Blisters on the hands

Many of us have had blisters on our hands before; they are often painful and uncomfortable but there are many other instances in which they are painless. A blister is a sac that develops on the outer layer of the skin and is filled with fluid. The majority of cases are not a cause for alarm. But it is useful to know that when there is a blister on the hand, it is not the most appropriate thing to pry it open as this may lead to an infection. If it opens up on its own, which can frequently happen especially during sleep, then it should be covered up with a piece of clean gauze so that further secretions can be speedily absorbed and the surface is protected from bacteria. If a blister is associated with severe pain or swelling, and there are other signs of an infection such as a shooting pain up that arm or even a fever, then it is time to visit a hospital and get a doctor to examine it. The body naturally produces blisters as a form of cushion to protect the underlying layers of skin and allow it to heal. The small blisters are called vesicles and the bigger ones, bullae.

Most blisters are caused by infection, friction, burns, exposure to certain chemicals, and some medical conditions. Many common conditions will be found to be responsible for this development. Depending on what may have caused any particular blister, the kind of fluid within the blister may be serum, blood, plasma, or pus. These lesions can occur anywhere in the body certainly, but what we are concerned with in this essay is the hand and how it is affected by them. Most blisters on the hands, therefore, will be caused by common things we encounter on a daily basis in the course of doing our work or while performing basic chores in the house. In this connection, even basic engagements such as cooking can be associated with the formation of blisters on the hands either as a result of repetitive contact with an object like a knife or a grinding stone for those women who use these items or from friction. They can equally result from washing clothes to gardening, and in the latter case, gardening with the use of hoes and cutlasses is likely also to cause this problem.

Basically, therefore, blisters are often caused by one of these broad causes already mentioned in the first sentence of the paragraph above. Friction as we have seen above is a common cause of this condition. Any engagement that causes repetitive action on an area of the hand will cause the formation of blisters depending on the amount of friction exerted on that area by the object. Areas of the hand most likely to form blisters are the palms and the fingers and fingertips. The palm is involved most commonly because it is the part of the limb that is used to grasp objects. So if the object is a hot pot or a cutlass, the degree of injury determines how large the resulting blister will be. A large one, called a bulla, will usually have to be opened up to let out the fluid in it and produce relief. The fingers may also be affected in contact with any of the utensils mentioned above. Many people of my generation who went to public schools and were often punished by having to cut grass would appreciate these effects. In the same way, blistering of the finger tips can be a side effect of playing stringed musical instruments.

Burns can also be responsible for causing blisters. We already discussed how this can be a problem when people are cooking. The risk is similar when one is using an iron to stretch out clothing. Consequently, it is useful to examine the different types of burns that can cause such injuries; first-degree burns will cause superficial damage to the skin as well as pain, swelling, redness, and blanching when the area of the burn is squeezed. Even when there is no observable blister at the beginning, one will form within a couple of days as the outermost layer of the skin is lifted off the remaining layers thus allowing the formation of a sac of fluid that protects those deeper layers. In second-degree burns, blisters may form immediately as the outermost layer, as well as the underlying skin layers, are damaged so much that fluids immediately gather. In third-degree burns, every layer of the skin is involved in the damage, and the skin may appear like leather and become brown or grey in appearance. These burns require emergency medical attention as they may take several months to heal and different types of physiotherapy will be needed.

Medical conditions such as contact dermatitis and chickenpox can also cause conditions like this. And so also do situations like allergic dermatitis that may be associated with itching and swelling. This can also happen in cases like Steven-Johnson’s syndrome which is characterised by blistering, fever, peeling of the skin, and red eyes.

It is associated with the intake of certain medications especially those that contain sulfonamides and can be aggravated by toxic epidermal necrolysis and sepsis. The former term means that the skin dies off in large areas and sloughs off in sheets, thereby exposing underlying skin layers. Sometimes, this reaction is so severe that some people die as a result of it. However, most blisters will heal on their own without the need to have them treated. When such a blister is left alone and not opened up, a new layer of skin will soon grow beneath it and the top skin which contains the blister can then dry off naturally and fall off. Many surgeons and dermatologists recommend that the blisters be left alone because they actually are the best dressing you can have over the area of the burn wound.

A blister of that nature can be covered with a piece of gauze, that is suitably bulky to be able to absorb whatever fluid comes out of the wound. If the bulla is a large one, it can be opened up a bit at its most dependent aspect to drain all the excess fluid and the collapsed blister covered up subsequently with gauze. Chemical compounds such as cosmetics, detergents, and chemical solvents used in the paint industry can similarly cause burns that will show up on the hands like blisters. Warfare agents like mustard gas, agent orange, and sarin are known to cause similar injuries although they are not necessarily only limited to the hands. As many of these effects are due to some form of an allergic reaction, part of the treatment will have to involve avoiding the compound altogether. These are recognised as stimuli and so when the cause of the problem is avoided, the healing process can begin. Once a blister has formed in response to a chemical agent, an adverse reaction to a drug, or an uncertain medical condition, it is wise to go to a hospital and allow a doctor to have access to the lesion so that an informed opinion can be obtained.

As a general rule, a blister occurring on the hands must be treated with seriousness especially when the cause is uncertain. Blisters are often painless, mild in character, and can be dealt with at home. Healing is often guaranteed. However, in some conditions, the condition is severe enough to warrant a hospital visit and even hospitalisation. If a large bulla affects the entire palm as a consequence of Steven-Johnson’s syndrome, it is only wise for that person to not only seek hospital treatment but also to accept the offer of hospitalisation when made because they will be unable to fend for themselves. Simple things like holding a cup of water or cutlery will not be possible because of the immense swelling and pain. As the hand is such an important organ, such limitation to its use can be the meaning between swift recovery and prolonged misery.

Questions and answers

Dear doctor, how long does it take for a newly delivered mother to resume menstruation? 0706xxxxxxx

Typically, a normal period will resume in about 6 to 8 weeks after delivery. However, when a woman does exclusive breastfeeding, there may be no menstruation for as long as she does that. That means that for some women, there is no menstruation for 18 months while many others will resume menstruation at various intervals between six weeks and the end of breast-feeding.

Dear doctor. I am 32 years old and I suffered from burns to my legs, lower abdomen, and parts of my back. I was in the hospital for four months and have just been discharged. Over the last two weeks, I have seen the development of some swellings which my doctors have said are keloids and for which they have told me that there is no certain cure. What do you advise me to do? I am not married at my age and now this will disfigure me further. Please help me. 0701xxxxxxx    

Well, your doctors will probably advise you better about what is available and achievable. You can start off by putting on a pressure garment over the keloids especially as they are on the lower limbs. That is likely to help keep the scars flat and they can then be further treated with steroid injections into the base of the lumps. After this phase, the use of liquid nitrogen and laser surgery can be deployed to help remove some by burning the most prominent ones. It is a slow and time-consuming process deployed in stages and the results are less than perfect but the most obvious ones can be made acceptable cosmetically. In some places, python fat is used in treating this unusual problem.

Dear doctor, kudos for your good works sir. Please what effect does the taking of expired sugar cubes have on one’s health? The one I refer to here expired in September 2019. 0808xxxxxxx

You have no reason to be scared. Sugar never spoils and even the granulated one that is advised to be discarded two years after opening can be used effectively for a long time beyond that date. Cube sugar is even useful longer than that. And so a packet of sugar may have a date when it says it is best to be consumed but usually will not have an expiry date.

Read Also: ‘Why human teeth bite should not be neglected’

Dear doctor, thank you for the great job you are doing? I just came into Abuja some days ago after spending my vacation in my hometown in the East, and I started feeling itching, unusual discharge, and burning sensation in my vagina. A relative, who is a doctor, prescribed some antibiotics for me and I felt some relief but after a few days the itching returned. I told the doctor and he said I should do HVS and Urine MCS. The Urine MCS shows it is Candida Albicans and Escherichia coli, that I am resistant to about six antibiotics including the one I used previously and that I am sensitive to Streptomycin and Septrin. The HVS shows growth of proteus spp and its sensitivity is multi-drug resistant. Kindly enlighten me on this discovery and the possible causes and prevention. The doctor told me I would take injections but he is not available. He asked me to go to the hospital.  Lastly, please enlighten me about egg banks; I watched a programme where they talked about keeping the female eggs in a bank so that when they have delayed marriage, the egg will sort their conception issues at that time. Is this done in Nigeria? 0903xxxxxxx  

You need to see a doctor to study the results you have as well as the antibiotics they were tested against. Sometimes, those so-called infections are in truth, contaminants within the specimens you have obtained hence the unrealistic nature of the spectrum of drugs you can use. Frequently, when such drug resistance is encountered in true clinical settings, the patients are very ill. That does not appear to be the case with you. I would, therefore, urge you to proceed with caution, get professional help with the choice of antibiotics to use, and ensure thereby, that the treatment that you eventually get is the best you can obtain anywhere.  As for egg banks, the fertility clinics available have them. With the right combination of circumstances, they can assist you in this regard but it is the sperm bank that is of relevance to your inquiry rather than an egg bank because it is the stored semen that will be used to fertilise your harvested egg to produce the offspring you desire so much.

Dear doctor, I often ejaculate within minutes of having unprotected sex but if I use a condom, I can go on for hours without any hope of ejaculating. Am I okay doctor? This explains the reason why I ignore the condom and at times, the thing even breaks. Doctor could you please recommend a better condom for me? Thanks sir. 0706xxxxxxx

Well, the problem you may have is that you feel very extreme sensitivity without a condom while using it not only diminishes the excitement experienced by your penis, but also helps you keep the organ erect because it may help you trap blood inside it.

On that score, I do not see anything wrong with you as a person.

All condoms are similar in action. If you fail to wear it properly, it would tear no matter who the manufacturer is. As for alternatives to known condom, the people who sell such products should be able to educate you about them, and tell you the merits and demerits of choosing one over the other.

Dear doctor, my friend says that whenever she removes her panties it will be covered within a few minutes by some small ants. Is this normal and what drugs can she use to deal with it? 0818xxxxxxx

The presence of ants in the pants indicates there is either an infection resulting in a vaginal discharge or the urine is sweet, perhaps due to diabetes. So what she needs to do is simple: see a doctor for the relevant tests to be conducted so that treatment can be administered.

Dear doctor, I urinate frequently so I went for fasting blood sugar. The result was 113 mg per cent but I learned it shouldn’t be more than 110 mg per cent. Does it mean I am diabetic? 0803xxxxxxx

That result does not mean that you are diabetic but it may be a warning that you are close to it. It could mean that your glucose tolerance is impaired or you are becoming resistant to insulin, the blood-borne substance that controls your blood sugar and produced in a gland called the pancreas. Usually, you will need to record a figure of more than 126mg per cent in fasting glucose to be worried about diabetes. You need, therefore, to have the test repeated while you avoid in the meantime a diet that is rich in carbohydrates and sugar. A repeat of the fasting blood sugar with 2 hours postprandial glucose measurement will help make a clear diagnosis.

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