9 Common Rashes With Blisters

Itchy and Painful Blisters Are Symptoms of Several Diseases

Blisters, or vesicles, can be painful or itchy, and they can occur with several common rashes. The causes of these rashes include viruses, bacteria, plant toxins, mites, and allergic reactions. Some causes are unknown. What they have in common is that it is very important to avoid scratching any blisters as this can lead to bacterial skin infections. While the itch can be intense, you'll want to soothe it with strategies such as cold compresses, oatmeal baths, and treatments recommended by your doctor.

Chickenpox

Photo of a typical chicken pox lesion
Photo © CDC/Dr. Heinz F. Eichenwald

Chickenpox is a very itchy rash caused by the varicella virus. Since the development of the chickenpox vaccine two decades ago, it isn't seen as frequently.

The classic chickenpox rash looks like a dew drop on a rose petal.  A person with chickenpox will have 100 to 300 blisters. These can be located on the skin or in the mucous membranes.

The rash develops 10 to 21 days after being exposed to the virus and one to two days after developing symptoms such as fever, headache, tiredness, and loss of appetite. Over the course of eight to 12 hours after the blister develops, the fluid gets cloudy and the blister bursts on its own, leaving a crust for a week. A new crop of blisters can be produced as the old ones heal. The blisters may leave a scar, known as a pockmark.

The fluid inside the blisters is highly infectious, and the virus is also spread by coughing and sneezing, so it's best to avoid contact with susceptible people. Pregnant women with chickenpox may need treatment with special medications. Anyone who has been exposed to chickenpox, even if they were immunized, is at risk for developing shingles later in life.

Shingles

Photo of shingles rash on arm
SIU/Getty Images

Shingles is a painful rash that is caused by reactivating the same virus that causes chickenpox. The first symptoms of shingles are itching, burning, or pain that occurs on one side of the body in a band-like area called a dermatome. The blisters break out along this band. They usually heal in seven to 10 days.

The fluid in the blisters of the shingles rash can transmit the virus to people who have not had chickenpox or who haven't been vaccinated to chickenpox or shingles. Once they scab over, they are not contagious.

The most common complication of shingles is the intense pain of the skin after the rash goes away. Fortunately, there are medications to treat shingles and a vaccine to prevent shingles.

Poison Ivy, Oak, and Sumac

Photo of poison ivy rash on arm
Photo © CDC

Poison ivy, or rhus dermatitis, is caused by exposure to an oily chemical found in certain plants including poison oak, ivy, and sumac.

This well-known rash starts out with blisters and redness on areas of the skin exposed to the plants. The fluid in these blisters won't spread the rash, although that is a common misbelief. Often, the rash will spread but that is due to ongoing contact with the toxic oil, which can remain on your skin and clothing for three weeks. You may have spread it around with washing after exposure or wearing clothing that still had the oil on it, and so a new crop of blisters will form.

Poison ivy and other forms of irritant contact dermatitis are treated with topical steroids. The rash will heal on its own in three weeks if untreated, usually without scarring. Sensitivity to poison ivy is hard to predict as people change from being insensitive to sensitive and back again. The best way to avoid an outbreak is learning to identify and avoid the plants and to immediately cleanse your skin with alcohol after contact.

Genital Herpes

Photo of herpes lesions on thigh
Photo © CDC/Dr. M.F. Rein & Susan Lindsley

Genital herpes is caused by one of the two types of the herpes simplex virus. The herpes virus works by infecting the skin and then staying around in the body to come back out and cause recurrent breakouts.

The symptoms start with tingling or burning on the skin. Soon, painful blisters crop up and break quickly to form ulcers. Genital herpes symptoms in women can be confused with a bladder or yeast infection.  In areas of the skin that are not moist, the ulcer crusts over. There is usually no scarring when the crust falls off. The fluid in the vesicles can transmit the virus to other people by intimate contact with mucous membranes (mouth, genitals, or anus).

There are treatments for herpes that can make the rash go away quicker or prevent a breakout from occurring, but none of the treatments get rid of the virus.

Cold Sores

Photo of cold sore on lip
Photo © CDC/Dr. Herrmann

Cold sores (fever blisters, oral herpes) are also caused by the herpes simplex virus. Once a person has been exposed to the herpes simplex virus, the virus is always in the body and can cause repeat eruptions. These breakouts are often triggered by trauma to the skin, menstruation, sun exposure, stress, fever, and other causes.

The blisters last for seven to 10 days. The fluid in the blisters and your saliva can transmit the virus through kissing, intimate contact, and sharing cups, eating utensils, towels, and lip cosmetics.

There are several medications that treat cold sores. There are oral and topical medications that can be used at the beginning of an outbreak to stop cold sores from erupting. There are also oral medications that people can take all the time to prevent outbreaks if they get frequent cold sores.

Dyshidrotic Eczema

Photo of dishydrotic eczema on the finger
Photo © Heather L. Brannon, MD

Dyshidrotic eczema, also known as pompholyx, is an itchy rash on the hands and feet. Many people with atopic dermatitis also have dyshidrotic eczema. It is not a contagious rash. The cause is yet unknown, but it is thought to be a complex reaction that happens in the immune system.

The rash involves thick blisters that resemble tapioca pudding appearing on the feet or hands, and especially the fingers. The blisters clear in two to three weeks leaving red, dry, and cracked scales. It can be difficult to walk when the blisters occur on your feet.

Dyshidrotic eczema is most often treated with topical steroids, but there are other medications that may be used.

Scabies

Photo of scabies rash on the leg
Photo © CDC/Susan Lindsley

Scabies is a rash caused by a tiny mite that burrows under the skin. The rash is red and bumpy and can appear as blisters. The rash is often seen on the wrists, between fingers, in armpits, and around the waistline.

You can transmit scabies to others with skin-to-skin contact, but it usually takes more contact than a quick hug or handshake. Scabies is treated with a lotion to kill the mite, but the rash can last up to a month. You'll need to wash all clothes and bedding in hot water and dry them in a hot dryer.

Impetigo

Photo of impetigo on the leg
Photo © CDC

Impetigo is a common bacterial infection of the upper layers of the skin caused by Streptococcus or Staphylococcus bacteria.

The most common form of impetigo often occurs on the face or limbs and is known for its "honey-colored" crust. This crust often looks like small blisters. There is a less common form of impetigo that causes large blisters, called bullae. That form tends to occur more in newborns and younger children.

Often, the treatment is with topical antibiotics, either over-the-counter or prescription. Oral antibiotics may also be used. Impetigo can also be due to MRSA, a strain of Staphylococcus that is resistant to the usual antibiotics and will require a more aggressive treatment.

Id Reaction

Photo © CDC

An id reaction (interface dermatitis) is an itchy rash with blisters that often occurs on the sides of fingers, but it can also be found on the chest or arms.

It is usually caused by a reaction to a fungal infection somewhere else on the body, such as athlete's foot, ringworm, or jock itch, although there may be other causes. It isn't contagious, although the root cause may be. Treating the cause will also resolve the id reaction.

Don't Scratch Those Blisters

A common theme for all skin rashes producing blisters is that they are itchy but you need to avoid scratching them. In some cases, the fluid in the blisters can transmit the bacteria or virus causing the blisters. But in every case, you risk getting a bacterial skin infection if you scratch the blisters or the raw skin left as they heal.

Talk to your doctor about the best tactics to reduce the itching. These can include cold, wet compresses, oatmeal baths, Calamine lotion, and an antihistamine such as Benadryl (diphenhydramine). You may also want to trim your nails so if you give in to the urge, you won't damage your skin as much.

A Word From Verywell

Itchy, painful, rashes with blisters are very frustrating. Check with your doctor for a diagnosis and see her immediately if you develop a fever, chills, or spread of the inflammation. Getting appropriate treatment is the quickest way to relief.

Sources:

Chickenpox (Varicella). CDC. https://www.cdc.gov/chickenpox/about/symptoms.html

Genital Herpes. CDC. https://www.cdc.gov/std/herpes/default.htm

Poison Ivy, Oak, and Sumac. MedlinePlus.gov. https://medlineplus.gov/poisonivyoakandsumac.html

Scabies. CDC. https://www.cdc.gov/parasites/scabies/index.html

Shingles. CDC. https://www.cdc.gov/shingles/index.html

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