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Cause and Effect
Blisters form when the skin rubs against another surface, causing friction. First, a tear
occurs within the upper layers of the skin, forming a space between the layers while
leaving the surface intact. Then fluid seeps into the space.
Soles and palms are most commonly affected for several reasons. The hands and feet often
rub against shoes, skates, rackets, or other equipment. Blister formation usually requires
thick and rather immobile epidermis, as is found in these areas. In addition, blisters
form more easily on moist skin than on dry or soaked skin, and warm conditions assist
blister formation.
Blister Care
If you get a blister, you’ll want to relieve your pain, keep the blister from
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and stave off
infection. Specific steps depend on the size of the blister and whether or not it is
intact. You can treat the vast majority of blisters yourself and need to call a doctor
only if blisters become infected, recur frequently, form in unusual locations, or are very
severe. Signs of infection include pus draining from the blister, very red or warm skin
around the blister, and red streaks leading away from the blister.
Small, intact blisters that don’t cause discomfort usually need no treatment.
Nature’s best protection against infection is a blister’s own skin, or roof. To
protect the roof, this type of blister can be covered with a small adhesive bandage if
practical.
Larger or painful blisters that are intact should be drained without removing the roof.
First clean the blister with rubbing alcohol or antibiotic soap and water. Then heat a
straight pin or safety pin over a flame until the pin glows red, and allow it to cool
before puncturing a small hole at the edge of the blister.
Drain the fluid with gentle pressure, then apply an antibiotic ointment such as bacitracin
with polymyxin B (double antibiotic ointment) or bacitracin alone. Avoid ointments that
contain neomycin because they are more likely to cause an allergic reaction.
Finally, cover the blister with a bandage. Change the dressing daily--more frequently if
it becomes wet, soiled, or loose.
Blisters with small tears are treated the same as those that you have punctured. Blisters
with larger tears should be "unroofed" carefully with fine scissors, and the
base should be cleansed thoroughly with soap and water or an antibacterial cleanser. Apply
antibiotic ointment and bandages as described above.
Additional padding may be necessary for exercise or sports. Ring-shaped pads made of felt
will protect small blisters. Larger blisters may require dressings. Some of the many
available dressing materials are DuoDerm (ConvaTec, Princeton, New Jersey), Spenco 2nd
Skin (Spenco Medical Corporation, Waco, Texas), Vigilon (CR Bard Inc, Murray Hill, New
Jersey), and Opsite (Smith & Nephew United, Largo, Florida). Additional,
doughnutshaped padding made of felt or lamb’s wool may be applied over the area
surrounding the blister. Then the entire dressing can be applied to help keep the dressing
in place on sweaty skin.
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