Blisters on the foot or hand can indicate several conditions. A blister is an accumulation of fluid in a cavity between the epidermis and the dermis as a result of abnormal friction, for example due to poorly fitting footwear, abrasive socks or prolonged walking. However, blisters on the foot can also occur as a result of an underlying condition. Common causes of blisters on the foot are: blistering eczema or pompholyx, athlete’s foot or athlete’s foot, pustular psoriasis, hand, foot and mouth disease (common in children). Rarer causes of blisters on the foot and hand include diabetic blisters and epidermolysis bullosa simplex, a rare hereditary condition. Your doctor can make a diagnosis and initiate treatment based on that. Usually, medication applied to the skin or taken by mouth is sufficient to relieve the symptoms.

Possible diagnoses of blisters on the foot are:

• Foot and hand blisters due to eczema

• Blisters on the hand due to vesicular eczema (pompholyx)
• Blisters due to hand eczema
• Blisters on the foot due to athlete’s foot

• Blisters on hands and feet due to autoimmune disorders

• Small blisters due to pustular psoriasis
• Bullous pemphigoid
• Pemphigus vulgaris

• Hand, foot and mouth disease
• Diabetes and skin problems

• Diabetic blisters
• Athlete’s foot

• Epidermolysis Bullosa Simplex
• Blisters on foot (and hand) due to chickenpox

 Pompholyx on the hand / Source: Chalco, Wikimedia Commons (GFDL)

Foot and hand blisters due to eczema

Eczema is often the culprit when it comes to blisters on the hand or foot.

Blisters on the hand due to vesicular eczema (pompholyx)

Cystic eczema is a special form of eczema that mainly occurs on the palms of the hands and soles of the feet. The blisters can be very itchy or cause a burning sensation. The blisters can clump into a larger spot. When the blisters start to heal, they dry up and flaky eczema develops. It mainly occurs in people under 40 years of age.

Blisters due to hand eczema

Is the skin on your hands dry, thick and flaky? Do you have deep, painful cracks in your hands that bleed? Then there may be more going on than dry skin. Hand eczema could be the culprit. It can manifest as acute and chronic eczema. Acute eczema is characterized by the following symptoms:

• redness
• swelling
• bumps and blisters
• The eczema can be wet because the blisters burst
• the blisters dry into scabs, after which the skin starts to flake (peel)
• eventually the redness decreases

In the chronic phase, the redness decreases further and you suffer from dry and flaky skin. The skin also becomes somewhat thicker and the skin lines are coarser and cracks can easily develop.Athlete’s foot / Source: Ellington, Wikimedia Commons (Public domain)

Blisters on the foot due to athlete’s foot

Athlete’s foot is a common skin infection caused by a fungus. Most people with athlete’s foot have no symptoms at all and are not aware that they have an infection. Wet, flaky spots between the toes, sometimes with painful cracks and blisters, are common symptoms. This may be accompanied by itching and/or burning.

Blisters on hands and feet due to autoimmune disorders

Autoimmune diseases are diseases of the immune system, in which the body’s natural defense system attacks itself. There are some autoimmune diseases that cause blistering on hands and feet, among other things.

Small blisters due to pustular psoriasis

This rare, severe form of psoriasis is mainly seen in adults and causes small blisters, usually on the feet and palms. However, it can also occur in other parts of the body. Pustular psoriasis is not contagious.

Bullous pemphigoid

Bullous pemphigoid is a rare skin condition that causes large, fluid-filled blisters. They develop on the lower abdomen, upper legs or armpits, but the hands and feet can also be affected. Bullous pemphigoid is most common in the elderly. The condition occurs when your immune system attacks a thin layer of tissue beneath your outer layer of skin. The reason for this abnormal immune response is unknown as of 2023, although it can sometimes be triggered by taking certain medications. Bullous pemphigoid often goes away on its own within a few months, but it can take up to five years to resolve. Bullous pemphigoid can be life-threatening, especially for older people who are already in poor health. The symptoms may include:

• itchy skin, weeks or months before the blisters form
• large blisters that do not break easily when touched
• Blisters often occur along folds or creases in the skin
• the skin around the blisters is normal, reddish or darker than normal
• rash that looks like eczema or hives
• small blisters or sores in the mouth or other mucous membranes

Pemphigus vulgaris

Pemphigus vulgaris is a rare autoimmune disease that causes painful blistering of the skin and mucous membranes. This skin disease usually starts with blisters in the mouth and then on the skin. Pemphigus vulgaris can be dangerous. The condition can cause serious complications if left untreated. Some of these complications can be fatal. The mortality rate from this disease averaged 75 percent before the introduction of corticosteroids in the 1950s. This has improved dramatically with treatments in 2023. The symptoms of pemphigus vulgaris include:

• painful blisters that start in the mouth or skin areas
• blisters near the surface of the skin that come and go
• limp blisters with a thin roof
• the blisters break easily, forming superficial, painful erosions
• blisters bleed quickly
• sometimes secondarily infected

 Hand, Foot, and Mouth Disease on the Hands of an Adult / Source: James Heilman, MD, Wikimedia Commons (CC BY-SA-3.0)

Hand, foot and mouth disease

Hand, foot and mouth disease is a common, relatively harmless viral infection that mainly affects children but can also affect adults. It usually starts in the throat. This viral infection causes small blisters in the mouth and on the hands and feet. The blisters are often painful.

Diabetes and skin problems

Diabetic blisters

Both type 1 diabetes and type 2 diabetes can cause skin problems in the medium term, including ‘diabetic blisters’ although these are not very common. They are mainly observed in patients with long-standing diabetes mellitus and mainly appear on the feet and lower legs. They are tightly wound blisters filled with clear fluid that develop spontaneously within a few days. They heal slowly.It is also known as ‘bullosis diabeticum’. This is a distinct, spontaneous, non-inflammatory blistering of the skin that only occurs in people with diabetes mellitus. Bullosis diabeticum tends to develop with long-term diabetes or in combination with multiple complications. It occurs in approximately 0.5% of diabetic patients. Men are twice as likely to develop bullosis diabeticum than women. These blisters appear spontaneously and can occur anywhere on the body.

Athlete’s foot

Diabetics are more likely to develop athlete’s foot. Symptoms include:

• flaky, red and painful skin
• Athlete’s foot often occurs between the toes
• the affected skin feels soft
• blisters with clear fluid coming out of them
• discolored, thick and brittle toenails
• itchy feet

Epidermolysis Bullosa Simplex

Epidermolysis bullosa is a rare, hereditary condition in which blisters can develop more or less spontaneously on the skin, as a result of improperly functioning proteins (cell bridges) that anchor the epidermis to the dermis, causing the epidermis to easily detach from the dermis and retain moisture. comes between the layers: blisters. In people with epidermolysis bullosa, these blisters develop with very light and short-term friction, sometimes just by wearing clothes or shaking hands. Mild forms of this condition only cause blisters on the hands and feet. The complaints often first manifest themselves in childhood.

Blisters on foot (and hand) due to chickenpox

Chickenpox is an infectious disease caused by the varicella-zoster virus. It is accompanied by an itchy rash with small, fluid-filled blisters. Chickenpox is highly contagious to people who have not had the disease or been vaccinated against it. The itchy blister rash caused by the infection with the virus appears 10 to 21 days after exposure to the virus and usually lasts for about five to 10 days. Other signs and symptoms, which may occur one to two days before the rash, include:

• fever
• loss of appetite
• headache
• fatigue and general malaise

Once the chickenpox rash appears, it goes through three stages:

• Raised pink or red bumps (papules), which erupt over several days.
• Small fluid-filled blisters (fluid blisters) that form in about one day and then break and leak.
• Scabs, which cover the broken blisters and take several days to heal.

New bumps will continue to appear for several days, so you may have all three stages of the rash (bumps, blisters, damaged lesions, and scabs) at the same time. The disease is generally mild in healthy children. In severe cases, the rash can cover the entire body and lesions can form in the throat, eyes and mucous membranes of the urethra, anus and vagina.

read more

• Blisters on foot and hand: causes of blisters and blisters
• Pompholyx (vesicular eczema): blisters and blisters on hands and feet
• Blisters in the mouth: causes blisters or sores in the mouth
• Childhood diseases with spots on the skin, blisters, rashes
• Blisters on hands: causes of blisters on palms