blood_blister

Blood Blister

Blisters, a common skin injury has two basic forms. First is a “regular” blister which is filled with lymph.

The other type of called a blood blister, and it is a bubble of blood that forms under the skin as a result of a pinch, bruise or trauma. The blisters form from ruptured capillaries and contain blood/bloody serum. It is usually inflicted upon by injury.

Any blister is an area of concern for those of us with lymphedema as it represents a potential, if popped, for an infection.

The word “blister” entered English in the 14th century. It came from the Middle Dutch “bluyster”, blister and was a modification of the Old French “blostre” which meant a leprous nodule – a rise in the skin due to leprosy

Blood Blisters

Blood blisters are a type of blister that is filled with blood rather than the fluid commonly associated with blisters. Blood blisters are caused by a rupture of the blood vessels underneath the skin’s surface. This rupture is usually caused by some form of trauma, such as pinching.

Like all forms of blisters blood blisters form on the upper layer of the skin. They are the body’s natural response to pressure or injury. What differentiates blood blisters from other blisters is the fact that the trauma caused the blood vessels to rupture.

For the most part, blood blisters do not require special medical attention. Blood blisters that are severe or that reappear, however, may require medical treatment. Similarly, those that are caused by conditions that threaten a person’s health in other ways, such as burns and infections, should be checked.

When caring for blood blisters at home, it is best to refrain from popping the blister. Popping blood blisters can lead to infection and can slow down the body’s natural healing process. To avoid popping, blood blisters should be covered with a soft dressing. If the blister does pop, the resulting pocket of skin should not be peeled away. Rather, the body should be allowed to heal the area on its own schedule.

Blood blisters should also be washed frequently in order to keep them clear of irritants. Applying zinc cream to the area can also help dry up the blister and speed the healing process. When blood blisters break, however, they should be treated with antiseptic in order to prevent infection.(1)

Blisters and Infections

Important point (1) - for people with lymphedema to understand that blisters should not be popped if at all possible. Left alone, blisters will generally self heal. Popping them is dangerous as it provides anopen door to a bacterial infection.

Important point (2) - If you have diabetes and lymphedema, special care must be taken as you risk of an infection is dramatically increased. If the blister is large, sore or red, you should contact you doctor.

Important point (3) – Many of us because of other medical conditions, for example cancer, may have a suppressed immune system. It is even more critical for you to correctly treat the blister, prevent it from popping and becoming infected. Sepsis, a life threatening infection could result.

Signs of infection could include:

pus draining from the blister

very red or warm skin around the blister

red streaks leading away from the blister

extreme tenderness

any rise in your body temp

If you have any indication of infection, contact your doctor immediately. Antibiotics need to be started immediately as well.

If the blister appears infected, it should be opened (preferably by a doctor) and drained entirely, an appropriate dressing and ointment applied, and the victim treated with antibiotics. Dicloxacillin, erythromycin, cephalexin, or augment are good antibiotics commonly used. The treatment needs to be for a miminum 5 days or until the skin appears normal. Complete the course prescribed by your doctor. Do not stop taking the antibiotic until the prescription is finished.

Causes of Blood Blisters

Friction, constant rubbing and pressure are the most common causes of blisters. But there are many medical conditions that cause them as well.

These include:

Allergic reactions to drugs

Atopic dermatitis

(eczema)

Blistering skin diseases including porphyria cutanea tarda and dermatitis herpetiformis

Chicken pox

Contact dermatitis (may be caused by poison ivy)

Herpes simplex (cold sores, genital herpes)

Herpes zoster virus (shingles)

Impetigo

Sunburn

Allergic reaction

Pemphigus vulgaris

Incontinentia pigmenti syndrome (IPS)

Other types of injuries to the skin that may cause a blister include:

Burns from exposure to heat, electricity, chemicals, radiation from the sun, or friction.

Cold injuries from being exposed to cold or freezing temperatures.

Some spider bites, such as a bite from a brown recluse spider . Symptoms of a brown recluse spider bite include reddened skin followed by a blister that forms at the bite site, pain and itching, and an open sore with a breakdown of tissue (necrosis) that develops within a few hours to 3 to 4 days following the bite. This sore may take months to heal.

Treatment of Blood Blisters

There is often disagreement on whether or not blood blisters should be opened and drained or allowed to dry up on their own.

I prefer that (especially with lymphedema) the blister NOT be opened as the open area could easily lead to an infection. Left alone, most blood blisters will resolve themselves in one or two weeks time.

To care for the blister:

Cleanse the area with a mild soap (I use an antibacterial soap).

Apply a soft gause pad over it, especially if it is in an area that would be easy to bump or scrap.

Do not pop the blister

A cold or ice pack may help reduce swelling and discomfort.

If you must pop a blister

Preferably this should be done by your doctor. I understand some of us hate going to a doctor or think we can handle it ourselves.

These guidelines should be followed: (2)

Use a sterilized needle or razor blade (to sterilize it, put the point or edge in a flame until it is red hot, or rinse it in alcohol).

Wash your hands thoroughly with soap and water

Wash the area thoroughly, then make a small hole and gently squeeze out the clear fluid.

Apply a dab of an antibiotic ointment with polymixin B and/or bacitracin to help protect against infection. Use caution with ointments that have neomycin in them because they are more likely to cause an allergic reaction.

If the fluid is white or yellow, the blister may be infected and needs medical attention.

Do not remove the skin over a broken blister. The new skin underneath needs this protective cover.

Look for signs of infection to develop. These include pus drainage, red or warm skin surrounding the blister, or red streaks leading away from the blister.(2)

When to Call A Doctor

See the doctor if there is redness around the wound, red streaks, swelling, drainage, fever, tender bumps in the groin or armpit upsteam from the wound, or an unexplained increase in pain or tenderness. You should also call the doctor if you begin running a fever. or the blister starts oozing blood or pus.

References

Blood Blisters – Wise Geek – (1)

Blisters – WedMD (2)

External Links

Blisters – First Aid – Mayo Clinic

Blisters and Vesicles – Medline Plus

Blisters, Calluses and Corns – Kidshealth

How to Care for and Prevent Blood Blisters -e How

Codes and Classifications

ICD-10

T14.0

Superficial injury of unspecified body region

Abrasion Blister (nonthermal) Bruise Contusion Haematoma Injury from superficial foreign body (splinter) without major open wound Insect bite (nonvenomous) Superficial injury

Excludes: multiple superficial injuries NOS ( T00.9 )

ICD-9-CM Diagnosis 910Superficial injury of face neck and scalp except eye