Blisters: How to Prevent and Treat Them

Skin blisters can be quite painful. Even though they can occur anywhere skin is present, they most often occur on the hands and feet. Fortunately, there are ways to treat blisters when home or when traveling. In addition, the procedure to pop a blister can be safe and effective, if done correctly.

Anatomy of a blister

As shown above, the skin is composed of three layers:

1. The epidermis is the outermost layer (the layer we see).
2. The dermis is below the epidermis.
3. The subcutaneous layer is the deepest.

When a blister is present, there is fluid between the dermis and epidermis layers, the fluid raises the epidermis.

Causes of blisters

Blisters are caused by a reaction of the skin due to friction.

Foot blisters can develop in people who spend much time on their feet or perform sports activities like jogging, running, or hiking.

Hand blisters develop in people who use their hands a lot at work, like factory workers, and people who play sports like tennis, golf, or pickleball.

Types of blisters

The most common types of blisters:

• Blisters from friction. The friction leads to the epidermal layer growing outward, creating a fluid-filled sac containing a clear liquid.
• Blood blisters. Types of blisters that contain blood in the fluid-filled sack. In these blisters, the friction causes the small blood vessels to leak, and the blood becomes trapped between the epidermis and dermis.
• Blisters from a burn. They can occur from heat or cold.

A burn blister is from a burn to the skin. The body produces the blister as a barrier while the burned skin is repairing.

Frostbite is a condition where the skin is damaged from the cold. A blister may form one to two days after the skin is warmed and healing.

Diagnosis of blisters

A blister diagnosis is made by visual inspection, no special imaging tests or labwork is needed or assists in making the diagnosis. However, an x-ray may be needed to evaluate the underlying bones if the blister results from trauma.

The outside layer of a blister is dead skin without nerve endings. Thus, the pain you feel from a blister is caused by pressure on the new skin's intact nerve endings (under the blister).

Prevention of blisters

The best way to treat a blister is to keep one from forming in the first place. There are several steps you can take to prevent a blister from forming.

Footwear

Have properly fitted footwear to prevent friction, which can be between the skin of the toes, feet, and footwear. Your shoes should not be too tight or loose.

Socks

Have properly fitted socks. Like shoes, socks that are too tight or too loose can cause blisters.

The types of socks that are best for runners and other athletes have been a discussion of much debate, and studies have yet to be conclusive. Some people say the best is the wicking type that moves the foot's moisture to the outside of the sock and away from the foot. Others say socks that absorb moisture are best. It is a personal preference for which kind you prefer as both types are good at preventing blisters.

However, it is important to keep the feet dry to avoid blisters. One study published in the journal Skin Research and Technology on March 2014 found that skin with surface hydration (water) made it more likely to form blisters.

Gloves

Wear gloves when doing manual labor to decrease skin friction. In addition, using powder inside gloves to absorb the sweat helps reduce blister formation.

Treatment for blisters

Typical treatments of blisters:

• Bandage. Cover the blister with a soft sterile bandage to keep it clean.
• Pads. Silicone and gel padding can protect the blister from further friction.
• Popping the blister. This should only be done for friction types of blisters, not for burn types.

Popping the blister

You can pop the blister with a sharp object to let the fluid drain A physician does this best, but it can also be performed at home or when traveling. Many resources state not to pop the blister on your own, however, when there is much pain, the fluid is clear, and it is significantly raised, there are usually no problems.

Popping the blister at home or when traveling is a simple procedure. The skin on the outside of the fluid bubble is essentially dead skin without nerve endings. Therefore, when you place a needle or sharp object into the blister, there is no pain when going through the dead skin. To do so:

1. Clean. Gently clean the blister area with rubbing alcohol or soap with water. Also, thoroughly wash both hands with soap and water.
2. Choose. The sharp object could be the sharp end of a safety pin or a paper clip. Any sharp object should work.
3. Sterilize. To sterilize a needle (sharp object), you can use boiling water or a flame, like from a match. Just let it cool before using it.
   
4. Pierce. The sharp object is introduced to pierce a hole into the dead skin, creating a space for the blister fluid to drain.
5. Remove the fluid. After creating the hole, it would be best to use mild pressure to remove the fluid.
6. Dead skin. Once the blister is pierced, the dead skin will not be painful when touched and will usually slough off on its own.

Blister complications

The most common complication is an infection before or after the blister is evacuated. If bacteria are introduced, the area will show signs of infection, including redness, warmth, swelling, pain, pus, or a foul smell.

If any of these signs or symptoms are present, consult your physician immediately.

To prevent infection, placing some antibiotic ointment or cream on the evacuated blister area is always a good idea. In addition, it can be covered with a clean bandage.