A blister is a small pocket of fluid that has formed within the upper layers of the skin, typically caused by forceful rubbing (friction), burning, freezing, chemical exposure, or infection. Most blisters are filled with a clear fluid called serum or plasma. However, blisters can be filled with blood (if tissue damage is more severe) or with pus if infected.
The most helpful advice with regard to friction induced blisters on the foot is PREVENTION, PREVENTION, PREVENTION! A forming blister will draw your attention the area thus providing a window of opportunity with which to act. At this stage the skin will have developed a ‘hot spot’ which, if protected from further friction, will not develop into a fluid filled blister. If it is not possible to rest and/or protect the hot spot then a blister will form.
If a blister has formed it is best not to drain it unless it is particularly large or painful, however if it is drained an effort should be made to preserve the Epidermis (outer layer of skin). For a few hours after a blister has been drained the area will often feel more uncomfortable, so draining of blisters would only be advised if the foot can be rested afterwards. If a blister has been drained an effort should be made to press the loose epidermal roof down onto the base of the blister, thus providing at least some protection from infection and friction. Blisters will heel quicker when drained
A drained blister should always be covered with a sterile dressing. For ‘hot spots’ that have yet to develop into a blister then the area should be rested, or if that is not possible, then covered with moleskin or a similar material. ‘COMPEED’ blister prevention adhesive plasters are very good in reducing friction over ‘hot spots’ as they have a thin lining of hydro-gel that dissipates friction affectively.
If ladies ‘squeeze’ their feet into evening wear dress shoes where the toes are likely to be rubbed then the ‘DIGI-TUBES’ are excellent. These products simply slip over the toe, are discreet, and are available at our surgery.
Where there has been a history of repeated blister formation in the same area of the foot, and especially when associated with a particular activity eg football, squash, jogging etc, then the advice of a Podiatrist would be indicated in order to provide a blister prevention strategy. This would involve an analysis of the activity and footwear worn, with a practical demonstration of what to apply, and how to apply the recommended materials to the foot.
Additionally this may involve a modification to the inlay of a shoe or football boot. For example blisters under the large knuckle in footballers (particularly towards the end or beginning of a season when pitches are often dry and hard) are very common but can be prevented (or at least reduced in severity) by removing the stud that sits over the area and replacing it with a shorter stud. Alternatively if moulded studs are worn then the prominent stud(s) could be reduced in length.