Blisters: The First Aid Is Counter-Intuitive

The skin is made of three major layers, the dermis (external), the epidermis, and the hypodermis (deepest layer). When these layers become agitated a blister will form between the dermis and the epidermis. In more severe cases the blister can also affect the hypodermis as well.

A blister is simply a small pocket of fluid that forms when there is friction or some kind of other irritation. The fluid is released in the area by the body in order to try and protect the underlying tissue by acting as a liquid cushion.

Causes

Blisters can form when wearing improper fitting or new shoes, or from wearing tight fitting jewelry such as a watch with a strap that irritates, or in more severe cases it may be a reaction from other types of skin damage. This can include blisters from burns, such as a sun burn, a chemical burn, or a thermal burn (touching a hot object).

Still in other cases, blisters can also form as a result of an infection, such as the case with measles, shingles, or chicken pox.

Prevention Tips

• When purchasing new shoes make sure they fit well.
• When breaking in new shoes do it slowly over several days.
• Avoid sun burn blisters by avoiding direct exposure to the sun and use sunscreen.
• Take some precautions at work and at home to avoid burns.
• Where protective gloves when performing manual work, especially if you are not accustomed to it.
• For sports use any new equipment slowly to allow the tissue (hands and feet usually) to become accustomed to it.

First Aid

Although it may be very tempting, do not puncture a blister. Remember, it's there to protect the underlying tissue. As long as the dermis is intact nothing can enter. If you break the blister you will be exposing very sensitive tissue, making it prone to pain and infection. Eventually the body will reabsorb the fluid and the dermis will reattach to the other layers. If this does not happen the extra skin will eventually come off on its own once the fluid is reabsorbed.

Until it heals protect blisters with a small donut-shaped pad. Use a dressing for further protection and change the dressing frequently. Ease up on activity to prevent the blister from becoming worse.

If a blister breaks, do not peel off the skin. Leave it in place to protect the underlying sensitive area. Clean the area with soap and water. Keep the area dry. Watch for signs of infection and seek medical help if needed.

If the activity that causes the blister is over and won't be repeated e.g. a very long hike or if you otherwise absolutely must break the blister, first clean the area thoroughly and use a sterilized needle. Puncture a tiny hole in the side just barely big enough for the fluid to drain out. Do not any of the skin, as this will expose a very sensitive area and you will experience pain from even the slightest touch. Keep the area clean and apply a bandage.

Warning: In the case of chemical or second degree burns, medical help should be obtained. The reason for this is there is a much higher risk of infection. This is even more vital if the burn has occurred on a larger area of the body, e.g. the entire back, or if it has occurred in a sensitive area, e.g. the face or neck.

Blisters vs. Calluses and Corns

A similar condition is what we call calluses. They are also formed by friction, however, they tend to form over longer time periods when the friction is of less severity, but prolonged. A callus is a hardened skin area that forms in order to protect the underlying tissue. If a callus is allowed to continue it can become extremely hard and can also grow deeper into the tissue. This can cause discomfort and pain, and may eventually require surgical removal. The feet and hands are the most susceptible to calluses.

A corn usually occurs on the tips of toes, very common when your toes rub on the front of the shoes. With a corn there seems to be a very thick area right in the middle of the corn. This can become quite painful especially when performing the activity that caused the corn, such as running. Use a different shoe for a while, wear thicker socks, or put a bandage over the area until it heals. Sometimes a corn is softer and can be more prone to infection. So always keep your feet clean and watch for signs of infection.