Blisters on the fingers and hands can be due to burns, friction, dyshidrotic eczema, frostbite, herpes, chickenpox, contact dermatitis, hand foot and mouth disease, insect bites, scabies, or pustular psoriasis.
Our fingers and hands are exposed to many outside elements. These external factors or underlying medical conditions/ internal factors may lead to blisters or bumps on the fingers and hands.
Some of these blisters, such as those due to shingles and dyshidrotic eczema, can be triggered by stress and are sometimes referred to as stress bumps on the fingers. Similarly, heat and excess sweat can trigger dyshidrotic eczema, which is sometimes referred to as summer finger bumps.
The fluid inside finger and hand blisters can be serum, pus, or blood. Blisters with clear fluid are often called “water blisters”, while those with blood are referred to as “blood blisters”.
Based on their size, you may come across different names. Vesicles are small blisters that are less than 5 mm in size. A bulla is a large blister (bullae for multiple). The term blister can be used for both these entities.
Below you will find 13 causes of blisters on fingers and hands, along with pictures and treatment options.
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1. Friction blisters
Friction blisters occur due to repetitive rubbing against a surface or object, with the palms and fingers being commonly affected areas.
This repetitive friction can lead to the separation of skin cells and fluid accumulation, resulting in water blisters. Sometimes, excessive friction can cause blood blisters on the fingers and hands.
Causes
Friction can result from several factors, including:
- Lifting heavy objects.
- Rowing.
- Kids playing with monkey bars.
- Excessive sweating and moist hands make it easier to form blisters.
- Objects with rough surfaces.
- Thumb-sucking in kids.
Some conditions can make the skin fragile and can make one more prone to blisters. These include:
- Epidermolysis bullosa
- Porphyria cutanea tarda
- Certain medications
Symptoms
Continued rubbing can lead to redness, stinging, and burning. The area may heat up. This is followed by a pale blister.
Friction blisters are usually filled with clear fluid. The fluid acts as a cushion to protect underlying skin and help in its healing.
Over time, the fluid gets absorbed and the overlying skin peels off. In some cases, continuous rubbing may lead to bleeding changing clear fluid to red or reddish-brown.
Treatment
- Avoid popping the blister
- Most friction blisters will heal on their own. You can cover the blister with a bandage to protect it.
- Hydrocolloid blister plasters may help in faster healing.
- If the blister is uncomfortable, it may be drained with a sterile needle. It is important to not remove the roof of the blister to prevent infection.
You should see a doctor if you see any signs of infection like swelling or visible discharge (like pus) or discoloration.
2. Burn blisters
Burns can lead to blisters on fingers and hands. Burn blisters usually have clear fluid.
Causes
Blisters form when heat damages the epidermis and part of the dermis, which are the upper and middle layers of skin, respectively. These are called second-degree burns.
Burns can occur due to several reasons in our daily life.
- Hot oil or fluids
- Flames of stove
- Hot objects like a cooking pan or griddle
- Exposure to heat at work
One can also get sunburn due to excessive exposure to sun rays.
Symptoms
Burns can present with redness, swelling, pain, and blisters.
Treatment
- Cool the burned area by running under cool water.
- Pat it dry and keep it clean.
- You can cover the blister with a bandage.
- Over-the-counter painkillers may reduce inflammation.
- Watch out for any signs of infection like visible discharge, extreme pain, and increasing redness.
- If the burns are deep or serious and involve a large area of the body, one should go to the hospital immediately.
3. Frostbite
Frostbite is damage to the skin and underlying tissues due to exposure to extremely cold temperatures.
Extreme cold can cause the blood vessels to narrow, a process known as vasoconstriction. This reduces blood flow to areas that are meant to deliver heat, resulting in the formation of ice crystals.
Causes
Frostbite can occur due to several environmental causes, either alone or in combination with underlying medical conditions or internal factors:
- Winter season especially when accompanied by a moist condition
- Exposure to cold at a high altitude
- Immobilization (old age or small babies)
- Alcohol or drug abuse
- Smoking
- Altered mental status
- Malnutrition
- Presence of medical conditions like diabetes, hypothyroidism, peripheral vascular disease, stroke
- Smoking
Symptoms
The most commonly affected areas are:
- Hands
- Feet
- Ears
- Nose
- Lips
Frostbite occurs in stages:
Frostnip: This is the first stage and can make the skin red or pale. One may feel a tingling sensation. This is a warning signal and does not cause any permanent damage.
Superficial frostbite: In this stage, the skin may feel warm. It may sting or there can be swelling. On rewarming, the surface can look mottled or blue. After 12 to 36 hours, fluid-filled blisters may appear.
Deep frostbite: Continued exposure to cold can affect the skin and the tissue underlying it. One may lose sensations leading to total numbness and the skin can turn pale or gray.
On rewarming, large blisters may appear in 24-48 hours. The dead tissue will start turning black.
Sometimes, frostbite can cause blood blisters on the fingers and hands.
Treatment
Treatment of frostbite depends on the severity of the symptoms. If you think you have frostbite, it’s best to get medical attention.
The wet or tight clothing and rings should be removed.
The treatment may include:
- Rewarming the area in a warm water bath (direct heat should not be applied). The rewarming should be started only after one knows that there will be no further exposure to cold. Thawing and then exposure to cold temperatures again can cause more damage.
- Pain medication to reduce discomfort.
- Protection of injured areas.
In addition:
- Do not rub the area.
- Do not break the blisters.
4. Contact dermatitis
Finger and hand blisters can be the result of a skin rash called contact dermatitis.
Contact dermatitis can be of two types:
Allergic contact dermatitis occurs due to contact with an allergen like poison ivy, latex, animal dander, molds, dust, pollens, and metals like nickel.
Irritant contact dermatitis occurs due to contact with an irritant which damages the skin barrier and leads to inflammation. Our hands commonly come in contact with irritants like cleaning products, harsh detergents, and chemicals at work.
Symptoms
Contact dermatitis may present with the following symptoms:
- Itchiness
- Redness
- Burning
- Blisters
- Oozing
- Dryness
Continuous scratching may lead to sores on the fingers and hands.
Treatment
- Remove or avoid the allergen or irritant.
- Use a cool compress to reduce itching.
- Consider taking antihistamines to alleviate itching.
- Keep the affected area clean and dry.
- Avoid popping the blisters.
5. Dyshidrotic eczema
Dyshidrotic eczema aka pompholyx can lead to small itchy, painful blisters on the fingers and hands, especially along the sides or between the fingers. It can also involve the feet.
Causes
The underlying cause is not known. However, it is often seen in people with a history of other eczema, or allergies or who have a family history of dyshidrotic eczema.
The associated risk factors include hot and humid environments, stress, excessive sweating, and contact with metals like nickel or cobalt.
It is commonly seen in the age group of young adults 20-40 years (more often in females).
Symptoms
The rash may be preceded by burning or itching in the area. The rash appears as red bumps which are filled with clear fluid aka blisters. These may heal in 2-3 weeks leaving red and dry skin.
Treatment
- Your doctor may prescribe topical steroids.
- Oral steroids may be prescribed in severe cases.
- In resistant cases, immunosuppressants or phototherapy may be helpful.
- Botulinum toxin injection may help by decreasing sweat which is one of the trigger factors.
6. Herpetic whitlow
Herpetic whitlow is a viral infection that causes painful blisters or bumps on the fingers and fingertips. The affected area may be red and swollen.
Causes
It is caused by the herpes simplex virus. One can get this by coming in direct contact with infective lesions – cold sores or genital herpes.
It can also occur due to autoinoculation, that is fingers getting infected by touching one’s own lesions.
One can get it following an injury. It is commonly seen in healthcare workers especially those working in dental offices. It can also be seen in children who suck their thumbs.
Symptoms
One may feel pain and tingling followed by redness or swelling and a cluster of blisters. These blisters can come together to form larger blisters.
It usually involves one finger but may involve other areas of the hand. It may be accompanied by fever and enlarged lymph nodes.
Treatment
In most cases, the symptoms resolve in 2-4 weeks. In some cases, your doctor may prescribe antiviral medications (best when used in 48 hours).
In addition, one has to take precautions not to spread the virus to other parts of the body.
7. Shingles
Shingles is a viral infection that can lead to painful and itchy blisters on fingers and hands.
Cause
Shingles also called herpes zoster occurs due Varicella zoster virus. Varicella zoster is a type of herpes virus; however, this is different from herpes simplex virus types 1 and 2 which cause cold sores and genital herpes.
Varicella zoster virus causes chickenpox and once a person gets chickenpox, the virus stays inside the body for life.
This virus can reactivate leading to shingles. It can occur due to a weak immune system, certain drugs or medications, stress, diabetes, old age, etc.
Symptoms
Shingles present with a painful itchy blister rash. It can involve any part of the body. It usually appears on one side like the left hand, left arm, or one side of the torso, and so on.
It starts with burning, itching, or pain in the area followed by red bumps which form blisters. These blisters crust and scab. It may be accompanied by other systemic symptoms like fever, headache, or weakness.
Even after the lesions on the skin heal, one may have persistent pain. This is called postherpetic neuralgia.
One can spread the virus to others who are not vaccinated against chickenpox or who never had chickenpox. The infected person will get chickenpox and not shingles.
Shingles can be prevented by vaccination – Shingrix vaccine (it is considered 90% effective).
Treatment
Antiviral medications may help in faster healing of the lesions. It can also prevent complications.
In some cases, your doctor may prescribe medications for pain like topical numbing creams, gabapentin, or amitriptyline.
8. Chickenpox
The rash from chickenpox can present as a generalized eruption of blisters, which can include the hands and fingers.
Cause
Chickenpox is a viral infection caused by the Varicella-zoster virus. The rash may involve the entire body in comparison to Shingles which usually involves part of the body on one side – left or right.
Symptoms
The rash usually starts on the trunk (chest or back) and face. It appears in phases: first red bumps appear, which turn into blisters and finally, they scab.
The new bumps appear continuously so one can see bumps, blisters, and scabs at the same time. The rash usually lasts for 7 to 10 days
It may be accompanied by systemic symptoms like fever, malaise, or headache.
The virus can spread by direct contact with lesions. One stays infectious until the blisters scab.
Chickenpox vaccine can prevent the infection. CDC recommends 2 doses of vaccine for children, adolescents, and adults who are not vaccinated against chickenpox and never had chickenpox.
Treatment
Chickenpox clears on its own. Over-the-counter acetaminophen can be recommended to reduce fever.
In people with weak immune systems or medical conditions like diabetes or cancer, antiviral medications (like acyclovir) may be prescribed.
9. Hand, foot, and mouth disease
Hand, foot, and mouth disease is a common viral infection that can lead to finger and hand blisters.
Cause
It is caused by the Coxsackievirus. It is common in young children but anyone can get it. This is a contagious skin condition and can spread in schools or daycares.
Symptoms
It can lead to fever followed by a rash on hands and feet which appear as red bumps. They may form blisters. In addition, one can have mouth sores or blisters, sore throat, and malaise.
The hand, foot, and mouth disease rash is usually not itchy in comparison to chickenpox rash which is usually itchy.
Treatment
The rash usually clears on its own. There is no specific treatment. In some cases, pain medication may be given.
One should keep a lookout for any signs of dehydration. The child should be encouraged to take fluids.
10. Impetigo
Impetigo is a bacterial infection that can cause small blisters with crusting on the hands. It is common in young children.
Cause
The most common bacteria which can cause impetigo is Staphylococcus aureus.
It is a contagious skin condition and can be transmitted by direct contact with the lesions or by contaminated surfaces.
Symptoms
The commonly affected areas are the face (around the mouth and nose), hands, and feet.
It leads to red bumps which form blisters. These can burst, revealing raw areas, on which golden or honey-colored crust forms.
Lesser common types are:
- Bullous impetigo in which large blisters appear on the trunk of infants or young children.
- Ecthyma is a serious form leading to deep ulcerative lesions.
Treatment
- Prescription topical mupirocin (an antibiotic) is used for the treatment.
- In severe cases, oral antibiotics may be prescribed.
- One should follow good hand hygiene to prevent the spread of infection to other parts of the body.
11. Insect stings and bites
Insect bites are common on areas that are commonly exposed like hands, arms, legs, feet, or face.
Common offenders are
- Bees
- Mosquitoes
- Bed bugs
- Ants
- Spiders
- Flies
Symptoms
These insect bites usually present as red itchy bumps. These bumps can form a blister. These bumps occur due to our skin’s reaction to stings or secretions.
The appearance of each bite may vary depending on the insect or bug.
Treatment
- The bump or blister usually clears on its own.
- Antihistamines and topical steroids may help in reducing the symptoms.
In some cases, insect stings can lead to a severe allergic reaction called anaphylaxis. It can cause difficulty in breathing, low blood pressure, shock, and can be life-threatening. One should go to the hospital immediately in such a case.
12. Scabies
Scabies is a skin rash that can result in itchy finger and hand blisters, especially in between the fingers. It is caused by a mite called Sarcoptes scabiei.
In addition to hands, it can involve folds and flexures of skin like wrist, elbow, armpit, nipple, waist, buttocks, and penis.
In young children, the head and neck, palms, and soles are commonly affected.
Symptoms
It leads to a rash with intense itching which can be worse at night. The rash may appear as red bumps, hives, or blisters. You can also see tiny burrows which are small raised curved lines caused by female mites.
Intense itching associated with it can cause open sores and secondary infection, leading to impetigo.
This is a very contagious skin condition. It can spread by direct skin-to-skin contact. It can also spread by sharing personal items like bedding, clothes, or towels.
Diagnosis
It can be diagnosed clinically by examining the lesions. In a few cases, a skin sample may be taken to examine under a microscope to look for eggs, feces, or mites.
Treatment
Your doctor may prescribe the following medications:
- Topical permethrin – 5% (lower concentration is available over the counter; however, it may not completely get rid of scabies).
- Crotamiton cream or lotion (10%).
- Benzyl benzoate lotion (25%).
- Sulfur ointment (5% – 10%).
- Oral ivermectin pills.
- Antihistamines to reduce itching.
- Antibiotics if there is a secondary bacterial infection.
- Other members of the same household may require treatment as well.
13. Pustular psoriasis
Psoriasis is an autoimmune inflammatory skin condition that can lead to red patches covered with scales. Pustular psoriasis is a rare variant of psoriasis that leads to pus-filled blisters on the body.
These pustules are not infectious, meaning they are not the result of any microbes like bacteria. These occur due to the collection of white blood cells, which are one type of cells in our blood.
Causes
The exact cause is not known; however, several risk factors are associated with it.
- Sudden withdrawal of systemic steroids
- Electrolytes imbalance
- Certain medications (lithium, penicillin, interferon-alpha, etc.)
- Pregnancy
- Stress
- Infections (like Streptococcus or Staphylococcus)
- Smoking
Symptoms
It can be either generalized when it involves the whole body, or it can be localized.
The localized form which can affect hands is of two types:
- Acrodermatitis continua of Hallopeau: Pustules affecting the fingers, toes, and nail beds.
- Palmoplantar psoriasis: Pustules affecting the palms and soles.
These pus-filled blisters can turn brown, crust, and peel off.
Treatment
It is important to identify the trigger factor and address that. Generalized pustular psoriasis requires immediate medical attention and hospital admission.
Localized pustular psoriasis may be treated with the following:
- Topical steroid
- Topical synthetic vitamin-D
- Topical salicylic acid and coal tar
- Acitretin, retinoid (Vitamin-A derivative)
- Immunosuppressants like methotrexate or cyclosporine
- Biologicals
- Phototherapy
Diagnosis
In the majority of cases, examination of lesions and review of history can help in identifying the cause of hand blisters.
In some cases, your doctor may do additional tests to rule out other skin conditions. These may include:
- Culture of the blister fluid.
- Skin scrapings.
- Skin biopsy in which a small skin sample is taken and sent to a lab for examination under a microscope.
- Blood tests.
- Allergy test.
Prevention
Below are some general measures to help avoid hand and finger blisters:
- Be careful when handling hot objects or cooking in the kitchen. Use thick gloves to handle hot objects.
- Avoid exposure to extremely cold temperatures and wear weather-appropriate clothing.
- Avoid contact with known allergens or irritants.
- Practice good hand hygiene to avoid getting viral or bacterial infections.
- If applicable, get vaccinated against chickenpox and shingles.
- Protect your skin from UV rays by using sunscreen or sun-protective clothing.
- Use insect-repellent bands while doing outdoor activities.
- Wear full-sleeved shirts or full-length pants to avoid insect bites.
- Manage your stress.
- Eat healthy and rest well.
Summary
Blisters on the fingers and hands can occur due to various reasons like friction, burns, cold temperature, infections, or autoimmune conditions.
While most blisters will heal on their own, some may need medical attention depending on the cause. It is important not to pop the blister, as that can lead to sores on the fingers and hands, delay healing, or cause an infection.
If you see any signs of infection like swelling, intense pain, or visible discharge like pus or discoloration, it’s best to get immediate medical attention.
References
- Shah M, Al Aboud DM, Crane JS, et al. Pustular Psoriasis. [Updated 2022 Aug 8]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan.
- Pustular Psoriasis: Treatment Options. American Academy of Dermatology Association.
- Pustular Psoriasis. National Psoriasis Foundation.
- Betz D, Fane K. Herpetic Whitlow. [Updated 2022 Aug 1]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan.
- Basit H, Wallen TJ, Dudley C. Frostbite. [Updated 2022 Jun 27]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan.
- Blistering skin conditions. Oakley A. DermNet.
- Scabies: Diagnosis and Treatment. American Academy of Dermatology Association.
- Hand, Foot, and Mouth Disease (HFMD). CDC.
Disclaimer: This blog post is for information purposes only and does not replace medical advice.