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Bullous pemphigoid

Bullous pemphigoid is a rare skin condition that causes itching, redness and blisters. It may last a few years and sometimes causes serious problems, but treatment can help.

Check if you have bullous pemphigoid

Bullous pemphigoid mainly affects people over 60.

Large red, blotchy, dry rash with small scabs on the arm of a person with white skin
It usually starts as sore, itchy red patches
Lots of sore, red patches with small blisters spread on white skin spread across a woman's chest
It can affect large areas of the body or limbs
Large red, flaky, dry rash with scabs and a small orange blister on white skin
After a few weeks, small blisters may appear
A large orange blister and a smaller, dark blister on the wrist of a person with white skin
The blisters can grow quite big and may contain blood

Not everyone gets blisters. If you do, they may keep coming and going for months or years.

There are several other causes of blisters if you're not sure it's bullous pemphigoid.

Non-urgent advice: See a GP if:

  • you have an itchy red rash that doesn't go away in a few weeks
  • you have lots of blisters, or big, painful blisters
  • you have blisters that keep coming back
  • your skin is red, hot and swollen, or a blister is filled with green or yellow pus

A GP can check what the cause might be.

If they think it could be bullous pemphigoid, they may refer you to a specialist for tests and treatment.


Coronavirus (COVID-19) update: how to contact a GP

It's still important to get help from a GP if you need it. To contact your GP surgery:

  • visit their website
  • use the NHS App
  • call them

Find out about using the NHS during COVID-19

Treatment for bullous pemphigoid

Bullous pemphigoid eventually goes away on its own, but it can last a few years.

Treatment can help your skin heal, stop new patches or blisters appearing, and reduce the risk of your skin getting infected.

The main treatments are:

Your skin should eventually heal without scarring, but it might be a bit darker than it was before.


Do not burst your blisters – your skin might get infected.

If a blister is in an annoying place (like the bottom of your foot), your doctor can drain it with a needle.

Bullous pemphigoid can be serious

Even with treatment, bullous pemphigoid can sometimes cause serious problems.

The main risks are:

  • skin infections – these can be very serious if they get deeper into your body (sepsis)
  • side effects of steroid treatment – including high blood pressure, weakened bones and a higher risk of getting infections

Steroids will be used as little as possible, and at the lowest possible dose, to help avoid side effects.

Make sure you attend any check-ups your doctor recommends so problems can be spotted and treated early.

Causes of bullous pemphigoid

Bullous pemphigoid is caused by a problem with the immune system (the body's defence against infection). Instead of attacking germs, it attacks and damages the skin.

It's not known why this happens. Sometimes it's been linked to skin damage (such as sunburn) or taking certain medicines.

Bullous pemphigoid is not:

  • contagious – it can't be spread to other people
  • caused by an allergy
  • affected by diet or lifestyle

Page last reviewed: 16 April 2018
Next review due: 16 April 2021