by Dan Williams

Created on: September 13, 2009

Treating blisters is controversial with the general public, but also in the medical community as well. Physicians as well as podiatrists have mixed feelings on the proper way to treat the common blister. The majority of blisters occur on the feet and hands. Any area of skin that is recurrently rubbed can create a blister. A fluid filled raised area, involving the most superficial area of the skin, which is due to repetitious movement against an object.

They are painful and cannot be prevented all of the time. The controversy arises when one decides should the top layer be removed or not. Blisters that are removed, and treated with proper care heal twice as fast as blisters that are allowed to heal on their own. After many consultations with health care providers, a general consensus is as follows:

1. Update your tetanus status. A blister can be an open wound.

2. Blisters should not be popped, if one is a day or two from medical treatment. The blister acts as a shield protecting the exposed skin, which is raw and painful. This also helps prevent infection; however, this is also a bit exaggerated as the dermis also protects the skin from infection. When one has a laceration, with active bleeding many heal just fine. The infection myth on blisters is exaggerated with little evidence for support.

3. Blisters should be popped when presenting to a health care provider, as well as the skin removed. They heal much faster when open to air. A blister is similar to a burn. All burn units in the emergency department remove the skin; the area of a blister when the top layer is removed is now an open wound. Wound instructions are as follows:

a. Wash wound with soap and water.

b. Cover during the day may apply Silvadene or topical ointment.

c. Leave open to air at night.(all wounds need air to heal)

d. Observe for worsening of the condition, increase redness, a red line moving up from the blister, or drainage.

Blisters can be a nuisance, it is advisable to wear gloves, proper fitting shoes, and at least two pair of socks when increasing activity such as hiking, running or jogging. Nylon and rayon socks are ill-advised as they will cause more friction, cotton or wool is better in the long run. Remember, when you are not conditioned for physical activity, blisters will occur at a higher rate. Proper prevention will still not reduce all of your chances in obtaining a blister; however you can minimize the severity.

Individuals with diabetes, skin conditions, as well as the elderly with their thin skin, are at higher risk for blisters. More caution and care should be implemented with these individuals. Taking breaks with repetitious tasks such as raking leaves, shoveling and using hand tools, help in reducing blisters. When redness or irritation begins, please try and stop the task at hand. Lotion may help in softening the area. Approach the task another day.

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