Blisters can make even the simplest of tasks a pain — literally. A poorly fitting shoe or repetitive activity that causes friction against a focused area of skin can break the bonds between skin cell layers, leading to the formation of a fluid-filled pocket. Dealing with a blister typically involves measures to reduce pain, prevent infection and protect the wound as it heals.
Let It Be
Although it is tempting to drain a blister, the best course of action is usually to let it be. There are several advantages to leaving a blister intact. The fluid inside a blister and the overlying skin protect the fragile, irritated skin at the base of the wound. The unbroken skin that forms the roof of a blister also provides a defensive barrier against infection. Finally, the sterile fluid inside a blister contains proteins and other substances that promote wound healing. As a rule of thumb, therefore, trust the natural wisdom of your body and resist the urge to drain a blister.
If a blister opens — spontaneously or otherwise — do not remove the outer layer of skin. The skin at the base of a new blister is exquisitely sensitive and prone to infection. Leaving the roof of a blister in place helps prevent pain and provides some protection against infection.
Ice
Ice can help relieve the pain and swelling of a new blister, especially during the first few hours after it forms. Place a few ice cubes and a small amount of water in a plastic bag, wrap the bag in a towel and apply it to the blister. A cold pack is another convenient option for local pain relief.
Covering
If you have an open blister, covering it helps prevent infection. Apply a loose bandage after cleaning the area with soap and water. Use an adhesive bandage for small blisters or a gauze pad and tape for large blisters. If the bandage gets wet, change it. Avoid watertight and waterproof bandages, which trap moisture.
You can leave an intact blister uncovered, unless it is located in an area that is likely to get rubbed or bumped frequently. The overlying skin provides adequate protection against infection.
Antibacterial Cream
Bacteria can easily infect an open blister. To reduce the chance of infection, keep the area clean and apply an over-the-counter antibacterial cream. Reapply the cream each time you wash the area and change the bandage. You can stop using the antibacterial cream once new skin forms at the base of the blister. Do not use a topical antibiotic if you are allergic to these products. Antibacterial cream is not needed for an intact blister.
Cushions
Cushioning a blister helps prevent pain during use of the affected area. Several manufacturers offer various blister pads and cushions. Alternatively, cut a piece of moleskin or molefoam into a ring shape and apply it around the blister. If you are planning an extended hike, take some moleskin in case you develop a foot blister. Having some on hand may spell the difference between an enjoyable expedition and an agonizing walk.
Take a Break
Taking a break for a few days from the activity that led to the development of a blister will help you avoid further injury and speed the healing process. If you are training and find the notion of a break unfathomable, cushion the area and keep it as dry as possible. Dr. Stephen Pribut, clinical assistant professor of surgery at George Washington University Medical Center and a member of the advisory board of "Runner's World," states, "If you have normal sensation in your feet and the blister is not affecting your gait or stride, you can continue to run. But pain is a warning sign. Stop if you are in pain."
When to Seek Medical Help
Infection is the most serious health risk associated with a blister. Warning signs of infection include white or yellow opaque blister fluid; redness and swelling extending from the wound; abnormal warmth of the affected skin; fever; increasing pain; and failure to heal. Seek urgent medical help if you develop one or more of these signs and symptoms, especially if you have poor circulation, diabetes or reduced sensation in your feet and hands.
References
- Aetna InteliHealth; Blister (Overview); May 2010
- Johns Hopkins Medicine: Blisters
- Dr. Pribut's Running Injuries; Friction Blisters: Prevention, Treatment, Cause; Stephen M. Pribut, D.P.M.; June 2011
- "The Journal of Family Practice"; Do Topical Antibiotics Improve Wound Healing?; Sabina Diehr, M.D. et al; February 2007
- MedlinePlus; Cellulitis; Linda J. Vorvick, M.D.; May 2011
