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Friction Blisters Treatment & Management

  • Author: Robert A Schwartz, MD, MPH; Chief Editor: Dirk M Elston, MD  more...
 
Updated: Jun 13, 2016
 

Medical Care

Management of friction blisters includes sterile drainage of the site while leaving the blister roof intact to serve as a dressing. This method helps relieve some discomfort and protects the site from superinfection. A donut of moleskin may also be applied to minimize additional trauma to the blister and to relieve discomfort. If the blister roof is already fully or partially removed, treat the site as an open wound with appropriate antiseptic and surgical bandage application. Hydrocolloid dressings have also been proven to decrease discomfort and encourage healing. Some recommend debridement of the skin of the blister, the use of a topical containing nitrofurazone, and the application of a bandage.[14]

Prompt attention to friction blisters is important to prevent the development of secondary impetigo with possible cellulitis and sepsis. Institute appropriate systemic antibiotic therapy if impetigo develops. Use of povidone-iodine solution (Betadine) may be beneficial.[15]

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Complications

Impetigo may become a serious complication with resulting cellulitis and sepsis.

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Prevention

Foot blisters, caused by frictional forces, can be prevented by wearing properly sized boots, conditioning feet through regular road marching, wearing socks that reduce friction and moisture, and possibly use of antiperspirants to the feet.[16] Increased cutaneous surface hydration enhances the rate of skin temperature change and the risk of blister formation.[17] Prevention of friction blisters has focused on antiperspirant agents and appropriate footgear.[18, 19] Antiperspirant agents decrease the likelihood of developing friction blisters, but their use is confounded by a high incidence of irritant contact dermatitis. Since increased skin surface hydration may be a risk factor for blister formation, a product that lowers skin hydration might be useful. Three different preventative foot blister commercial products were tested on 30 apparently healthy adults. Only the power product was beneficial.[20]

The incidence of friction blisters on the feet may be somewhat decreased by the use of neoprene insoles, acrylic-based socks, or thin polyester socks combined with a thick wool or polypropylene sock that can maintain its bulk in the presence of moisture from sweat and compression.[21, 22, 23, 24, 25] Appropriately fitted shoes also are helpful in the prevention of friction blisters.

Friction blisters, which occur when shear loading causes the separation of dermal layers, were avoided when a triglyceride lubricant with T-shirt knit cotton was used.[26] The results of such textile and surface treatment performance are of value.

Sock fabrics may have distinct moisture properties when tested in a realistic military setting. One pair of socks 99.6% polypropylene and 0.4% elastane was compared with a blend of 50% Merino-wool, 33% polypropylene, and 17% polyamide, one on each foot. In this study, the blend stored almost 3 times more moisture, making it more desirable that the polypropylene socks.[27]

Paper tape was not found to be particularly protective against blisters in marathoners, although this intervention was well tolerated and had high user satisfaction.[28]

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Contributor Information and Disclosures
Author

Robert A Schwartz, MD, MPH Professor and Head of Dermatology, Professor of Pathology, Pediatrics, Medicine, and Preventive Medicine and Community Health, Rutgers New Jersey Medical School; Visiting Professor, Rutgers University School of Public Affairs and Administration

Robert A Schwartz, MD, MPH is a member of the following medical societies: Alpha Omega Alpha, New York Academy of Medicine, American Academy of Dermatology, American College of Physicians, Sigma Xi

Disclosure: Nothing to disclose.

Coauthor(s)

W Clark Lambert, MD, PhD Professor and Head, Dermatopathology, Departments of Pathology and Dermatology, Rutgers New Jersey Medical School

W Clark Lambert, MD, PhD is a member of the following medical societies: American Academy of Dermatology, American College of Physicians, American Society of Dermatopathology, International Academy of Pathology, Medical Society of New Jersey, Sigma Xi, Society for Investigative Dermatology

Disclosure: Nothing to disclose.

Kuljit Chima, MD Assistant Attending Physician in Clinical Dermatology, Columbia University Medical Center

Kuljit Chima, MD is a member of the following medical societies: American Academy of Dermatology

Disclosure: Nothing to disclose.

Specialty Editor Board

Michael J Wells, MD, FAAD Associate Professor, Department of Dermatology, Texas Tech University Health Sciences Center, Paul L Foster School of Medicine

Michael J Wells, MD, FAAD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, American Medical Association, Texas Medical Association

Disclosure: Nothing to disclose.

Jeffrey Meffert, MD Associate Clinical Professor of Dermatology, University of Texas School of Medicine at San Antonio

Jeffrey Meffert, MD is a member of the following medical societies: American Academy of Dermatology, American Medical Association, Association of Military Dermatologists, Texas Dermatological Society

Disclosure: Nothing to disclose.

Chief Editor

Dirk M Elston, MD Professor and Chairman, Department of Dermatology and Dermatologic Surgery, Medical University of South Carolina College of Medicine

Dirk M Elston, MD is a member of the following medical societies: American Academy of Dermatology

Disclosure: Nothing to disclose.

Additional Contributors

Robin Travers, MD Assistant Professor of Medicine (Dermatology), Dartmouth University School of Medicine; Staff Dermatologist, New England Baptist Hospital; Private Practice, SkinCare Physicians

Robin Travers, MD is a member of the following medical societies: American Academy of Dermatology, American Medical Informatics Association, Massachusetts Medical Society, Women's Dermatologic Society, Medical Dermatology Society

Disclosure: Nothing to disclose.

References
  1. Hoeffler DF. Friction blisters and cellulitis in a navy recruit population. Mil Med. 1975 May. 140(5):333-7. [Medline].

  2. Gerhardt LC, Strässle V, Lenz A, Spencer ND, Derler S. Influence of epidermal hydration on the friction of human skin against textiles. J R Soc Interface. 2008 Mar 10. [Medline]. [Full Text].

  3. Dai XQ, Li Y, Zhang M, Cheung JT. Effect of sock on biomechanical responses of foot during walking. Clin Biomech (Bristol, Avon). 2006 Mar. 21(3):314-21. [Medline].

  4. Gerhardt LC, Strassle V, Lenz A, Spencer ND, Derler S. Influence of epidermal hydration on the friction of human skin against textiles. J R Soc Interface. 2008 Nov 6. 5(28):1317-28. [Medline]. [Full Text].

  5. Hashmi F, Richards BS, Forghany S, Hatton AL, Nester CJ. The formation of friction blisters on the foot: the development of a laboratory-based blister creation model. Skin Res Technol. 2013 Feb. 19(1):e479-89. [Medline].

  6. Brennan FH Jr, Jackson CR, Olsen C, Wilson C. Blisters on the battlefield: the prevalence of and factors associated with foot friction blisters during Operation Iraqi Freedom I. Mil Med. 2012 Feb. 177(2):157-62. [Medline].

  7. McNamara AR, Ensell S, Farley TD. Hand Blisters in Major League Baseball Pitchers: Current Concepts and Management. Am J Orthop (Belle Mead NJ). 2016 Mar-Apr. 45 (3):134-6. [Medline].

  8. Sasmaz S, Karaoguz A, Uzel M, Coban YK. Pyogenic granuloma on the hand subsequent to friction blister in a hand surgeon. Dermatol Online J. 2006. 12(3):22. [Medline].

  9. Yavuz M, Davis BL. Plantar shear stress distribution in athletic individuals with frictional foot blisters. J Am Podiatr Med Assoc. 2010 Mar-Apr. 100(2):116-20. [Medline].

  10. Ashique KT, Kaliyadan F. Long-Term Follow-up and Donor Site Changes Evaluation in Suction Blister Epidermal Grafting Done for Stable Vitiligo: A Retrospective Study. Indian J Dermatol. 2015 Jul-Aug. 60 (4):369-72. [Medline].

  11. Ko WC, Chen YF. Suction blister epidermal grafts combined with CO2 laser superficial ablation as a good method for treating small-sized vitiligo. Dermatol Surg. 2009 Apr. 35(4):601-6. [Medline].

  12. Garg K, Singh D, Mishra D. Peeling skin syndrome: Current status. Dermatol Online J. 2010 Mar 15. 16(3):10. [Medline].

  13. Harth W, Taube KM, Gieler U. Facticious disorders in dermatology. J Dtsch Dermatol Ges. 2010 Feb 12. [Medline].

  14. Sevilla JA, Rodriguez FM, Dallasta RM. [The treatment of blisters caused by friction while hiking the Road to Santiago]. Rev Enferm. 2007 Jan. 30(1):32-6. [Medline].

  15. Gonzalez de la Guerra JM, González Campo M. [Betadine in the care of friction blisters. Treatment protocol in primary health care]. Rev Enferm. 2013 Jun. 36(6):24-31. [Medline].

  16. Knapik JJ. Prevention of food blisters. J Spec Oper Med. 2014 Summer. 14(2):95-7. [Medline].

  17. Kirkham S, Lam S, Nester C, Hashmi F. The effect of hydration on the risk of friction blister formation on the heel of the foot. Skin Res Technol. 2014 May. 20(2):246-53. [Medline].

  18. Knapik JJ, Reynolds K, Barson J. Influence of an antiperspirant on foot blister incidence during cross-country hiking. J Am Acad Dermatol. 1998 Aug. 39(2 Pt 1):202-6. [Medline].

  19. Reynolds K, Darrigrand A, Roberts D, Knapik J, Pollard J, Duplantis K, et al. Effects of an antiperspirant with emollients on foot-sweat accumulation and blister formation while walking in the heat. J Am Acad Dermatol. 1995 Oct. 33(4):626-30. [Medline].

  20. Hashmi F, Kirkham S, Nester C, Lam S. The effect of topical anti blister products on the risk of friction blister formation on the foot. J Tissue Viability. 2016 Apr 29. [Medline].

  21. Jagoda A, Madden H, Hinson C. A friction blister prevention study in a population of marines. Mil Med. 1981 Jan. 146(1):42-4. [Medline].

  22. Knapik JJ, Hamlet MP, Thompson KJ, Jones BH. Influence of boot-sock systems on frequency and severity of foot blisters. Mil Med. 1996 Oct. 161(10):594-8. [Medline].

  23. Smith W, Walter J Jr, Bailey M. Effects of insoles in Coast Guard basic training footwear. J Am Podiatr Med Assoc. 1985 Dec. 75(12):644-7. [Medline].

  24. Spence WR, Shields MN. Insole to reduce shearing forces on the soles of the feet. Arch Phys Med Rehabil. 1968 Aug. 49(8):476-9. [Medline].

  25. Spence WR, Shields MN. New insole for prevention of athletic blisters. J Sports Med Phys Fitness. 1968 Sep. 8(3):177-80. [Medline].

  26. Guerra C, Schwartz CJ. Investigation of the influence of textiles and surface treatments on blistering using a novel simulant. Skin Res Technol. 2011 Apr 21. [Medline].

  27. Bogerd CP, Niedermann R, Brühwiler PA, Rossi RM. The effect of two sock fabrics on perception and physiological parameters associated with blister incidence: a field study. Ann Occup Hyg. 2012 May. 56(4):481-8. [Medline].

  28. Lipman GS, Ellis MA, Lewis EJ, Waite BL, Lissoway J, Chan GK, et al. A prospective randomized blister prevention trial assessing paper tape in endurance distances (Pre-TAPED). Wilderness Environ Med. 2014 Dec. 25 (4):457-61. [Medline].

 
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