How to understand and treat Epidermolysis Bullosa (EB) and make dressing less distressing for patients
EB is a rare, inherited group of skin disorders characterised by extreme skin fragility. It is estimated to affect around 500,000 patients worldwide¹.
The merest touch – a bump or even a hug – can cause painful wounds and severe blistering. For some patients, this can mean a life overshadowed by pain, distress, endless dressing changes and treatments.
With understanding and the right care, things can be improved for these patients.
How does EB affect patients and their families/carers?
EB can vary in severity in symptoms, ranging from mild to severe. However, all patients with EB experience pain and discomfort. The suffering isn’t just limited to the skin but extends to the psychological: the dread of a dressing change, a life dictated by routine and regime. The impact on patients, families, caregivers and healthcare professionals can be devastating.
Download our EB patient brochure (aimed at parents, carers and family members of children with EB)
The challenges of EB care
With wounds at many different stages of healing, the management of EB is complex.2
It is vital to select a dressing regimen that does not further damage the patient’s fragile skin.2 This can be particularly challenging.
Factors to consider in developing a care plan for EB include:
- protecting the periwound skin
- avoiding skin stripping
- addressing the bio-burden
- managing exudate
How do you select the best wound dressing for EB?
The combination of fragile skin and frequent dressing changes means that atraumatic dressings are recommended to prevent further pain, damage or bleeding.2 Silicone-based dressings are easier to apply and remove than traditional dressings.3 They also help protect the wound and periwound skin, creating a favourable environment for wound healing.
Safetac® is Mölnlycke’s game-changing silicone contact layer. Its innovative design allows the dressing to mould softly to the skin and yet not stick to the moist wound,3 making it easy to remove without damaging the skin.4, 5 It all adds up to a less painful experience for patients at dressing change.6
Download our EB cutting guide brochure.
How do you keep dressings for EB in place?
If dressings slip, they can tear fragile skin and cause wounds to stick to clothes or bedding². To increase dressing retention for EB, the dressing should be held in place with a retention bandage. The bandage should put no additional pressure on the wound and should allow freedom of movement to prevent shearing from causing additional blistering.2 Tubular bandages can be used.2
How do you manage infections in EB care?
Due to the large areas of open wounds that EB may cause, patients have a high risk of infection. Antimicrobial cleansers, moisturisers and topical treatments are necessary to manage the bio-burden.2
How do you manage blisters in EB care?
Left unchecked, EB blisters can spread rapidly and so need careful management.2 Intact blisters should be lanced with a sterile needle at their lowest point to limit tissue damage.2 Sterile swabs or sponges can be used to gently compress and encourage complete emptying of the blisters.
Make dressing less distressing for patients with EB
By educating yourself and other members of your team, you can play a key role in helping to reduce the unnecessary pain and suffering caused by EB. The Clinical Learning Hub provides flexible and on-demand training and education, including information on managing EB.
Visit the Clinical Learning Hub
Knowing which products are suitable for patients with EB is vital. The recommended solutions for managing EB, as set out in the international consensus best practice for skin and wound care in EB2 include several Mölnlycke products and solutions:
- Mepilex®7, 8
- Mepilex® Lite7
- Mepilex® Transfer7, 9
- Mepitel®7, 10
- Mepitac®7, 9
- Tubifast® Garments7
- Tubifast® TwoWay Stretch7
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References
- DEBRA (www.debra.org.uk/what-is-eb/) (accessed 23/10/2025)
- Denyer J, Pillay E, Clapham J, Best practice guidelines for skin and wound care in epidermolysis bullosa. Internation consensus. Wounds International, 2017.
- White R et al. Evidence for atraumatic soft silicone wound dressing use. Wounds UK 2005 1(3):104–109.
- Zillmer R, et al. Biophysical effects of repetitive removal of adhesive dressings on peri-ulcer skin. J Wound Care 2006;15(5):187–191.
- Waring M, et al. An evaluation of the skin stripping of wound dressing adhesives. J Wound Care 2011; 20(9):412–422.
- White R. A multinational survey of the assessment of pain when removing dressings. Wounds UK 2008; 4 (1).
- Mölnlycke. Data on file. 2019.
- Schumann H et al.Atraumatic dressings in fragile skin conditions: the use of soft silicone dressing (Mepilex) in hereditary and acquired bullous skin disease. Poster presentation. European Wound Management Association. 2005.
- Yuen WY, Hiuzinga J, Jonkman MF. Punch grafting of chronic ulcers in patients withlaminin-322-deficient, non-Herlitz junctional epidermolysis bullosa. Journal of American Academy of Dermatology. 2013;68(1):93–97.
- Gorell ES, Leung TH, Khuu P, Lane AT. Purified type I collagen wound matrix improves chronic wound healing in patients with recessive dystrophic epidermolysis bullosa. Paediatric Dermatology 2015; 32(2):220–225.
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