blistering

Blistering refers to the formation of blisters, fluid-filled sacs that form between layers of the skin or within the skin layers themselves. In dermatology, blisters are often categorized by size as vesicles (less than 5 mm) or bullae (greater than 5 mm). The term can describe both the process of blister formation and the resulting lesions, and it is sometimes used metaphorically to denote rapid, intense, or harsh action or critique.

Causes of blistering are diverse. Mechanical friction or shear forces from ill-fitting footwear or repetitive rubbing can separate epidermal cells, producing a friction blister. Thermal burns, sunburns, and chemical exposures can also create blisters. Infections may cause blistering as part of the skin’s inflammatory response. Autoimmune blistering diseases, such as pemphigus vulgaris and bullous pemphigoid, involve antibodies that disrupt skin adhesion, leading to widespread blistering. Inherited conditions like epidermolysis bullosa cause fragile skin that blisters easily from minor trauma.

Diagnosis typically relies on history and physical examination, with skin biopsy and immunofluorescence used when an autoimmune process is suspected. Large or persistent blisters may require careful drainage under sterile conditions, while avoiding rupture to reduce infection. Treatment is directed at the underlying cause and includes protective wound care, cleanliness, and appropriate dressings. Burns may require cooling, debridement, and tetanus prophylaxis; autoimmune blistering diseases often need systemic therapies such as corticosteroids or immunosuppressants.

Prevention focuses on reducing risk factors, such as wearing properly fitting footwear, using protective padding, and avoiding irritants or excessive heat. The prognosis of blistering depends on the cause; friction blisters typically heal without scarring, while those related to burns or systemic diseases may require more extensive treatment and can result in scarring or ongoing management.