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Blood Blisters on Breast

by Dr. Joe Morales

Blood blisters on breast can make wearing bras uncomfortable. A blood blister is a type of blister that forms when sub-dermal tissues and blood vessels are damaged without piercing the skin. It consists of a pool of lymph, blood and other body fluids trapped beneath the skin. If punctured, it suppurates a dark fluid.

Sometimes the fluids are cut off from the rest of the body and dry up, leaving behind dead cell material inside the blister with a texture like putty. Some blood blisters can be extremely painful due to bruising where the blister occurred.blood blister on breast

If the lump on the breast resembles a fluid-filled bubble on the skin, it may be a blood blister. This occurs when blood vessels just below the skin are damaged, causing blood to flow in between two layers of skin, forming a blister.

  • If the lump is a blister, do not attempt to burst it, because it should drain and heal on its own.
  • As a blood blister on the breast will most likely have been caused by wearing a bra, try not to wear a bra until it heals.
  • If this is not possible, avoid the bra that caused the blister until it heals.

Blood blisters on the breasts as well are termed as such because they are formed when the blood vessels underneath the skin of the breasts are damaged. These blisters appear on the skin on the breast and will be filled with fluid. The damaged blood vessel causes the blood to get trapped between the two layers forming the skin.

If such a blister appears on the breast, it is important not to attempt to break it. It will burst on its own and drain the fluid. Most of the time blood blisters are a result of wearing bras that are tight. Until the blister bursts and heals, it is advisable not to wear bras.

Blood blisters on breast pictures

What do blood blisters look like?blood blisters on breasts 2

Causes of small red blood blisters on breast

The blood blisters on your breast can be brought about by quite a number of condition which include cancer and cysts. Activities that involve the breast like breastfeeding and anything that could lead t friction on the breast precipitates blister formation.

A blood blister is characterized by pain and a brown or red color appearance. However, it needs the help of a qualified health care provider to point out the condition and ascertain the likely cause.

Any woman can experience sore blisters on her nipples from breast-feeding — no matter how many children she has given birth to or how much experience she has breast-feeding. Irritated nipples can be painful and make feeding time difficult. Fortunately, there are a variety of ways to manage many of the conditions that trigger it.

Blisters on or around your nipples as the result of breast-feeding vary from mild to extreme. Additional symptoms include itching, a burning sensation, and small cracks in the nipples, shininess, redness and tenderness. Pain can shoot deep into the breast while you are feeding your baby or after the feeding is complete. In some cases, your baby will exhibit symptoms as well, such as cottage-cheese like patches on the inside of the lips, crying during feedings or a rash.

Improper feeding techniques will trigger blisters on or around the nipples. For example, the position that you feed your baby in may trigger soreness and blisters. The condition also may develop if your baby does not latch on properly while feeding, bites or chews on your nipple or continues sucking as you remove him from your breast. Some conditions, such as thrush, will also trigger blisters on or around your nipple.

It is good practice that once you notice any unusual pimple or experience any pain on your breast, report as soon as possible for appropriate action.

1. Blood blister on breast from breastfeeding

A blister formed as a result of breastfeeding is called a milk blister, or blocked nipple pore, similarly, it is also called a bleb or nipple blister, or simply “milk under the skin.” It occurs when a tiny bit of skin overgrows a milk duct opening and milk backs up behind it.

A milk blister usually shows up as a painful white, clear or yellow dot on the nipple or areola, and the pain tends to be focused at that spot and just behind it. If you compress the breast so that milk is forced down the ducts, the blister will typically bulge outward. Milk blisters can be persistent and very painful during feeding, and may remain for several days or weeks and then spontaneously heal when the skin peels away from the affected area.

This is not the same as a blister on the nipple caused by friction. This type of blister, which may sometimes be a red or brown “blood blister,” can be caused by friction from baby’s improper latch or sucking or from the use of a badly fitting nipple shield or pump.

In this type of blister, the problem is nipple damage due to friction, rather than a milk duct opening being blocked. Another potential cause of blister-like sores on the nipple or breast is herpes.

A white spot on the nipple may also be caused by an obstruction within the milk duct (as opposed to skin covering the milk duct). The obstruction might be a tiny, dry clump of hardened milk or a “string” of fattier, semi-solidified milk.

The first type of milk duct obstruction will often pop out from the pressure of nursing or manual expression, or can be gently scraped from the surface of the milk duct with a fingernail. The second type can often be manually expressed from the milk duct; reducing saturated fats can help to prevent recurrence of this type of obstruction. Both of these types of milk duct obstruction are associated with recurrent episodes of mastitis.

There are various causes of milk blisters on breasts as below:

  • Milk blisters are thought to be caused by milk within a milk duct that has been sealed over by the epidermis and has triggered an inflammatory response. The underlying cause of a milk blister may be oversupply, pressure on that area of the breast, or the other usual causes of plugged ducts. Latch, suck, and or tongue problems may contribute to blisters because of friction on the tip of the nipple.
  • Thrush (yeast), can also cause milk blisters. Thrush occasionally appears as tiny white spots on the nipple, but can also appear as larger white spots that block one or more milk ducts. If you have more than one blister at the same time, suspect thrush as the cause. In most cases, yeast is often accompanied by a “burning” pain, and the pain tends to be worse after nursing or pumping (whereas a plugged duct generally feels better after the breast has been emptied).

2. Cancer

Cancer of the breasts manifests as lumps that are at times painless. Lumps on the surface of the breast are relatively common. Luckily, the National Health Service (NHS) in England identifies that up to 85 percent of lumps on the breast are benign. A lump filled with blood may seem to be a cause for concern, but in most cases the reason for this is not serious.

Formation of breast lumps is a relatively common occurrence among women who are in their reproductive age. Breast lumps are sometimes accompanied by discharge from the nipples. The discharge can be whitish, colored or even blood stained.

While most women are bound to get scared with such occurrences, the truth is that about in eighty percent of the cases, the reason could be a harmless breast cyst or lump or an infection which can be taken care of using medications.

There are many factors that can cause breast lumps and the causes can be harmless or life threatening depending on the diagnosis. However, most breast lumps are not a matter of great concern and can be dismissed after a simple physical examination. The causes range from hormonal imbalances, clogged ducts, abscesses and in some cases, cancer as well.

Tumors can be cancerous and non-cancerous. If you have lumps that cause pain and swelling along with breast tenderness and pain and bloody discharge from the nipples, it can either be a cyst in the breast or an infected breast due to abscesses and mastitis during lactation. There are also chances of it being a cancerous tumor. Lumps caused due to infections can be rectified through antibiotics and sometimes through draining.

When the lump in the breast and the bloody discharge is due to cancer, you might have to go through a lumpectomy or mastectomy based on the size of the tumor and how far it has spread. Radiation therapy and chemotherapy follows.

Breast lumps with bloody discharge can also be due to cancer. This is why it is recommended to check the lump and ensure that it is indeed a harmless one. Lumps due to breast cancer can easily be treated when they are discovered early enough.

3. Friction

A friction blister is a soft pocket of raised skin filled with clear fluid caused by irritation from continuous rubbing or pressure. Friction blisters usually occur on the feet, where tight or poor-fitting shoes can rub and irritate delicate toes and heels for long periods of time.

This type of irritation causes minor damage to the skin and the tissue just beneath the skin, then fluid accumulates just beneath the outermost layer of skin. If the irritation is enough to damage small blood vessels, the blister also may contain blood, and is then called a blood blister.

The blister manifests with the following symptoms:

  • It is a small pocket of puffy, raised skin containing clear fluid.
  • It is usually painful when touched. A blister can appear anywhere.

A clear blister or red/brown blood blister on the nipple is usually caused by friction or high vacuum just like a blister anywhere else on the body. A blister may form if your baby is in a shallow latch so pay careful attention to positioning.

Blisters on nipples may also form from a badly fitted nipple shield or pump. Once the source of the friction has been found the blister should quickly heal on its own. If the blister bursts before it has healed beneath and you have sore broken skin on your nipple check out treatments.

This kind of blister can be known by looking at it. That is to say that if it looks like a blister and feels like a blister, and if it’s in a place that could have been irritated by pressure or rubbing, it likely is a blister. Friction blisters typically drain on their own within days. A new layer of skin forms beneath the blister, and eventually the blistered skin peels away.

Just in case the pressure or friction continues in the same area, the blister may last two weeks or longer. Continued friction may rub away the delicate top skin layer, and the blister may break open, ooze fluid and run the risk of becoming infected or developing into a deeper wound. If the irritation is mild, the blister may heal despite continued irritation, and eventually a callus will form.

4. Cysts

Cysts are lump formations on the breast that are filled with fluid or blood. They are mostly benign in nature and hence not very dangerous. However, they may cause pain and swelling in the breast and sometimes discharge from the nipples. This is especially worse during menstruation as lumps are basically formed when there is hormone fluctuation in the body.

In addition, cysts can be formed inside the breasts or on the surface of the skin. They are very common among women who are in the age group of 20-50 years. Women who undergo hormone replacement therapy after menopause too can get cysts.

5. Boils

Boils are brought about by a bacterial infection on a particular part of the body, the breast for this case. They are painful and itchy, after which they form red blisters in the early stages. They swell/ inflame then form pus in the course of time. They brought about by a strain of bacteria that is called staphylococcus aureus.

Treatment for blood blisters on breast

Because blisters typically get better on their own in just a few days, generally no special treatment is required other than to keep the blisters clean and dry. Because the skin provides a natural protection against infection, a blister should be left intact if possible.

Similarly, do not try to drain the blister or pierce or cut away the overlying skin. Try to avoid further irritation, or protect the blister with a sterile bandage if continued irritation is unavoidable. If the blister breaks on its own, wash the area with soap and water, gently pat dry, use an antibacterial ointment and cover it with a bandage.

People with diabetes and people who cannot reach blisters easily (because of a physical disability or other ailment) may need to have their blisters evaluated by a breast specialist or other health care professional.

People with diabetes often have nerve or circulation problems that make it more difficult to recognize wounds, and that cause wounds to heal more slowly. In these people, a simple breast blister might go unrecognized and could become infected.

You could seek the intervention of a doctor when you get widespread blistering, itchy blisters or blistering in a place that has not been exposed to rubbing or pressure should be evaluated by a physician. These are signs of an illness, not friction blisters on your breast.

Concerning blisters brought about by breastfeeding, the following treatments and management techniques will really be of great use:

Apply moist heat prior to nursing, clear the skin from the milk duct, nurse or pump with a hospital-grade pump, than follow up with medication to aid healing. You are supposed to repeat this for several days (or longer) until the plugged duct opening stays clear. The steps below give a deeper insight on how to undergo the procedure:

An Epsom-salt soak before breastfeeding

  1. Apply moist heat to soften the blister prior to nursing. Several times per day, add a saline soak prior to applying the moist heat. An epsom-salt soak before breastfeeding helps to open the milk duct opening and also aids in healing.
  2. Use a solution of epsom salt around 2 teaspoons to 1 cup water.
  3. To achieve better results, soak the epsom salt in a small amount of very hot water, then further water is added to cool it down enough to soak in.
  4. Try to add this epsom-salt soak to your routine at least 4 times per day.
  5. Prior to nursing (and directly after the epsom-salt soak) place an extremely hot wet compress on the milk blister immediately before nursing or pumping.
  6. Be careful not to burn yourself.
  7. A cotton ball soaked with olive oil can be used to soften the skin instead of the wet compress.

Clear the skin from the milk duct.

This may not be necessary, as the combination of the heat and nursing/pumping should cause the skin to expand and the blister to open. However, it can be helpful to do one of the following at least once per day until skin no longer grows over the duct.

  1. Rub the blister area with a moist washcloth.
  2. If a plug is protruding from the nipple, you can gently pull on it with clean fingers.
  3. Loosen an edge of the blister by gently scraping with your fingernail.
  4. If you try the above methods and they do not work, a sterile needle may also be used to open the blister. In order to minimize the risk for infection, ask your health care provider to do this on your behalf (do not do this on your own). There is a much greater risk of infection if you do it yourself.
  5. First, wash the area well with soap and water; pat dry. Use a sterile needle to lift the skin at the edge of the blister. If a sterile needle is not available, sterilize needle with an autoclave or commercial sterilizing solution, by holding in a match flame until red hot (cool before using), or by soaking 10-15 minutes in rubbing alcohol.
  6. Use a lifting action, at the edge of the bleb, rather than a piercing action. Don’t push into the blister as it can push bacteria deeper into the nipple.
  7. If there is any loose blister-like skin, your health care provider may need to remove that also, using sterile tweezers and small sharp scissors to entirely remove the excess skin. F
  8. Follow up with a soap and water wash (Make sure you use an antibiotic ointment after nursing).

Nurse or pump with a hospital-grade pump.

Nurse first on the breast with the milk blister, directly after applying heat.

Before you nurse, it can be helpful to use breast compression and attempt to hand express back behind and down toward the nipple to release any thickened milk that has backed up in the duct. Sometimes clumps or strings of hardened milk (often of a toothpaste consistency) can be expressed from this duct.

Treat the milk blister after nursing to aid healing.

Lecithin supplements can help to heal and prevent recurrent plugged ducts

Massaging the breast, areola and nipple with a massage oil

Massaging the breast, areola and nipple with a massage oil containing grapefruit seed extract (GSE) can help to heal recurrent milk blisters. To make the massage oil:

  1. Mix a few drops of grapefruit seed extract or citrus seed extract into olive oil.
  2. Once per day, spray breast and nipple area with a solution consisting of 5 drops of grapefruit seed extract, 1/4 cup vinegar, and 2 cups water.

Apart from that, vitamin E ointment – applied very sparingly and wiped off before feedings (too much vitamin E can be toxic to baby) can also be of great help.

On the other hand, blisters brought about by bacterial infections as in those seen with boils can easily be manage using proper hygiene and antibiotics.

References and Sources

  1. http://www.healthcentral.com/breast-cancer/c/78/149467/breast-boils/
  2. http://www.ladycarehealth.com/information-on-lumps-on-the-breast-with-blood-in-them/
  3. http://www.patienteducationcenter.org/articles/friction-blisters/

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