Foot Blister Prevention: What You Can Recommend To Athletes

Start Page: 68
By Mark A. Caselli, DPM, and Jean Chen-Vitulli, DPM

Pertinent Treatment Tips
Since it’s not always possible to prevent blisters, it is important to relieve pain, prevent enlargement or infection, and promote a speedy recovery when they do occur. Small, intact blisters that don’t cause discomfort usually don’t need treatment. The best protection against infection is a blister’s own skin or roof. To protect the roof, you can cover this type of blister with a small adhesive bandage or blister guard.
However, you should drain larger or painful blisters that are intact without removing the roof. Proceed to apply an antibiotic ointment and cover it with a bandage. Remind runners to change their dressings daily.
If you’re dealing with blisters that have large tears, you should “unroof” them and cleanse the base thoroughly with soap and water or an antibacterial cleanser. Then cover it with an antibiotic ointment and bandage.
Additional padding may be necessary for continuing sports activity. Ring-shaped pads made of felt will protect small blisters. Larger blisters may require dressings such as DuoDerm (ConvaTec), Spenco 2nd Skin (Spenco Medical Corporation), Vigilon (CR Bard, Inc.), or Opsite (Smith & Nephew United). Doughnut-shaped paddings may be used in conjunction with these dressings.

Dr. Caselli (pictured) is Vice-President of the greater New York Regional Chapter of the American College of Sports Medicine and is a Professor in the Dept. of Orthopedic Sciences at New York College of Podiatric Medicine.
Dr. Chen-Vitulli is a podiatric orthopedic resident at the V.A. Hudson Valley Health Care System in Montrose, N.Y.


References 1. Burkhart CG: Skin disorders of the foot in active patients. The Physician and Sportsmedicine, Vol 27, No 2, February 1999. 2. Caselli MA, Longobardi SJ: Lower extremity injuries at the New York City marathon. JAPMA, Vol 87, No 1, January 1997. 3. Ellis J: Between a sock and a hard place. Runners World, Vol 24, No 8, August 1989. 4. Feet first (care and treatment of foot ailments). Chemist & Druggist, Miller Freeman UK Ltd, November 25, 2000. 5. Knapik JJ, Reynolds K: Risk factors for blisters during road marching: Tobacco use, ethnicity, foot type, previous illness, and other factors. Military Medicine, Vol 164, February 1999. 6. Knapik JJ, Reynolds K, Barson J: Influence of an antiperspirant on foot blister incidence during cross-country hiking. J Am Acad Dermatol, Vol 41, No 4, October 1999. 7. Knapic JJ, Reynolds KL, Duplantis KL, Jones BH: Friction blisters. Pathophysiology, prevention, and treatment. Sports Med, Vol 20, No 3, September 1995. 8. Ramsey ML: Avoiding and treating blisters. The Physician and Sportsmedicine, Vol 25, No 12, December 1997. 9. Schwartz SEB: Avoiding the rub. Runners World, Vol 27, No 7, July 1992.

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