CARING FOR ATHLETES
Prevention and Treatment of Friction Blisters
Blisters are common in athletes. They are due to friction on the top layer of the skin, whereby, separating the top layer of skin from a lower layer of skin. Separation of the skin layers allows fluid to accumulate between the layers. Blisters may become quite painful and can become infected if not treated properly.
The two most common causes of blisters are improperly fitted shoes and abnormal biomechanical foot function. In both cases, the blisters may be prevented by the choice of a proper shoe, an in-shoe orthotic device if there is a biomechanical problem, and/or correct athletic taping techniques. It is not uncommon for athletes to use two pair of socks to prevent excessive friction. Vasoline and Spenco SecondSkin may also be helpful.
The following guidelines regarding prevention and treatment are advised.
Prevention:
1. If you know where a shoe rubs, start out the activity with the area taped or
covered with a thin layer moleskin.
2. Change socks frequently. Be alert to folds in the socks that can rub until a blister forms.
3. Wear a combination thin inner liner and thicker wool outer sock. This has two purposes: The inner liner absorbs any perspiration so that the feet stay dry, and it places the shearing force between the layers of the socks, not between the layers of the skin.
4. Use a drying powder to reduce moisture.
5. Buy shoes that fit well. Break them in gradually by a wearing for a few minutes at each workout and increasing the time they are worn. This helps calluses to form in areas of greatest friction.
6. Stop and cover a “hot-spot” as soon as you feel it developing. The sooner you protect the hot-spot, the less painful it will be. Do not be afraid to put Vasoline on the hot-spot.
Treatment:
Do not cut off the roof of the blister or place large holes in it to drain the fluid. If the blister is more than one centimeter in diameter, and is painful, only then may it be desirable to drain. The skin around and over the blister should be cleansed with alcohol or Betadine, and a sterile needle or blade used to lance the blister. This should be followed by the application of a topical antibiotic, which is then covered by a sterile adhesive bandage. The sterile bandage should be covered with Vasoline and then covered with another bandage so that friction takes place between the two bandages without involving the skin.
Use padding to protect the blister until the roof reattaches to the base. Using moleskin over a thin gauze pad that rests on the blister itself insures that the roof of the blister reattaches.
If the roof of the blister is torn off, the protective covering must be replaced. Unfortunately, no synthetic material is as good as one’s own skin. Tincture of Benzoin and Flexible Collodion to form a thin membrane over the raw blister may be used. Zinc Oxide has been found to be an effective agent for packing blisters when the roof has been removed. In addition, Mueller’s New Skin is effective in providing a temporary roof for raw skin.