Blisters

Blisters are a common problem that has likely affected most people at some point in their lifetime, whether it’s from their exercise routine or from that new pair of shoes that they hadn’t worn in properly. Blisters present as small, puffy pockets of fluid that tend to have a yellow appearance beneath a thin layer of skin. This fluid is actually a ‘serum’ which tends to contain plasma components including antibodies and white blood cells. The fluid actually serves to protect the damaged skin and help it heal, which is why most people are advised against popping blisters where possible. The feet are particularly prone to blisters because of the regular friction and rubbing they’re exposed to when we walk on them.

Blisters on the feet are typically easier to identify due to their fluid-filled pocket-like appearance in an area that has recently experienced some pain or discomfort, likely from rubbing. You’ll notice a raised area of thin skin (the skin's outer layer) with clear or yellow fluid, although this may turn red if a blood blister has formed.

Blisters tend to be accompanied by pain or tenderness, especially when pressed against by footwear. You’ll likely experience some redness or irritation around the blister, and some slight swelling in the area may appear. Blisters can vary in size, can occur anywhere on the feet, and it’s not uncommon to develop multiple blisters at once.

Many people find it interesting to learn that blisters actually appear as a natural response to injury (often from pressure or friction) from your body, much like in the case of calluses. Specifically, it happens when the layers of skin slide and rub across one another excessively. We often see them develop in response to:

• Poorly fitting footwear, including stiff shoes and new shoes that have not been worn in adequately before wearing them for a prolonged period
• Excessive foot moisture, such as from sweating or wearing socks that trap moisture against the skin instead of wicking it away
• Sunburn and other burns can also cause blisters, as the exposure to heat damages the layers of the skin, producing blisters. 
• Harsh chemicals, allergic reactions and infections can all also contribute to the development of blisters.

One of the most common questions that we get asked about blisters is whether they should be popped (or drained), or whether you should try to keep them intact. As a rule of thumb, if you’ve managed to keep your blisters intact so far, we recommend you leave it and not pop or drain it, given that the fluid is serving several protective and healing mechanisms and will help you get out of pain faster. In most cases, your body will reabsorb the fluid as the blister heals.

There are certain cases where it may be more advisable to drain the blister, such as if you’re training for an athletic event and your blister has a high likelihood of popping anyway - it’ll be better to drain it in a controlled manner (your podiatrist can help with this) as opposed to it popping against your shoe and sock and having the outer layer of skin essentially ripped away without the right protection. All popped blisters carry a risk of infection, so it’s always important to take great care and use sterile instruments and dressings.

When at home with a blister, we recommend that you do your best to try to protect the blistered area from further damage using padding and being selective in your choice of footwear. If your blister has already popped, then clean the area and apply an antiseptic to the area with a protective dressing. If your blistered area becomes more painful or red, or does not show signs of healing as expected, always see your podiatrist.

Here at Matt Raden Podiatry, our trusted and experienced podiatrists listen to the concerns, goals and needs of our patients with blisters on their feet and utilise evidence-based treatment methods to help you get the best outcomes, including helping to reduce the chance of getting more blisters in the future. 

If your circumstances mean that it is in your best interest to drain your blisters, then we can do this for you in a safe and sterile environment, using the right tools, antiseptic products and protective padding. For those involved in athletic events, we can also help you protect the high-pressure areas on your feet to support you through completing your event, whether that means helping you manage your existing blisters developed in training, or helping you prevent new blisters in high-risk areas. We can also safely dress blisters that are popped, and monitor you for signs of infection, particularly if you’re high-risk and have problems with healing or blood flow to the feet. 

Your podiatrist will also discuss a range of preventative measures that you can take in the future, including:

• Choosing the right footwear: one of the best ways to prevent blisters on your feet is to wear comfortable, well-fitting shoes. Shoes that are too tight or too loose can cause friction and pressure on your feet, leading to blisters. Look for shoes with a wide toe box that allows your toes to move freely, and avoid shoes with high heels or pointed toes.
• Breaking in new shoes: new shoes can be stiff and tight, which can cause blisters on your feet. To prevent this, break in new shoes gradually by wearing them for short periods of time at first and gradually increasing the length of time you wear them. You can also try stretching the shoes before wearing them to help loosen them up.
• Wearing moisture-wicking socks: moisture can contribute to the formation of blisters on your feet. To prevent this, wear moisture-wicking socks that help to keep your feet dry. Avoid cotton socks, as they tend to trap moisture and can contribute to blister formation.
• Using protective padding: if you have a spot on your foot that is prone to blisters, and you’re about to go for a long walk or hike, we recommend using protective padding to prevent friction and pressure. Moleskin or gel pads are good options for protecting your feet from blisters.