Do flea bites blister?

Summary

Flea bites can blister. However, this isn’t the common skin reaction. Typically flea bites develop as hard, itchy papules (welts).

Details

Insect Bites & Blisters

The bites of many blood-feeding arthropods can cause bullous (blister-like) reactions. Some of these parasites include fleas, bed bugs, ticks, mosquitoes, and kissing bugs. Of the possible culprits, fleas are most likely to cause a blistery bite, especially on legs.

Bullous eruptions sometimes seem to appear spontaneously, leaving the sufferer unaware of the cause. Insect bites are frequently the reason for the reaction. However, those afflicted may not realize they’ve been bitten, and this makes diagnosis difficult.

Reactions to Flea Bites

Flea bites can vary in intensity, depending upon a person’s individual response and level of sensitization. The bite reaction may manifest as whealing (raised skin), itchy papules (hard bumps), vesicles (numerous small blisters), or bullae (large blisters).

Common Reaction: Papules

The most common lesion associated with flea bites is a papule (hard bump). They typically appear in groups and are extremely itchy. Papules are a delayed reaction to the bite, occurring 12-24 hours after a flea has fed. Papules may develop a small central vesicle within 1-3 days.

Severe Reactions: Blisters & Vesicles

Bullous Eruptions

Occasionally, in extreme cases, flea bites take the form of large, red, irregular-shaped blisters. Bullous eruptions are delayed reactions which occur 48-72 hours after the bite. The reaction peaks at 72 hours.

An allergic response causes fluid to accumulate beneath skin in numerous, small, fluid-filled sacs called vesicles. With time, these vesicles merge together to form larger blisters (bullae). The tense blisters appear translucent or red, and there may be accompanying redness at their base. The blisters measure 3-6 mm in diameter. The reactions look similar to those seen with bullous pemphigoid, bullous impetigo, and linear IgA disease. It’s not uncommon for the blistered skin to die (epidermal necrosis).

Individuals at Greater Risk

Extreme reactions to insect bites are more common for children than adults. People with HIV, hematopoietic malignancy, or chronic lymphocytic leukemia are also more likely to experience a severe bite response.

Treating Blisters from Insect Bites

To treat bullous insect bites, the recommended course of action is to: 1) Drain the blister. 2) Relieve the itching by applying a hydrocortisone cream and taking an antihistamine. 3) In severe cases, systemic corticosteroids may be required.

References