The borders of the redness are expanding;
• The clear contents change to purulent secretion;
• The pain becomes constant or throbbing;
• There may be yellowish-dirty flaking, crusts.

Such a condition requires special treatment (often - antibiotic therapy), so it requires a doctor's consultation.

What fluid fills a water blister?

The internal fluid of a water callus is often transparent, but can also be yellowish or reddish (if the small vessels in the area where the callus is formed are injured). If the fluid is deep red, the callus is called a bloody callus: its contents are really blood that has spurted from a damaged vessel.

The standard water callus is filled with lymph, an intercellular fluid that has a chemical composition similar to blood plasma. Its composition is 95% water, about 3% protein, less than 1% mineral salts and glucose.

Symptoms of the water blister

In the area of constant friction, the skin is red and slightly swollen at first, and there is pain when pressure is applied. After some time, if the friction has not stopped, a bubble forms on the injured area, inside which a clear liquid collects: this is a water callus. The capsule of the bubble, when squeezed and strained, provokes sharp pain. The size of the blister can vary, and there are multiple lesions. If the capsule is damaged, the wall bursts, the contents leak out, the edges collapse and eventually dry up. If the wall breaks off completely, the water callus is transformed into a red, inflamed, wet wound that is very painful to touch.

The initial symptomatology can be divided into stages:

1. A small skin area in the place of friction acquires an intensely red color, a slight swelling is noted. Touching causes unpleasant sensations.
2. A bubble is formed on the skin in the area of redness, inside which a transparent content is visible. Touching it causes painful sensations.
3. The callus dries up and peels off, or it opens with a clear intercellular fluid. In the latter case, the walls of the capsule collapse and shrink. If the walls of the water callus peel off completely, a painful, wet wound is exposed.

If pain occurs not only with friction and pressure, but also at rest (constant or throbbing), or if the internal contents become cloudy, it indicates the development of infectious complications.

Water blister in a baby

Water callus is common in childhood, which is due to several reasons:

• Children's skin is more delicate and sensitive;
• A child cannot always say that a particular shoe is uncomfortable for him or her, that something rubs or disturbs him or her.

Uncomfortable shoes, too tight or, on the contrary, loose sneakers, sandals with stiff helmets, creases in the insoles, creases in socks or tights - all of these can lead to the formation of a water callus.

In most cases, such a problem is solved independently at home. However, in the future, in order to avoid such situations, you should think about preventive measures in advance, so as not to traumatize the delicate baby skin. In this case, the optimal prevention is a properly selected and high-quality shoes. It is important that the size corresponds to the baby's foot not only in length, but also in the fullness of the foot. The back of the shoe should have a certain rigidity that does not allow the heel to slip. And the toe part, in turn, should not be too narrow, so that the toes are not compressed and squeezed.

The best quality material for children's shoes is natural leather, which ensures normal air circulation and prevents moisture from rising in the foot area. In the warm season, textile models are preferred.

It is equally important to pay attention to the quality of tailoring, material and smoothness of the insole. Protruding threads, rough seams, bulges and creases in the insole are not a good option for a child.

In addition, you should not put on the baby the same pair of shoes every day. Both sneakers and sandals require regular drying and airing, and the child's feet must "learn" to adapt to different models and shapes of shoes. If you do not adhere to this principle, the probability of water blisters increases several times.

Complications and consequences

A water callus develops in the stratum corneum (superficial layer) of the skin. However, if you do not properly care for the problem area, it is possible to develop complications that will affect other layers. Although, it should be noted, such situations are extremely rare. Such complications include:

• Formation of a long non-healing wound (characteristic of patients suffering from diabetes mellitus);
• Suppuration with further development of purulent-inflammatory process.

Water callus with proper care is not dangerous for a healthy person. But for patients with diabetes, any wound can turn into a complication, and the risk of infection increases many times over.

The development of purulent-inflammatory process is promoted by excessive contamination of the wound, lack of necessary care, as well as high virulence of microflora penetrated into the tissues. Aggravate the situation by getting into the wound foreign bodies or necrotic elements, chronic disruption of local blood circulation, as well as delayed treatment of the wound. The most unfavorable complications are noted due to the refusal of a person from timely disinfection and treatment in the case of a burst water callus.

The first symptoms of suppuration are induration, increased redness and pain. According to experts, increased pain is an early, but unfortunately often ignored, sign of infection.

Diagnostics of the water blister

Despite the fact that in most cases water blister does not pose a threat to the health and life of the patient, the problem should not be completely ignored. First of all, it is necessary to make sure that we are really talking about a callus blister, and not about other similar pathologies. A specialist to confirm the diagnosis is enough to see the external clinical picture: laboratory tests are not required. Extended examination may be prescribed in doubtful and complicated cases. For example, the doctor may insist on carrying out:

• Clinical blood work, rheumatic tests;
• Tests to rule out infectious pathologies;
• Tests to assess thyroid function, pancreas;
• Allergy testing.

Instrumental diagnosis may be represented by skin biopsy with further histologic examination (in case of suspected mastocytosis, urticarial vasculitis, etc.).

Differential diagnosis

Differential diagnosis is carried out to exclude pathologies with similar symptoms. For example, bulges on the skin often occur in various dermatoses, contact dermatitis, and small itchy blisters are frequent companions of allergic reactions.

Treatment of the water blister

If the water callus is small in size, does not hurt at rest, does not fester, then treat it in any special way is not necessary: such a bubble is simply covered with a bactericidal plaster, preventing its possible damage and infection. [2]

Can a water callus be pierced? If it causes marked discomfort, it can be pierced to avoid spontaneous spontaneous opening. However, it must be done carefully and in compliance with certain rules:

• Before piercing the water callus is treated with disinfectant liquid (alcohol, vodka, manganese or furacilin solution);
• Only use a sterile needle for the procedure (you can hold it in alcohol or burn it over a fire);
• The puncture should not be made in the medial part of the water callus, but laterally to avoid traumatizing the callus base;
• After opening a water callus should be released from its fluid, blot it with a cotton disk or bandage soaked in disinfectant solution;
• You can (but not necessarily) apply Levomekol ointment or Solcoseryl gel;
• Finally, seal the wound with a bactericidal plaster.

After some time, the walls of the water callus will begin to dry up, but sometimes the bubble can again be filled with liquid content: in this situation, you should puncture it again, observing all the same conditions and sequence of actions.

If spontaneous opening of the water callus has occurred, the actions should be as follows:

• The wound is cleaned, disinfected;
• Lubricate with Levomekol ointment or Solcoseryl gel (desirable but not necessary);
• Seal the damaged area with a bactericidal plaster.

Sometimes a water blister does not open on its own, but its contents become cloudy, dense, there is constant or throbbing pain, the skin near the blister acquires a reddish tint - this indicates the attachment of microbial infection. In such a situation, the blister should be opened, drainage should be installed, a course of antibiotic treatment should be carried out: it is recommended to seek help from doctors.

Treatment of water callus at home

In most cases, a water blister will go away on its own if left untouched for a few days. It is allowed to treat the blister with zelenka, iodine or fucorcin, and then stick a bactericidal plaster on top.

Without piercing the water callus, one of the following preparations can be applied to it:

• Zinc ointment - drying and healing agent, which is applied to the unopened callus 3-4 times a day, until complete resorption of exudate.
• Salicylic ointment is an antiseptic and drying agent that is applied to the water blister 2-3 times a day. Sterile bandages soaked in the ointment can be applied.
• Boric alcohol is an available antiseptic that inhibits the growth and development of bacteria. It is used for treatment of affected areas 2-3 times a day, until the desired effect is achieved.

The means are applied three times a day, after which cover the surface with a bactericidal plaster (if you intend to wear shoes). The plaster should not be used overnight: the callus will dry faster.

If a person does decide to pierce a water callus, then it should be done as carefully as possible, applying all the rules of asepsis. It is impossible to make a puncture without pre-treatment of the callus, just as in no case should not pierce the wall of the capsule with an untreated needle.

Among folk remedies that are used to accelerate the recovery of damaged skin, the most popular are considered such:

• Take a leaf of aloe, rinse well, remove the skin from one side and apply to the water callus, fixing the plaster or bandage. It is optimal to carry out such a procedure every day at night, until the full recovery of the skin. During the day, the damaged place is sealed with a leukoplasty to avoid contamination.
• Make baths for the affected limb, using oak bark. For the procedure, prepare a decoction based on 1 full tablespoon of bark and 600 ml of boiling water (boiled for 5 minutes, removed from the fire and kept under a lid for about half an hour, then filtered and used as directed). Baths are taken daily, for 10 minutes. After the procedure, the skin should be thoroughly dried.
• Treat the water callus with tea tree oil diluted in half with olive oil. Repeat 4 times a day to disinfect and accelerate regeneration.

If a water blister is found in a patient with trophic ulcers or diabetes mellitus, then it is necessary to obtain the advice of the attending physician: independently opening such a capsule is not recommended.

Prevention

Regular and sufficient skin care, nutrition, quality choice of clothes and shoes - this is the best prevention of the appearance of both water blisters and many other dermatological problems. Separately, we can emphasize such recommendations of experts:

• Always choose clothes and shoes according to size, season, quality and comfort. Avoid wearing tight, rough and uncomfortable models and styles.
• Wear socks and shoes only on dry feet and avoid excessive sweating.
• Pay attention to how you feel. Take action at the first sign of pain without waiting for the problem to worsen.
• When working in the vegetable garden, garden, and during sports activities, wear protective gloves and appropriate equipment designed to protect the skin from possible damage.
• Keep your underwear and socks clean and change them in time. Cut your nails on time.
• Timely treat any infectious pathologies, including fungal etiology.

Forecast

Water blister usually goes away on its own within 3-7 days. The main conditions: do not traumatize the bubble, cover it with a clean and dry bandage until the contents are completely resorbed and the walls dry up. It is undesirable to open the capsule, as this will slow down the healing process and significantly increase the likelihood of infection in the wound. Doctors should be consulted if the pain increases or changes character, if the redness worsens, or if the problem recurs regularly in the same place.

If the patient suffers from uncompensated diabetes mellitus, or circulatory insufficiency, then it is not excluded infection of the wound with the development of an inflammatory process, which is dangerous for this category of patients.

In general, the prognosis can be considered favorable. Water callus disappears quickly and does not reappear if the causes of its appearance are eliminated.