Friction Blisters

We’re approaching the time of year when many people switch out their daily footwear, making this a good time to discuss the basics of blister care. Prevention is always important, but should a blister on the foot develop, it’s important to know what you can do on your own and what you’ll need a doctor’s help with.

If you’re getting a pair of boots out of the closet that you haven’t worn in months, they may no longer fit you. Friction blisters form as a result of rubbing under the skin through a process called shearing. It occurs when the skin encounters a lot of friction when the bone is in motion, causing tissue layers to move opposite each other. This is likely to occur if the shoes are too tight or too loose, allowing the foot to slide around inside. Feet change shape over time and boots get worn with use, so even if a boot was fitted right originally, it may not be now. Keep in mind, too, that most peoples’ feet are different sizes but their shoes usually aren’t. Friction also increases with moisture, making it important to switch out wet socks.

Usually, when a friction blister is developing, there will be some warning in the form of pain at the affected area. A person feeling this should stop their activity, if possible. If a blister does develop, try to keep the roof (the skin above the pocket of liquid) as intact as you can, even if it is already torn. Remove it only if it is already dirty and too ragged to cover the wound, and wash your hands and the area around it first. The roof is still functioning as a defense against infection, even if the swelling is painful or the roof is only partially present, and at this point, infection is the biggest concern.

While a large blister shouldn’t be popped, draining it still relieves pain. It is inadvisable for a diabetic or person with a weakened immune system to attempt this on their own, but other people may try sterilizing a needle with alcohol and then draining the blister. When dressing the wound, use non-adhesive padding. If the blister is on the bottom of the foot, place a doughnut-shaped moleskin pad around it and do not cover it. If it is not, the padding may be covered with a compressive or adhesive material. Small friction blisters usually heal on their own after a week or two. However, you should see a doctor if you have signs of infection, such as increased redness, pain, or pus. You should also see a podiatrist if you repeatedly get blisters in the same spot despite changing shoes, because the problem may be a bone abnormality.

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