Water callus in children and adults

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

Causes water blister

A blister is the appearance of a skin blister with a watery interior. Such a blister 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, a blister is 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, on the palm and elbows). Other parts of the body suffer from blistering much less often.

The most common reasons for this problem are considered to be the following:

• Incorrectly selected or poor-quality footwear that constantly damages (rubs) the feet. In most cases, this is due to the wrong size, shape, rough shoe sewing, uncomfortable soles, synthetic and poorly processed material. In addition, blisters on the toes can appear due to the lack of insoles or socks.
• Uncomfortable clothing items that are not the right size, containing synthetic materials. For example, women often complain about the appearance of blisters due to the use of uncomfortable and poor quality underwear.
• Foreign objects that get inside clothes or shoes (sand, small twigs, debris, pebbles).
• Disorders of the foot (clubfoot, flatfoot), gait characteristics in which the foot experiences increased pressure in a certain place.
• Excessive sensitivity of the skin (for example, due to hypovitaminosis or dermatological diseases).
• Insufficient air exchange inside shoes (leatherette shoes, synthetic socks, etc.), increased sweating of the feet or body as a whole.
• Increased stress on individual parts of the body (during sports, dance exercises, or other physical activities).
• Failure to observe personal hygiene.
• Fungal or other dermatological diseases.

Blisters on the fingers and palms can occur after a long bike ride, exercises on a horizontal bar, working with a hammer or an axe, a shovel or other gardening tools, and also when playing stringed musical instruments.

Risk factors

Among the risk factors that increase the likelihood of developing blisters, the following are particularly common:

• early childhood and old age (young children and the elderly have more vulnerable and sensitive skin);
• the 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, obesity;
• dermatological diseases (eczema, psoriasis, etc.);
• diabetes mellitus;
• hyperhidrosis.

Most often, people who, due to their occupation, spend most of their time on their feet, as well as women who prefer to wear high-heeled shoes, athletes, and dancers, experience the appearance of blisters.

Pathogenesis

As a result of prolonged compression 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 injured skin.

An inflammatory process develops, which is accompanied by a local increase in temperature and pain. If the external damaging effect continues, the blister fills up 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 becomes infected, which is manifested by the following pathological symptoms:

• the borders of redness expand;
• the transparent contents change towards purulent secretion;
• the pain becomes constant or throbbing;
• yellowish-dirty peeling and crusts may appear.

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

What fluid fills a blister?

The internal fluid of a blister is usually transparent, but it can also be yellowish or reddish (if small vessels in the area where the blister is formed are injured). If the fluid is deep red, then such a blister is called bloody: its contents are actually represented by blood that has poured out of a damaged vessel.

Typically, a water blister is filled with lymph – an intercellular fluid that is similar in chemical composition to blood plasma. Its composition is 95% water, about 3% protein, less than 1% mineral salts and glucose.

Symptoms water blister

In the area of constant friction, the skin initially turns red and swells slightly, and pain appears when pressed. After some time, if the friction does not stop, a blister forms on the injured area, inside which a clear liquid collects: this is a blister. The capsule of the blister, when squeezed and strained, provokes sharp pain. The size of the blister can be different, and multiple lesions can occur. If the capsule is damaged, the wall bursts, the contents flow out, the edges collapse and eventually dry out. If the walls come off completely, the blister transforms into a red, inflamed, wet wound, very painful to the touch.

Initial symptoms can be divided into stages:

1. A small skin area at the site of friction acquires an intense red hue, slight swelling is noted. Touching causes unpleasant sensations.
2. A blister forms on the skin in the area of redness, with transparent contents visible inside. Touching causes pain.
3. The callus dries up and peels off, or opens with the flow of transparent intercellular fluid. In the latter case, the walls of the capsule collapse and dry out. If the walls of the blister come off completely, a painful, weeping wound is exposed.

If pain occurs 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.

Blister in a child

Blisters are common in childhood and are associated with several causes:

• Children's skin is more delicate and sensitive;
• A child cannot always say that certain shoes are uncomfortable for him, that something is rubbing or bothering him.

Uncomfortable shoes, sneakers that are too tight or, on the contrary, too loose, sandals with hard straps, creases in the insoles, folds in the socks or tights - all this can lead to the formation of a blister.

In most cases, this problem can be solved independently at home. However, in the future, to avoid such situations, you should think about preventive measures in advance so as not to injure delicate baby skin. In this case, the optimal prevention is 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 shoes 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 squeezed or squeezed.

The highest quality material for children's shoes is genuine leather, which ensures normal air circulation and does not allow increased humidity 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, the material and the smoothness of the insole. Protruding threads, rough seams, bulges and creases on the insoles are not the most suitable option for a child.

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

Complications and consequences

A blister develops in the stratum corneum (superficial) of the skin. However, if the problem area is not properly cared for, complications may develop that will affect other layers. Although, it is worth noting that such situations are extremely rare. Such complications include:

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

A blister, if properly cared for, does not pose a danger to a healthy person. But for people with diabetes, any wound can turn into a complication, and the risk of infection increases many times over.

The development of a purulent-inflammatory process is facilitated by excessive contamination of the wound, lack of necessary care, and high virulence of the microflora that has penetrated the tissue. The situation is aggravated by foreign bodies or necrotic elements entering the wound, chronic disruption of local blood circulation, and delayed wound treatment. The most unfavorable complications are noted due to a person's refusal to disinfect and treat in a timely manner if a blister bursts.

The first symptoms of suppuration are compaction, increased redness and pain. As experts note, increased pain is an early, but unfortunately often ignored sign of infection development.

Diagnostics water blister

Despite the fact that in most cases a blister does not pose a threat to the patient's health and life, the problem cannot be completely ignored. First of all, you should make sure that it is really a callus blister and not other similar pathologies. To confirm the diagnosis, a specialist only needs to see the external clinical picture: laboratory tests are not required. An extended examination may be prescribed in questionable and complicated cases. For example, a doctor may insist on:

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

Instrumental diagnostics may include skin biopsy followed by histological examination (if mastocytosis, urticarial vasculitis, etc. are suspected).

Differential diagnosis

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

Treatment water blister

If the blister is small in size, does not hurt when at rest, and does not fester, then there is no need to treat it in any special way: such a blister is simply covered with a bactericidal plaster, preventing its possible damage and infection. [ 2 ]

Is it possible to pierce a blister? If it causes significant discomfort, it can be pierced to avoid spontaneous opening. However, this must be done carefully and in compliance with certain rules:

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

After some time, the walls of the blister will begin to dry out, but sometimes the blister can fill up with liquid again: in such a situation, it should be punctured again, observing the same conditions and sequence of actions.

If a blister opens spontaneously, the following actions should be taken:

• the wound is cleaned and disinfected;
• lubricate with Levomekol ointment or Solcoseryl gel (this step is desirable, but not mandatory);
• Cover the damaged area with a bactericidal plaster.

Sometimes a blister does not burst on its own, but its contents become cloudy, dense, constant or pulsating pain appears, the skin near the blister acquires a reddish tint - this indicates the addition of a microbial infection. In such a situation, the blister 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.

Treatment of blister at home

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

You can avoid puncturing a blister by applying one of the following medications to it:

• Zinc ointment is a drying and healing agent that is applied to an unopened callus 3-4 times a day until the exudate is completely absorbed.
• Salicylic ointment is an antiseptic and drying agent that is applied to the blister 2-3 times a day. You can apply sterile bandages soaked in the ointment.
• Boric alcohol is an affordable antiseptic that inhibits the growth and development of bacteria. It is used to treat affected areas 2-3 times a day until the desired effect is achieved.

The product is applied three times a day, after which the surface is covered with a bactericidal plaster (if you plan to wear shoes). The plaster should not be used at night: this will dry the callus faster.

If a person decides to pierce a blister, it should be done with the utmost care, using all the rules of asepsis. You cannot pierce a blister without first treating it, just as you should never pierce the capsule wall with an untreated needle.

Among the folk remedies that are used to speed up the restoration of damaged skin, the most popular are the following:

• Take an aloe leaf, wash it well, remove the skin on one side and apply it to the blister, fixing it with a plaster or bandage. It is best to carry out this procedure every night until the skin is completely restored. During the day, the damaged area is covered with adhesive tape to avoid contamination.
• Baths are made for the affected limb using oak bark. For the procedure, a decoction is prepared based on 1 full tablespoon of bark and 600 ml of boiling water (boil for 5 minutes, remove from heat and keep under a lid for about half an hour, then filter and use as intended). Baths are taken daily for 10 minutes. After the procedure, the skin should be thoroughly dried.
• Treat the blister with tea tree oil diluted half and half with olive oil. Repeat 4 times a day to disinfect and speed up regeneration.

If a blister is found in a patient with trophic ulcers or diabetes, then it is necessary to consult a doctor: it is not recommended to open such a capsule on your own.

Prevention

Regular and adequate skin care, proper nutrition, quality choice of clothes and shoes are the best prevention of the appearance of both blisters and many other dermatological problems. The following recommendations from specialists can be highlighted separately:

• Always choose clothes and shoes according to size, season, quality, and comfort. Avoid wearing tight, rough, and uncomfortable models and styles.
• Put on socks and shoes only on dry feet, do not allow excessive sweating.
• Pay attention to your feelings. At the first sign of pain, take action without waiting for the problem to worsen.
• When working in the garden, orchard, or during sports activities, wear protective gloves and wear appropriate equipment designed to protect the skin from possible damage.
• Keep your underwear and socks clean, change them promptly. Trim your nails on time.
• Treat any infectious pathologies promptly, including those of fungal etiology.

Forecast

A blister usually goes away on its own within 3-7 days. The main conditions: do not injure the blister, cover it with a clean and dry bandage until the contents are completely absorbed and the walls dry out. It is not advisable to open the capsule, as this will slow down the healing process and significantly increase the likelihood of infection getting into the wound. You should contact a doctor if the pain intensifies or changes in nature, if the redness worsens, or if the problem regularly recurs in the same place.

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

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