9 Common Rashes That Occur Alongside Blisters

Causes and Treatment of Vesicular Rashes

Blisters, or vesicles, can develop as a feature of many common rashes. Vesicles appear when fluid becomes trapped under the top layer of skin, known as the epidermis.

When a rash appears in the same place as multiple blisters, it is known as a vesicular rash. In some cases, the blisters can consolidate into larger single vesicles. When they burst, the fluids will usually crystallize and leave behind a residual crust.

Here are nine examples of common rashes that are characterized by vesicles:

Chickenpox

A child with chicken pox.
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Chickenpox is an itchy rash caused by the varicella virus. Since the introduction of the chickenpox vaccine two decades ago, the disease has not been seen as frequently as it used to be.

The classic chickenpox rash looks rather like a dewdrop. A person will typically have 100 to 300 of these located either on the skin or the mucous membranes of the throat, eyes, anus, or genitals.

The rash will develop anywhere from 10 to 21 days after exposure to the virus and one to two days after the appearance of the initial symptoms (fever, headache, fatigue, loss of appetite).

Over the course of the next eight to 12 hours, the fluid-filled blisters will get cloudier and burst, leaving a yellowish crust. A new crop of blisters can sometimes develop where old ones have healed and may even leave a permanent scar (known as a pockmark).

The virus can easily be spread by coughing, sneezing, or coming to contact with ruptured blisters. Anyone who has been exposed to chickenpox, even if they were immunized, is at risk for developing shingles later in life.

Shingles

shingles
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Shingles (herpes zoster) is a painful rash caused by reactivation of the same virus that causes chickenpox. The initial symptoms may include a burning, itching, or aching sensation on one side of the body. Fatigue is also common.

Because the virus is embedded in nerve cells, the reactivation will develop along a nerve string known as a dermatome. Dermatomes are responsible for servicing a specific area of skin on either one side of the body or the next.

As the blisters begin to rupture along the band of nerves, there will be a persistent and often excruciating pain. While the blisters will heal within seven to 10 days, the pain (known as postherpetic neuralgia) can last for weeks, month, or even years.

The fluid in the blisters can transmit the virus to others who have not had chickenpox or have not received the chickenpox or shingle vaccine. Antiviral medications can significantly reduce the duration or severity of a shingles outbreak

Poison Ivy, Poison Oak, or Poison Sumac

arm with a blistering poison ivy rash
Image courtesy CDC

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

The itchy and blistering rash will develop on areas of the skin exposed to the oils. While the fluid from the blisters cannot cause a rash in others, contact with the toxic oils on skin or clothing can.

Rhus dermatitis and other forms of allergic contact dermatitis are commonly treated with topical steroids. The rash will heal on its own in around three weeks, usually without scarring. Over-the-counter calamine lotions can help further relieve symptoms.

Genital Herpes

Genital herpes is most commonly caused by a type of virus known as herpes simplex virus 2 (HSV-2).

Symptoms typically start with a tingling or burning sensation. Shortly after, herpes blisters will start to develop and erupt into painful ulcers. Because the blisters are often hidden in women, genital herpes may sometimes be misdiagnosed as a bladder or yeast infection.

The fluid in the vesicles can transmit the virus to others during sex or intimate contact. While antiviral drugs can shorten the duration of an outbreak, there are none that can rid the body of HSV-2.

Cold Sores

Herpes simplex
CDC

Cold sores, also known as fever blisters or oral herpes, are most commonly caused by herpes simplex virus 1 (HSV-1).

Once a person has been exposed to HSV-1, the virus will remain in the body forever and occasionally reactivate, causing the formation of one or several blistering rashes. The triggers for these outbreaks include everything from stress and menstruation to excessive sun exposure and fever.

A cold sore can be painful and may take anywhere from seven to 14 days to heal. The fluid in the blisters can pass the virus to others through kissing, oral sex, or the sharing of cups, utensils, or personal care items.

Antiviral can help relieve the symptoms and reduce the duration and/or severity of an outbreak. Topical medications are also available.

Dyshidrotic Eczema

Dyshidrotic Eczema
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Dyshidrotic eczema, also known as pompholyx, is an itchy rash that primarily develops on the hands and feet. It is not contagious and is often seen in persons with atopic dermatitis.

While the cause is yet unknown, it is believed to be related to poor immune function. The vesicular rash has an almost tapioca-pudding-like appearance and can take up to three weeks to heal (often leaving behind red, dry, and cracked scales).

Large, painful blisters have been known to develop, making it difficult to walk if they appear on the feet. The rash is most often treated with topical steroids.

Scabies

Red papules on the skin due to scabies
P. Marazzi/Science Photo Libary/Getty Images

Scabies is a rash caused by a tiny mite that burrows its way beneath the skin. The red, bumpy rash will often develop into tiny, fluid-filled blisters. A scabies rash is most often seen on the wrists, between the fingers, under the arm, and around the waistline.

You can transmit scabies through skin-to-skin contact (although it usually takes more than a quick hug or handshake to do so). Infestations can also occur as a result of contaminated clothing and bedding.

Scabies is commonly treated with antiparasitic lotions that kill both the mite and its eggs. Oral medications are also available.

Impetigo

Impetigo rash beneath a mans lower lip
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Impetigo is a common bacterial infection affecting the upper layers of the skin, caused either by Streptococcus or Staphylococcus bacterium.

The most common type occurs on the face or limbs and is characterized by sores that quickly develop into vesicles. As the blisters burst, they leave behind a tell-tale honey-colored crust.

There is a less common form of impetigo that causes large blisters, known as bullae, primarily in newborns and younger children.

Treatment typically involves the use of broad-spectrum antibiotics. Impetigo can also be caused by MRSA, a strain of Staphylococcus that is resistant to standard antibiotics and may require a more aggressive, multi-drug approach.

Interface Dermatitis (Id) Reaction

Dermatitis Rash

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An interface dermatitis (Id) reaction is an itchy rash with small, fluid-filled blisters that develop in response to a primary infection, usually fungal. It most often occurs on the sides of fingers but can also be found on the chest or arms.

Athlete's foot, ringworm, or jock itch are just some of the infections associated with an Id reaction. Treatment of the underlying infection will usually resolve the rash.

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