What causes blisters, itching, ulceration, and oozing on the lower leg, and what should be done about it?
Dec 01, 2025
Source: Cainiu Health
Dr. Liu Wenmin
Introduction
In general, blisters on the lower leg accompanied by itching, ulceration, and oozing may be caused by friction irritation, insect bites, eczema, contact dermatitis, or varicose veins of the lower extremities with ulcers. Depending on the specific situation, patients may improve symptoms through conservative management, medication, surgical treatment, or other approaches. Skin problems on the lower leg can worsen due to scratching, so proper protection should be maintained in daily life to avoid friction and insect bites.
Generally, blisters on the lower leg accompanied by itching, ulceration, and oozing may be caused by friction irritation, insect bites, eczema, contact dermatitis, or varicose veins of the lower limbs with ulcers. Depending on the specific situation, patients can improve symptoms through general management, medication, or surgical treatment. A detailed analysis is as follows:
1. Friction Irritation
Tight pants or prolonged walking can cause repeated friction and damage to the skin of the lower leg, leading to fluid leakage and blister formation. Scratching may easily result in ulceration and oozing. Switch to loose, soft clothing, avoid rubbing the affected area, disinfect with iodophor, apply sterile ointment, and keep the wound dry.
2. Insect Bites
When insects bite, they inject saliva that triggers an allergic reaction, causing local blisters and itching. Scratching can break the skin and lead to secondary infection and ulceration. Wash the affected area with soapy water, avoid scratching, apply menthol ointment to relieve itching, and protect ulcerated areas with sterile gauze.
3. Eczema
Skin inflammation triggered by genetic or environmental factors leads to damaged stratum corneum, resulting in blisters and itching. Scratching can cause ulceration and oozing. Follow medical advice to apply calamine lotion or desonide cream externally and take loratadine tablets orally. Avoid contact with irritants such as soap.
4. Contact Dermatitis
Exposure to allergens such as metals or dyes causes inflammatory skin reactions, manifesting as blisters and itching, which may progress to ulceration after skin breakdown. Avoid contact with allergens, use normal saline wet compresses on the affected area, and follow medical instructions to apply hydrocortisone butyrate cream externally and take cetirizine hydrochloride tablets orally.
5. Varicose Veins of the Lower Limbs with Ulceration
Impaired venous return leads to blood stasis in the lower leg, causing poor skin nutrition and susceptibility to injury, resulting in ulcers, blisters, and oozing. Avoid prolonged standing, elevate the affected limb, and take medications such as micronized purified flavonoid extract (MPFF) tablets and calcium dobesilate capsules as prescribed. Severe cases may require surgical intervention such as high ligation of the great saphenous vein.
Skin conditions on the lower leg can worsen due to scratching. Daily protection should focus on avoiding friction and insect bites. If the ulcerated area expands, oozing persists, or fever develops, prompt medical attention is essential. Proper medical care is necessary to prevent the spread of infection and protect overall health.
