Butterfly skin, when the skin is extremely fragile

Butterfly skin is a popular term that actually refers to the clinical manifestation of a group of diseases that fall under the heading of epidermolysis bullosa. Of these there are some forms that are more severe or more serious that give extreme fragility of the skin and hence the name butterfly skin, referring to the texture of the butterfly tissue, which is very fragile and breaks easily.

We should speak more of “butterfly skins” than just “butterfly skin” because the latter term in the singular is used to refer to this group or the whole group of diseases. There are three types of epidermolysis bullosa which, in turn, are divided into further subtypes. This is why, for the general public, the term “butterfly skin” is preferred to emphasize the extreme fragility of the skin.

What are the causes of butterfly skin?

In epidermolysis bullosa or butterfly skin, most of them, if not all, are caused by genetics. They are genetic diseases in which there is an alteration of constituent proteins of the skin that predispose the skin to the fact that, with the slightest friction, it can become unhooked or detached and give rise to blisters. These blisters then, when healing, sometimes give rise to scars and retractions.

Can the appearance of butterfly skin be prevented?

Not at the present time. Prevention, if it can be done at all, would be through genetic studies.

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It would be more correct to speak of butterfly skin than butterfly skin because there are many different types. The most important is a form called recessive dystrophic epidermolysis bullosa recessiva or Hallopeau-Siemens form, which is a very complex form. This one really does leave a lot of scarring and is very problematic. In this type of butterfly skin, many studies are being done to diagnose it prenatally. That is to say, butterfly skin is a manifestation of a genetic disease that, in principle, is very difficult to find out before birth and that, in the future, it is hoped that, with the studies that are currently being carried out, we can reach a situation in which we will be able to prevent it, in the sense of being able to know which children will manifest this.

How is butterfly skin treated?

As a treatment, above all, specialists in pediatric dermatology recommend that patients should wear appropriate footwear and clothing to avoid rubbing. For example, there is a form of epidermolysis bullosa called epidermolysis bullosa simplex that, usually, people who suffer from it begin to notice symptoms when they wear new shoes or very tight shoes, in the sense that they manifest blisters when rubbing in a much more important way than we could manifest the rest of people. It is normal that, when you buy a new shoe, if it is not well adjusted, it can blister, but these people suffer a lot.

For example, years ago when men went to the military service, they were people who could not wear boots because they would get blisters at the slightest friction.

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We can detect that a person suffers from epidermolysis bullosa or butterfly skin because of this, because they have blisters with very subtle rubbing in unusual situations.

Unfortunately, today there are no specific treatments for almost any variety. These treatments are aimed at preventing the appearance of blisters and erosions. Some measures are the use of comfortable or even orthopedic shoes, adapted shoes, cotton clothing… Above all, parents should be instructed that it is a very difficult entity to manage, and that they should try to make children cope with it as well as possible, avoiding that they touch their skin too much, causing wounds, rubbing and erosion.

Fortunately it is a very rare disease and the severe varieties of epidermolysis bullosa have a very low incidence, while mild epidermolysis bullosa (epidermolysis bullosa simplex, for example) are slightly more frequent. Still, fortunately, children with butterfly skin are few and it is considered a minority disease.

Are there any home remedies to treat butterfly skin?

Not a home remedy, but they are children who benefit from good skin hydration, good hygiene and the use of photoprotectors because they are children who, having delicate skin, almost anything can cause wounds, erosions and small ulcers. The concept of butterfly skin comes from this extreme fragility of the skin which, as mentioned above, is produced by these genetic errors in the structure of the skin itself.