Water callus in children and adults

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

Causes of the water callus

Water callus is the appearance of a skin vesicle with a watery interior. Such a bubble may have a whitish, yellowish, reddish or gray tint. This is not only an aesthetic defect, but also a source of painful and rather unpleasant sensations.

In general, 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, lower legs) and upper extremities (in the area of \u200b\u200bthe fingers, on the palm and elbows). Other parts of the body suffer from water calluses much less frequently.

The most common causes of this problem are:

• Incorrectly selected or poor-quality shoes, constantly damaging (rubbing) the legs. In most cases, we are talking about the wrong size, shape, rough tailoring of shoes, uncomfortable soles, synthetic and poorly processed material. In addition, water calluses on the toes may appear due to the lack of insoles or socks.
• Uncomfortable items of clothing that do not match the size, 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 clothes or shoes (sand, small twigs, specks, pebbles).
• Disorders of the foot (clubfoot, flat feet), features of gait, in which the foot experiences increased pressure in a certain place.
• Excessive sensitivity of the skin (for example, against the background of hypovitaminosis or dermatological diseases).
• Insufficient air exchange inside the shoes (leatherette shoes, synthetic socks, etc.), increased sweating of the legs or body as a whole.
• Increased load on certain parts of the body (during sports, dance exercises, or other physical activities).
• Non-observance of body hygiene.
• Fungal or other dermatological diseases.

Water calluses on the fingers and palms can occur after a long bike ride, exercises on the horizontal bar, working with a hammer or ax, a shovel or other gardening equipment, as well as when playing stringed musical instruments.

Risk factors

Among the risk factors that increase the likelihood of the formation of water calluses, the following are especially common:

• early childhood and old age (small children and the elderly have more vulnerable and sensitive skin);
• the presence of pathologies associated with bone and skin deformities (bursitis, arthritis, gout, heel spur, flat feet, clubfoot, etc.);
• diseases of internal organs, chronic pathologies that negatively affect the condition of the skin and the quality of blood circulation;
• phlebeurysm;
• overweight, obesity;
• dermatological diseases (eczema, psoriasis, etc.);
• diabetes;
• hyperhidrosis.

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

Pathogenesis

Due to prolonged squeezing or friction on the surface tissues of the skin, there is a rush of blood to the damaged area, increased vascular permeability, tissue edema, 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 pathogens through injured skin.

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

Subsequent stages may be different: the wound heals or becomes infected, which is manifested by the following pathological symptoms:

• the boundaries of redness expand;
• transparent contents change towards a purulent secret;
• the pain becomes constant or throbbing;
• yellowish-dirty peeling, crusts may appear.

This condition requires special treatment (often antibiotic therapy), therefore, it requires a doctor's consultation.

What liquid fills the water callus?

The internal fluid of the water corn is often transparent, but it can also be yellowish or reddish (in case small vessels are injured in the area of corn formation). If the liquid is saturated red, then such a callus is called bloody: its contents are really represented by blood that has poured out of a damaged vessel.

As a standard, water callus is filled with lymph - an intercellular fluid, which in its chemical composition is similar to blood plasma. Its composition is represented by 95% water, about 3% protein, less than 1% mineral salts and glucose.

Symptoms of the water callus

In the area of constant friction, the skin first turns red and swells slightly, pain appears when pressed. After some time, if the friction has not stopped, a bubble forms on the injured area, inside which a transparent liquid collects: this is water callus. The bladder capsule, when squeezed and strained, provokes a sharp pain. The size of the callus can be different, and multiple lesions occur. If the capsule is damaged, the wall bursts, the contents flow out, the edges fall off and dry out over time. If the walls come off completely, then the water callus transforms into a red, inflamed, weeping wound, which is very painful when touched.

Initial symptoms can be divided into stages:

1. A small skin area at the site of friction acquires an intensely red tint, there is a slight swelling. Touch causes discomfort.
2. A bubble forms on the skin in the area of redness, inside which transparent contents are visible. Touch causes pain.
3. The corn dries up and exfoliates, or opens with the outflow of a transparent interstitial fluid. In the latter case, the walls of the capsule collapse and dry up. If the walls of the water callus come off completely, then a painful weeping wound is exposed.

If the pain appears not only with friction and pressure, but also in a calm state (constant or pulsating), or if the internal contents become cloudy, then this indicates the development of infectious complications.

Water callus in a child

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

• the skin of children is more tender and sensitive;
• a child cannot always say that this or that shoe is uncomfortable for him, that something rubs or interferes with him.

Uncomfortable shoes, too tight or, conversely, loose sneakers, sandals with hard harnesses, creases in the insoles, folds in socks or tights - all this can lead to the formation of water callus.

In most cases, this 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 injure the delicate baby skin. At the same time, optimal prevention is properly selected and high-quality shoes. It is important that the size matches the baby's leg, not only in length, but also in the fullness of the foot. The heel of the shoes should have a certain rigidity that does not allow the heel to slip. And the nose, in turn, should not be too narrow so that the fingers do not shrink or squeeze.

The most high-quality material for children's shoes is genuine leather, which provides normal air circulation and does not allow moisture to increase in the foot area. In the warm season, preference is given to textile models.

It is equally important to pay attention to the quality of tailoring, and to the material and smoothness of the insole. Sticking threads, rough seams, bulges and creases on the insoles are not the most suitable option for a child.

Also, don't wear the same pair of shoes every day. Both sneakers and sandals require regular drying and airing, and the child's foot must “learn” to adapt to different models and shapes of shoes. If you do not adhere to this principle, then the likelihood of the appearance of water blisters increases several times.

Complications and consequences

Water callus develops in the stratum corneum of the skin (superficial). However, if you take care of the problem area incorrectly, then complications may develop that will affect other layers. Although, it is worth noting that such situations are extremely rare. These complications include:

• the formation of a long-term non-healing wound (typical for patients with diabetes mellitus);
• suppuration with the further development of a purulent-inflammatory process.

Water corn, with proper care, does not pose a danger to a healthy person. But for patients with diabetes, any wound can turn into a complication, and the risks of infection increase many times over.

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

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

Diagnostics of the water callus

Despite the fact that in most cases water callus does not pose a threat to the health and life of the patient, the problem cannot be completely ignored. First of all, you should make sure that we are really talking about a callous blister, and not about other similar pathologies. To confirm the diagnosis, it is enough for a specialist to see the external clinical picture: no laboratory tests are required. An extended examination can be prescribed in doubtful and complicated cases. For example, the doctor may insist on:

• clinical blood test, rheumatic tests;
• analyzes to exclude infectious pathologies;
• tests to assess the functioning of the thyroid gland, pancreas;
• allergy tests.

Instrumental diagnosis can be represented by a skin biopsy with further histological examination (with suspicion of mastocytosis, urticarial vasculitis, etc.).

Differential diagnosis

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

Treatment of the water callus

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

Can water callus be pierced? If it delivers severe discomfort, then it can be pierced to avoid spontaneous spontaneous opening. However, this must be done carefully and in compliance with certain rules:

• before piercing, water callus is treated with a disinfectant liquid (alcohol, vodka, a solution of potassium permanganate or furacilin);
• for the procedure, only a sterile needle is used (you can hold it in alcohol or ignite it over a fire);
• the puncture should be performed not in the middle part of the water callus, but on the side to avoid injury to the callous base;
• after opening the water callus, you need to release the liquid from it, blot it with a cotton pad or bandage soaked in a disinfectant solution;
• it is possible (but not necessary) to apply Levomekol ointment or Solcoseryl gel;
• at the end, the wound should be sealed with a protective bactericidal plaster.

After some time, the walls of the water callus will begin to dry out, but sometimes the bubble can again fill with liquid contents: in such a situation, it should be pierced again, observing all the same conditions and sequence of actions.

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

• the wound is cleaned, disinfected;
• lubricate with Levomekol ointment or Solcoseryl gel (a stage is desirable, but optional);
• seal the damaged area with a bactericidal plaster.

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

Water callus treatment at home

In most cases, water corn goes away on its own if left untouched for a few days. It is allowed to treat the bubble with brilliant green, iodine or fucorcin, and then stick a bactericidal patch on top.

It is possible to do without piercing the water callus if one of the following preparations is applied to it:

• Zinc ointment is a drying and healing agent that is applied to unopened corn 3-4 times a day, until the exudate is completely resorbed.
• Salicylic ointment is an antiseptic and drying preparation, which is applied to water callus 2-3 times a day. You can apply sterile dressings soaked in ointment.
• Boric alcohol is an available antiseptic that inhibits the growth and development of bacteria. Apply to the treatment of affected areas 2-3 times a day, until the desired effect is achieved.

The funds are applied three times a day, after which they cover the surface with a bactericidal patch (if shoes are supposed to be worn). At night, the patch should not be used: this way the corn dries faster.

If a person nevertheless decided to pierce the water callus, then this should be done as carefully as possible, using all the rules of asepsis. It is impossible to make a puncture without pre-treatment of the corn, just as in no case should you pierce the wall of the capsule with an untreated needle.

Among the alternative remedies that are used to speed up the recovery of damaged skin, the most popular are:

• They take an aloe leaf, wash it well, remove the skin on one side and apply it to the water callus, fixing it with a plaster or bandage. It is optimal to carry out such a procedure daily at night, until the skin is completely restored. During the day, the damaged area is sealed with adhesive tape to avoid contamination.
• Baths are made for the affected limb using oak bark. For the procedure, a decoction is prepared on the basis of 1 full tablespoon of bark and 600 ml of boiling water (boil for 5 minutes, remove from heat and keep under the lid for about half an hour, after which it is filtered and used for its intended purpose). Baths are taken daily for 10 minutes. After the procedure, the skin should be thoroughly dried.
• Water callus is treated with tea tree oil, diluted in half with olive oil. Repeat 4 times a day for disinfection and accelerate regeneration.

If a water callus is found in a patient with trophic ulcers or diabetes mellitus, then it is necessary to consult the attending physician: it is not recommended to open such a capsule on your own.

Prevention

Regular and sufficient skin care, good nutrition, a high-quality choice of clothes and shoes are the best prevention of the appearance of both water blisters and many other dermatological problems. Separately, we can highlight the following recommendations of experts:

• Always choose clothes and shoes by size, by season, by quality, and also by degree of comfort. Avoid wearing tight, rough and uncomfortable models and styles.
• Wear socks and shoes only on dry feet, do not allow excessive sweating.
• Pay attention to your feelings. At the first appearance of pain, take action without waiting for the problem to worsen.
• When working in the garden, in the garden, as well as during sports activities, wear protective gloves, wear appropriate equipment designed to protect the skin from possible damage.
• Keep your underwear and socks clean and change them in a timely manner. Trim your nails promptly.
• Timely treat any infectious pathologies, including fungal etiology.

Forecast

Water callus usually goes away on its own within 3-7 days. Basic conditions: do not injure the vial, cover it with a clean and dry bandage until the contents are completely absorbed and the walls dry out. It is undesirable to open the capsule, as this will slow down the healing process and significantly increase the likelihood of infection entering the wound. Doctors should be consulted if the pain gets worse or changes in character, if the redness gets worse, or if the problem recurs regularly in the same place.

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

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