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Although blisters are one of the most common sports injuries, they should rarely hinder your training.  Blisters are characterized by an oval-like elevation of the skin containing clear fluid between layers of the epidermis. They are commonly caused by friction and shearing forces on the skin.  In some cases, if pressure or friction to the area continues there can be bleeding into the blister.  Common areas of involvement are the toes, the ball of the foot and the back of the heel.  

Extremes of dryness and moisture tend to decrease friction, whereas moderate moisture increases friction.  Therefore, prevention of blistering includes powder to reduce friction, socks that 'wick away the sweat,' and properly fitted shoes.  Avoid cotton socks as they retain moisture so that it feels like running in a soggy rag.  

Another area of prevention involves the shoes.  Keeping the shoes as dry as possible and the application of moleskin or padding around bony prominences will help reduce pressure. Gradually increase your activity, and don't ever do a race in new shoes or socks.  Many people experience mild swelling in the feet in the afternoon. Therefore, this is a good time to buy your sneakers to help assure a proper fit.  Try them on with the type and thickness of socks you'll be running in.   

As an additional form of prevention, some people apply a dab of Vaseline to the hot spot. Bodyglide© is an excellent product that reduces friction, and the company now also produces Footglide©.  For hardcore chafing, the old standby zinc oxide ointment will act as moisture barrier.  

Treatment includes draining the blister, the application of a small amount of an antibiotic ointment and a band-aid or gauze.  The top, or roof, of the blister should be maintained as it serves as protection for the tender skin underneath.  It is the body's natural band-aid. Therefore, deroofing the blister can lead to more irritation and inflammation, as well as the risk of secondary infection.  Laymen often heat up a needle until it's red, let it cool a bit and then perforate the blister near its edge.   Apply gentle pressure to allow the fluid to drain. If possible, perforate the blister several times around the periphery to help prevent recurrence. This also allows the roof to adhere to the skin resulting in less discomfort and faster healing.  A small blister often heals by itself and may not need to be drained.  

Those with diabetes, impaired circulation, or difficulty healing should not treat themselves They require professional care. If you do drain the blister, be aware of signs of infection:  pain, redness or red streaks, heat, swelling and pus.  Of course, seek professional care if these signs are present.  As a precaution, blisters should not be confused with small fluid-filled bubbles (called vesicles) that are commonly associated with athlete's foot.  If it itches, think possible fungal infection and try anti-fungal cream and powder.

With proper precautions blistering should not be a hindrance to your training.  If a blister does present itself, careful treatment will quickly alleviate the problem.

Photo by VladimirFLoyd/iStock / Getty Images

Photo by VladimirFLoyd/iStock / Getty Images

Dr Jay KernerBlisters