Blisters After Cryotherapy for Corns: Healing or Infection?

Regarding corns, the development of blisters after cryotherapy?

Hello Doctor: I previously had a viral wart on the sole of my foot, which has been mostly resolved with cryotherapy.
However, during my follow-up visit, the clinic doctor informed me that I also had a corn, so they performed cryotherapy on that as well.
The initial treatments went smoothly, but two weeks ago, the therapist applied liquid nitrogen to my corn quite aggressively and for a longer duration than usual.
The next day, I developed a blister the size of a grape, which was so painful that I couldn't walk.
I returned to have the doctor drain it, which provided some relief.
The doctor prescribed gentian violet ointment for me to apply.
I'm not sure if it was due to water exposure while bathing or something else, but the blister still had a lot of serous fluid.
One day, I used a sterile cotton swab to express the fluid from the previously drained hole, and it subsided.
I continued applying the medication and minimized water exposure.
At night, I left it uncovered to allow for ventilation, and in the morning, I applied the medication and covered it with gauze.
After work, I would remove the gauze to let it air out.
However, it has been getting redder and more purplish each day.
Currently, the entire perimeter of the blister is red-purple, while the center is white.
I would like to know if this is part of the healing process or if it has become infected.

Miss Lin, 20~29 year old female. Ask Date: 2020/05/23

Dr. Wu Yuxin reply Dermatology

The risk of infection is low; however, if there is significant tissue exudate after cryotherapy that affects mobility, it is recommended to aspirate the fluid under sterile technique and apply compression.

Reply Date: 2020/05/23

More Info

After undergoing cryotherapy for a corn, it is not uncommon to experience blister formation, especially if the treatment was more aggressive than usual. In your case, it sounds like the application of liquid nitrogen was prolonged, leading to a significant blister that has caused pain and discomfort.
Blisters are a natural response of the skin to injury, including cryotherapy. They form as a protective mechanism, allowing the underlying skin to heal while providing a cushion against further irritation. However, the development of redness and purple discoloration around the blister, along with the presence of fluid, raises concerns about the possibility of infection.

In general, the healing process of a blister can vary. Initially, it may appear red and swollen, which is a normal inflammatory response. However, if the blister becomes increasingly painful, red, or shows signs of pus, it may indicate an infection. The white center of the blister could be a sign of healing, but if the surrounding area continues to worsen, it is essential to monitor for signs of infection.

Here are some key points to consider regarding your situation:
1. Infection Signs: Look for symptoms such as increased redness, warmth, swelling, or discharge that is yellow or green. If you notice any of these signs, it is crucial to seek medical attention promptly.

2. Fluid Accumulation: The presence of fluid in the blister is common, especially if it was recently punctured. However, if the fluid continues to accumulate despite treatment, it may warrant further evaluation.

3. Treatment: The use of topical medications like the one prescribed (likely an antibiotic ointment) is appropriate, but it is essential to keep the area clean and dry. Avoid excessive moisture, as this can promote bacterial growth.

4. Monitoring: Keep an eye on the blister and surrounding skin. If the redness and swelling do not improve or worsen over the next few days, it is advisable to return to your healthcare provider for a reassessment.

5. Pain Management: If the pain is significant, over-the-counter pain relievers may help alleviate discomfort. However, consult with your doctor before taking any new medications.

In summary, while some redness and swelling can be part of the healing process, the worsening condition you describe could indicate an infection. It is essential to maintain good hygiene, follow your doctor's instructions, and seek further medical advice if symptoms do not improve or worsen. Your healthcare provider may need to evaluate the area, possibly perform a culture to check for infection, and adjust your treatment plan accordingly.

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