Blisters are one of the most common sports injuries. They can significantly impair performance and result in discomfort, pain and infection. However, they will only rarely result in a serious interruption of training. An online survey (Pribut, 2002, Internet http://www.drpribut.com/) revealed that only about 0.5% of all injuries which resulted in a one week interruption of training were caused by blisters.

None the less, prevention and treatment of blisters is an important issue. From fingers to toes blisters can interfere with performance. From a baseball pitcher with a blister on his hand to a runner with a blister in the arch, these unwelcome skin injuries can cause a missed start for a pitcher or a slow and painful run for the runner.

Causes:

Blisters in athletes are almost always caused by friction. Friction combined with excessive moisture sets up the right combination for blister formation. Sweaty palms and fingers need to be avoided as much as possible with those participating in pitching or racket sports. For runners - avoiding soggy socks and ill fitting shoes will be the best means of preventing blisters. Performing endurance sports in new shoes or new socks can also contribute to blisters.

Blisters occur most often in areas of friction and rubbing. Make sure this is minimized where ever you can. For chafing from clothing, try to avoid the clothing that rubs. Even jock straps can cause chafing in hot weather on a 20 mile run. Try alternative clothes. Thighs that rub together can cause chafing, irritation or blisters. Body glide is one of the products that can help with this problem.

What is a blister?

A blister is actually a separation of the epidermis from the dermis or a separation within the epidermis itself. Vesicle is the term applied to very small fluid filled bubbles and may occur in conjunction with athlete's foot. Bulla is the medical term used for "blister". Most often the fluid within the blister is clear, but on occasion there is bleeding into the blister ( a blood blister) and it is bloody.

Blister Prevention Tips

Vaseline or other moisturizers are recommended to use to prevent blisters. As a gooey and occlusive (non-breathing) material I do not recommend this, but it is true that many have successfully used it. I would not recommend trying it for the first time in a marathon. Go with what has worked in the past - and in particular good fitting, broken in shoes, with socks that wick moisture well.

If you are running or hiking and notice a "hot spot" you may apply moleskin or other padding to decrease friction.

Treatment:

Diabetics should not self-treat blisters, but should seek professional care. (Likewise those with impaired circulation). The rest of you should be careful to try to avoid infection and to observe carefully for signs of infection, such as redness or red streaks around the periphery of the blister, pus within the blister, and increasing pain or heat. The cardinal signs of infection are redness, heat, swelling, and pain.

The skin over the blister itself does provide protection from bacteria in the environment and does not always need to be punctured. A small blister may just be allowed to heal by itself. Sometimes you will need to have a blister punctured to reduce pressure on the underlying skin. (If you are diabetic this is often important and should be done in a doctors office or emergency room.)

The suggestion most often given is to heat a pin or needle over a flame until it glows red, allow it to cool and then carefully puncture the blister close to its edge. Apply gentle pressure to allow the fluid to drain. After you have punctured the blister and drained much of the fluid, you should not remove the protectective cover of skin. This skin acts as a biological dressing and will also reduce irritation on the raw tissues beneath. You should then apply an antibiotic cream or an antiseptic such as Betadine (povidone-iodine) and a sterile gauze as a dressing. Moleskin or tape applied to a blister will cause all of the skin to peel off along with the dressing.

If there are bony prominences on your foot either on the toes or the heels, padding may be used to minimize repetitive friction and pressure