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.^[22]Increased cutaneous surface hydration enhances the rate of skin temperature change and the risk of blister formation.^[23]Prevention of friction blisters has focused on antiperspirant agents and appropriate footgear.^{[24, 25]}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 powder product was beneficial.^[26]

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.^{[27, 28, 29, 30, 31]}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.^[32]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.^[33]

Paper tape was not found to be particularly protective against blisters in marathoners, although this intervention was well tolerated and had high user satisfaction.^[34]

A skin-textile friction analysis method can be used to quantify the yarn and fabric characteristics to minimize the risks of developing blisters and pressure ulcers, particularly in athletes and military personnel.^[35]

Medication

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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. [QxMD MEDLINE Link].
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. [QxMD MEDLINE Link].
Cohen PR. Pool Toes: Case Report and Review of Pool-Associated Pedal Dermatoses. Cureus. 2020 Nov 28. 12 (11):e11756. [QxMD MEDLINE Link].
Rushton RJ. Exploring the Mechanism for Blister Prevention Using Moleskin. Curr Sports Med Rep. 2020 Nov. 19 (11):451-453. [QxMD MEDLINE Link].
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. [QxMD MEDLINE Link].
Janssen L, Allard NAE, Ten Haaf DSM, van Romburgh CPP, Eijsvogels TMH, Hopman MTE. First-Aid Treatment for Friction Blisters: "Walking Into the Right Direction?". Clin J Sport Med. 2018 Jan. 28 (1):37-42. [QxMD MEDLINE Link].
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. [QxMD MEDLINE Link].
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. [QxMD MEDLINE Link]. [Full Text].
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. [QxMD MEDLINE Link].
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. [QxMD MEDLINE Link]. [Full Text].
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. [QxMD MEDLINE Link].
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. [QxMD MEDLINE Link].
Esther CL, Gabriel GN, Raquel SR, Alfonso MN. The influence of sock composition on the appearance of foot blisters in hikers. J Tissue Viability. 2022 May. 31 (2):315-318. [QxMD MEDLINE Link]. [Full Text].
Adhikari S, Dawadi S, Upadhyay J. Friction Blister by Climbing Harness: A Case Report. Wilderness Environ Med. 2019 Sep. 30 (3):302-305. [QxMD MEDLINE Link].
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. [QxMD MEDLINE Link].
Delebarre H, Chiaverini C, Vandersteen C, Savoldelli C. Orofacial management for epidermolysis bullosa during wisdom tooth removal surgery: A technical note. J Stomatol Oral Maxillofac Surg. 2019 Mar 22. [QxMD MEDLINE Link].
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. [QxMD MEDLINE Link].
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. [QxMD MEDLINE Link].
Garg K, Singh D, Mishra D. Peeling skin syndrome: Current status. Dermatol Online J. 2010 Mar 15. 16(3):10. [QxMD MEDLINE Link].
Harth W, Taube KM, Gieler U. Facticious disorders in dermatology. J Dtsch Dermatol Ges. 2010 Feb 12. [QxMD MEDLINE Link].
Knapik JJ. Prevention of food blisters. J Spec Oper Med. 2014 Summer. 14(2):95-7. [QxMD MEDLINE Link].
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. [QxMD MEDLINE Link].
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. [QxMD MEDLINE Link].
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. [QxMD MEDLINE Link].
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. [QxMD MEDLINE Link].
Jagoda A, Madden H, Hinson C. A friction blister prevention study in a population of marines. Mil Med. 1981 Jan. 146(1):42-4. [QxMD MEDLINE Link].
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. [QxMD MEDLINE Link].
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. [QxMD MEDLINE Link].
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. [QxMD MEDLINE Link].
Spence WR, Shields MN. New insole for prevention of athletic blisters. J Sports Med Phys Fitness. 1968 Sep. 8(3):177-80. [QxMD MEDLINE Link].
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. [QxMD MEDLINE Link].
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. [QxMD MEDLINE Link].
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. [QxMD MEDLINE Link].
Baby R, Mathur K, DenHartog E. Nondestructive Quantitative Evaluation of Yarns and Fabrics and Determination of Contact Area of Fabrics Using the X-ray Microcomputed Tomography System for Skin-Textile Friction Analysis. ACS Appl Mater Interfaces. 2021 Jan 27. 13 (3):4652-4664. [QxMD MEDLINE Link].

Media Gallery

Friction blisters on human foot. Courtesy of Andry French (own work), via Wikimedia Commons.

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Author

Robert A Schwartz, MD, MPH Professor and Head of Dermatology, Professor of Pathology, Professor of Pediatrics, Professor of Medicine, Rutgers New Jersey Medical School

Robert A Schwartz, MD, MPH is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, New York Academy of Medicine, Royal College of Physicians of Edinburgh, Sigma Xi, The Scientific Research Honor Society

Disclosure: Nothing to disclose.

Coauthor(s)

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.

W Clark Lambert, MD, PhD Clinical Professor of Pathology, Clinical Professor of Medicine (Professor of Dermatology), Rutgers New Jersey Medical School; Professor of Pathology, Rutgers Graduate School of Biomedical Sciences

W Clark Lambert, MD, PhD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, American College of Physicians, American Dermatological Association, American Federation for Clinical Research, American Society of Dermatopathology, College of American Pathologists, Dermatological Society of New Jersey, Institute of Electrical and Electronics Engineers, International Academy of Pathology, International Federation of Pigment Cell Societies, International Society of Dermatopathology, Medical Society of New Jersey, Sigma Xi, The Scientific Research Honor Society, Society for Investigative Dermatology, Xeroderma Pigmentosum Society

Disclosure: Nothing to disclose.

Specialty Editor Board

Michael J Wells, MD, FAAD Dermatologic/Mohs Surgeon, The Surgery Center at Plano Dermatology

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.

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.

Friction Blisters Treatment & Management

Prevention

References

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Contributor Information and Disclosures

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