Nobody likes a blister. But what exactly is a blister and how can we prevent them?

What is a blister?

• A blister is a pocket of fluid in the epidermis, the top layer of the skin. The fluid inside the blister is typically a clear fluid called serum. They can also contain blood, or may contain pus if the blister has become infected.

How does a blister form?

• The main cause of blisters are friction (rubbing). You can also get blisters for various reasons such as burns, freezing, infection, or allergic reactions.
• Friction blisters are the most common type that we see. They are considered one of the most common sporting injuries in the world but are often accepted as part of normal life. They form as an acute response to high levels of friction, pressure, shearing, or abrasion. This can be from ill fitting footwear, incorrect socks, high levels of activity, heat, or moisture. Typically it is a combination of factors.

How to treat a blister

• It is important to keep the blister intact and not ‘deroof’ it. By keeping the fluid in the blister it prevents further injury to the skin and protects the deeper layers. It also prevents infection.
• Apply an island dressing, making sure the adhesive aspect of the dressing isn’t touching the blister. If the adhesive aspect of the dressing touches the blister, when removed it can deroof the blister and open it up to potential infections.
• If the roof of the blister has come off completely then you need to dress it with an island dressing or you can use a hydrocolloid dressing. It is important that you monitor for signs of infection and keep it covered.
• See a podiatrist! If the blister is giving you any issues it’s always a good idea to see a podiatrist and make sure nothing sinister is happening. We are able to assess the site, ensure there isn’t any infection present, and offload the blister if needed.

How to prevent a blister

• In order to prevent a blister you need to address the cause, if it’s not addressed you will keep getting blisters. Like most injuries or issues, prevention is a much stronger treatment method than if you wait until a problem occurs.
• Have the correct size footwear. You need to make sure that your shoes are long enough to prevent your toes hitting the end, but not so big that your heel slips in and out. You also need to make sure the shoe is wide enough to prevent your toes rubbing together or being squished against the edge of the shoe.
• Avoid shoes with prominent seams. These can cause areas that are more likely to rub and create blisters.
• Make sure your shoes are breathable! Your feet can get hot and sweaty in non-breathable shoes and cause the skin to become irritated and more likely to blister.
• Make sure you break your shoes in slowly, don’t try to run a marathon or do lots of holiday walking in a brand new pair of shoes. Start wearing them around the house for short periods to help soften them, and then a few short walks before you head off on your long journey.
• Make sure you have the right socks! You want a sock that has moisture wicking abilities such as a bamboo sock or Merino wool. There are a great range of technical socks out there as well specially designed to wick moisture and/or prevent blisters.
• Make sure your socks are the right fit. Socks that are too small can become too thin and not protect your feet properly, or pull down off your heel and leave it unprotected. Socks that are too big can bunch up and create lumps and bumps that will cause blisters.
• Don’t wear wet shoes or socks. This increases the moisture present and makes the skin more susceptible to blisters.
• If you’re going on a longer walk, run, or hike, tape can help prevent blisters. You can apply tape to your skin in areas that rub to provide protection.
• Gel toe protectors or gel cushions from your local podiatrist can save your feet! Gel products help to cushion and protect blister prone areas and stop the rubbing they experience.
• Custom made devices from your podiatrist can help the severity of conditions such as claw toes or bunions can help reduce how much they rub on your footwear.
• Lubricants or powders designed to stop blister causing friction are a great short term option to save your skin.
• A fantastic long term solution is Engo patches. They are blue stickers that you place on your shoe, innersole, or orthotic in high friction areas to stop blisters. They are a great option for blister prevention if you want a long term option that you can use again and again.

We hope this information helps to keep you blister free and on your feet!

Kesia Byrnes

Podiatrist

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