Battling Blisters – First Aid

Blisters manifest themselves due to several different medical factors. For the outdoor enthusiast, however, it’s usually an external irritation that gives rise to a blister from ill-fitting footwear (material rubbing against skin – referred to as “shear”, not actually friction) or using a tool (axe handle, canoe paddle, etc.; or a thermal blister from grabbing a hot pan handle from the campfire. In each case, a painful, bubble-like swelling erupts on your skin as a blister. In most all cases, treatment is the same.

Initially, the best way to deal with a blister that is unbroken, is to carefully wash the area and apply a gauze pad over the area. You can then apply a couple of friction-eliminating treatments to the blister (and to the area of the footwear creating the friction).

 

Old school treatment is to apply Moleskin, a cushioned/adhesive-backed felt pad that can both prevent friction by strategically sticking it over the contact area of the footwear, or to cut a hole in the moleskin to surround and protect the blistered area from coming in contact with the friction area.

More recently, a preferred treatment is the use of a product called “Second Skin” – a gel designed to prevent, protect and treat blistering by applying a cushioning gel that forms a layer between the blister area and the friction-causing surface. 

There’s always the question of whether it’s better to pop and drain the liquid encapsulated within the blister bubble. Not usually! From a sanitary standpoint, the  wound is a self-contained sterile environment, protected against outside contamination  by the dome of skin containing the blister. 

Sometimes it may be necessary to drain a blister rather than let it the fluids be absorbed back into the surrounding area.  Care must be taken not to contaminate this no longer sterile environment you’ve opened up when you breach that protective dome of skin.

Here’s the hygienic way to “pop” a blister:

1. Carefully wash the blister and immediate surrounding area with soap/water or alcohol swab;  the Mayo Clinic website suggests applying iodine to the area (presumably ONLY if the skin is not broken);
2. Sterilized a needle or sharp point of a knife blade (use rubbing alcohol and water or carefully heat over a flame) and gently pierce or make a small cut at the lower edge of the blister at its base with the surrounding skin; 
3. Allow the fluid to drain out, carefully applying gentle pressure to encourage flow;
4. Leave the loose skin in tact, apply ointment and cover with a sterile dressing.

The blister should be checked regularly for signs of infection. After a few days, the dead/dry skin that formed the blister dome can be carefully cut away and the area re-bandaged.

A word of caution. If the blister has already popped on its own, wash the area with soap and water, but do NOT apply alcohol, iodine or hydrogen peroxide to the wound! Follow the cleaning with an ointment and gauze application.

Prevention is certainly better than a cure when it comes to blisters. Good-fitting, moisture-wicking socks (some suggest wearing two thin pairs instead on one) are insurance against blistering as are boots that are proper fitted and worn-in a bit before being used on an extended hike. Same goes for well-fitting, hand-forming gloves, too. Some canoeists re-shape the grip on their paddles to smooth over irritating/friction areas.

If you anticipate a friction area within your footwear, you can apply a section of Moleskin or Second Skin on that area to mitigate any friction issues before they materialize.