What You Need To Know About Diabetic Blisters

    What You Need To Know About Diabetic Blisters

    Diabetic bullae, more commonly known as diabetic blisters, is a kind of skin lesion occurring in people with diabetes mellitus. Why do they develop, and how will you treat them? Find out here.

    What Are Diabetic Blisters?

    Reports say diabetic bullae, with the medical name bullosis diabeticorum, rarely occurs. But when they do, it is mostly in people with uncontrolled blood sugar levels.

    However, there are also cases when the blisters serve as the first sign of an underlying impaired glycemic control. Some reports even say diabetic bullae may develop in prediabetes.

    The blisters can be described as¹:

    • Spontaneous, meaning the onset is abrupt. The lesions can develop overnight with no accompanying signs.
    • Painless. However, some people report on feeling mild discomfort or a burning sensation.
    • Fluid-filled. The fluid is usually clear.
    • Non-erythematous. This means diabetic bullae are typically non-inflammatory and the skin surrounding the blister looks normal.

    In many instances, the blisters develop in the lower extremities, particularly on the tip of the toes or the surface of the feet. Still, they can appear in the upper extremities, particularly in the forearms.

    Finally, note that the shape and size of diabetic bullae varies. Their diameter can be anywhere between 0.5 to 17 cm. They may also develop alone or in groups.

    What Causes Diabetic Bullae to Develop?

    The exact cause of diabetic bullae is unknown. Experts believe it involves multiple factors.

    For instance, several researchers concluded that people with insulin-dependent diabetes have a “marked reduced threshold to suction blister development” than the control group2. This means that people with diabetes are more vulnerable to the development of blisters³.

    Some experts, on the other hand, speculate that diabetic bullae may develop due to trauma, considering it commonly occurs in the feet.

    These factors, however, do not explain why diabetic blisters rarely occur in the majority of diabetic population.

    Treatment and Management

    Another interesting thing about diabetic bullae is that they usually heal on their own without any treatment in 2 to 5 weeks.

    Hence, if you develop diabetic bullae, treatment and management should focus on preventing infection. This points to NOT puncturing or bursting the blister.

    Some of the steps taken to manage blisters include:

    • Bandaging. Bandaging helps protect the blisters from being punctured or scratched.
    • Aspiration. Doctors may recommend aspiration, the process of draining the fluid with a needle. Note that this procedure leaves the “roof” of the blister intact, protecting the underlying wound from infection.
    • Topical antibiotic. Although not usually, doctors may also recommend the application of a topical antibiotic.

    Despite being a typically self-limiting skin condition, please consult a doctor if the blister leads to redness, swelling, or significant pain.

    Medical help is also necessary if the blister has been “de-roofed,” meaning the skin underneath becomes exposed. Cases like this require aggressive wound care to prevent ulceration or infection.

    Prevention

    Since the exact cause of diabetic bullae is unknown, there’s also no one way to prevent it.

    At this point, the best prevention is to keep your blood sugar under control. Be sure to follow your nutrition plan, perform regular, appropriate exercise, and take your medications.

    It might also help you to avoid trauma as much as you can. Always inspect your skin for wounds, wear shoes that fit properly, and use protective clothing when you need to do something that may cause trauma. For instance, wear protective gloves when handling equipment.

    Key Takeaways

    Diabetic bullae or blister is a rare skin condition in people with diabetes mellitus. The cause is unknown but the blisters are usually painless, non-inflammatory, and self-limiting. Treatment and management mainly revolves around keeping the blisters intact to prevent infection. If you develop blisters, please consult your doctor to have the right diagnosis and treatment.

    Learn more about Diabetes Complications here.

    Hello Health Group does not provide medical advice, diagnosis or treatment.

    Sources

    1. Diabetic bullae, https://www.bjd-abcd.com/index.php/bjd/article/view/52/120#:~:text=Diabetic%20bullae%2C%20also%20known%20as,reported%20in%201930%20by%20Kramer., Accessed May 4, 2022

    2. Bullosis Diabeticorum, https://www.ncbi.nlm.nih.gov/books/NBK539872/, Accessed May 4, 2022

    3. Reduced threshold to suction-induced blister formation in insulin-dependent diabetics, https://www.sciencedirect.com/science/article/abs/pii/S0190962283800073, Accessed May 4, 2022

    4. Cutaneous Manifestations of Diabetes Mellitus, https://diabetesjournals.org/clinical/article/33/1/40/31293/Cutaneous-Manifestations-of-Diabetes-Mellitus, Accessed May 4, 2022

    5. Bullosis diabeticorum: A distinctive blistering eruption in diabetes mellitus, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2802364/, Accessed May 4, 2022

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    Written by Lorraine Bunag, R.N. Updated Jun 03
    Expertly reviewed by Dexter Macalintal, MD