Preventing and treating blisters from physical activity

Why blisters occur during exercise

5 Ways to prevent blisters

• Wear shoes that fit you comfortably. If they’re too loose or too tight, they’ll cause friction as you move. Securely fitting shoes will help stop your foot slipping inside the shoe and reduce friction.²
• No matter how comfortable they felt in the shop, new shoes need to be “broken in”. Start by wearing them for short periods of time or smaller distances and increase these gradually.²
• Different activities create different forces on our bodies. Many shoes are designed to support specific types of activity, e.g. running, hiking, walking. Choosing shoes that suit your activity will ensure optimal support.²
• Take notice of any areas where your shoe causes extra pressure or friction, e.g. stitching or top edge of the heel. Sometimes, adjusting the laces or using a little padding is a suitable solution, but discomfort or irritation over a pressure point is a reason to consider other designs.²

• Socks that absorb moisture will increase the risk of friction and blisters. Natural fibres are not always the best option – as cotton and bamboo absorb moisture. Choose socks made of materials that draw moisture away from your skin e.g. wool or some synthetics. Look for phrases such as “moisture wicking” on the packaging.³
• Some people find wearing two layers of socks is beneficial. Using a thin sock (or liner) under a thicker sock can improve moisture wicking and provide extra cushioning. Others find that two layers increases the slipping of the foot within the shoe or between layers and increase friction.³
• Wear socks that are the right size for you. If they’re too small, they may cause extra pressure on your feet and irritate the skin. Socks that are too big can wrinkle, which also increases pressure and irritation.³
• Replace socks showing signs of wear. If the material is thinning or losing elasticity, it may start to cause problems and should be retired. ³

There are many products that can provide extra padding and comfort for pressure points. Foam padding or podiatry felt can be cut to fit and provide protection when placed in shoes or on equipment.⁸ For a less bulky option, consider a hydrocolloid dressing – often referred to as a second skin.¹

The essential functions of skin are often unrecognised or understated. Society can be more focused on our skin’s appearance, but it helps hold us together and is a barrier against various environmental harms. Maintaining your skin’s health is worth investing a little time and money. Use pH neutral products to cleanse and moisturise your skin.¹ Make sure you dry thoroughly (but gently) after washing, paying attention to trouble spots like in between toes. Apply sunscreen regularly when outdoors.²

Treating a blister safely at home

The main goals of treating a blister are managing pain, preventing infection, and restoring your skin’s integrity as quickly as possible. Firstly, assess the size and severity – is it intact or has it broken? How might it impact you daily activities? Do you have medical conditions that place you at higher risk of infection?

Over time, your body will reabsorb the fluid contained in a blister. In most cases, it’s better not to break the skin to drain the fluid because doing so creates a portal for possible infection.¹

Place a simple protective dressing over it – foam dressings are ideal as they provide cushioning and are less traumatic to remove.¹

If the blister does rupture, the dressing will absorb the fluid, and the area will be protected from outside sources of infection.

Try to avoid the activity that caused the blister until it has healed.⁵

1. Wash your hands thoroughly⁵
2. Clean the blister and surrounding area with an antimicrobial wound solution
3. A sterile needle is preferred but a small sewing needle cleaned with isopropyl alcohol will suffice⁹
4. Pierce the bottom edge of the blister, creating a small hole for the fluid to drain out by gravity⁹
5. Don’t remove the overlying skin – it’s still an effective barrier protecting the tissues below 9
6. Apply a new (unopened) dressing, ensuring it seals around the area to prevent contamination.⁵ You could also apply an antimicrobial contact layer under the main dressing. This would offer additional protection from infection and prevent accidental removal of overlying skin when the dressing is removed.¹

Please keep in mind this may not be recommended for those at higher risk of infection, e.g. diabetics or immunocompromised people.⁶

When to see a doctor about a blister

However, if your blisters are spreading, itchy or occurring on the skin where there has been no rubbing or friction, it’s time to visit your doctor, as these signs could be related to a disease or allergy.⁶

Another important reason to consult your doctor is if you notice any signs of infection:

• increased warmth, redness or swelling around blister⁵
• pus or discharge from blister⁵
• increasing pain around blister⁵
• blister is not healing⁷
• blister has a bad smell⁷

If you have conditions like diabetes, vascular disease or weakened immune system, you must be more watchful for these signs.⁶ Don’t hesitate to see your doctor – infections rarely get better by themselves.

Ongoing management

1. Monitor the area for any signs of infection – increased redness, pain or ooze. Feeling generally unwell or developing a fever may also indicate infection and you should promptly seek professional medical attention.⁴
2. Dressings don’t need to be changed daily. Every time a dressing is removed, there is an opportunity for contamination and disruption of the healing process. Modern wound care products are designed to remain in place for several days. Check the product instructions or discuss with a qualified clinician.¹
3. Give it time to heal – avoid activities that will aggravate the injury.³