Version July 2025
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What is bullous pemphigoid? —
This is a condition that causes blisters on the skin. Blisters are fluid-filled bumps on the skin.
Bullous pemphigoid is an autoimmune disease. This is when the body's infection-fighting system, called the "immune system," attacks healthy tissue instead of infections. Sometimes, bullous pemphigoid happens after people take certain medicines.
Bullous pemphigoid happens most often in adults age 60 and older.
What are the symptoms of bullous pemphigoid? —
Most commonly, bullous pemphigoid causes large blisters to form on the skin (picture 1). The blisters usually form on the trunk, arms, legs, armpits, or groin. But they can form anywhere on the body. The blisters can come and go. After a blister pops, there might be an open sore. These usually heal without a scar.
People with bullous pemphigoid also often have raised areas of skin. These might be red or skin colored. The raised areas can be under the blisters or in other places (picture 2). Some people have only the raised areas of skin and no blisters. Itching is common.
Some people with bullous pemphigoid also get sores in their mouth. These can hurt and can make it hard to eat.
Is there a test for bullous pemphigoid? —
Yes. To check whether your symptoms are caused by bullous pemphigoid, your doctor will do a test called a "skin biopsy." They will remove small samples of tissue from a blister or from the raised areas of skin. Then, another doctor will do tests on the samples and look at them under a microscope. Your doctor might also order special blood tests.
What can I do on my own to feel better? —
Do not pop the blisters unless your doctor tells you to. Also, follow your doctor's instructions about how to take care of your sores. That way, your skin is less likely to get infected.
How is bullous pemphigoid treated? —
Treatment usually includes 1 or more of the following:
●Steroid creams or ointments – These can reduce inflammation and itching and prevent new blisters from forming.
●Steroid pills – These can also reduce blisters, inflammation, and itching. Since the pills can cause side effects, it is important to take them exactly as instructed. You should also see your doctor for regular follow-ups.
●Other medicines that "calm down" the immune system
Treatment usually lasts 1 to 2 years or longer. Sometimes, symptoms return after treatment.
Patient education: Blisters (The Basics)
Patient education: How to use topical medicines (The Basics)
Patient education: Taking medicines when you're older (The Basics)
