Foot Blister Prevention: What You Can Recommend To Athletes
Minimizing moisture on the feet by using drying agents is another way to reduce blister formation. In a double-blind study conducted at the U.S. Military Academy, cadets who used the prescription antiperspirant Drysol (Person & Covey, Inc.) for at least three nights before a 21km hike had a 21 percent incidence of foot blisters, as compared to 48 percent for the placebo group. Drying foot powders, such as Zeasorb (Stiefel Laboratories, Inc.), and antiperspirant sprays (that contain aluminum chlorhydrate or aluminum chloride) are inexpensive ways to decrease moisture. Other Preventive Approaches Toughening the skin is another method of avoiding blister formation. Conditioning the skin by gradually increasing activity tends to lead to the formation of protective calluses rather than blisters. Applying multiple coats of tincture of benzoin to sensitive areas or soaking feet in strongly brewed tea (tannic acid) are commonly used skin toughening procedures. Protecting or “shielding” areas of the foot with a high potential for blister formation is an excellent preventive approach. Some of these susceptible areas include bony prominences such as: The dorsum of hammertoes; medial prominence areas of bunions and tailor’s bunions; the posterior heel; and the middle of the arch, especially when the athlete is using orthoses. Products such as Band-Aid Blister Block (Johnson & Johnson, Skillman, N.J.) and Dr. Scholl’s Cushion Blister Treatment (Schering-Plough Healthcare Products) are self-adhesive, silicone-like pads that act as an extra layer of skin to absorb friction. They are available in various sizes. If athletes apply them properly, these pads can stay on the skin for several days, even through showers. Cut slightly larger than areas of intense friction or sensitive skin, moleskin provides another inexpensive method of preventing blister formation. Liquid adhesives, such as Mastisol (Ferndale Laboratories, Inc.), promote adherence of moleskin to the foot. Alternatives to moleskin are the “liquid” bandages such as New Skin (Medtech Laboratories, Inc.), which dries to form a tough protective covering on the skin. Athletes may also consider using lambswool, commonly used by dancers, between the toes in order to prevent and/or soothe blisters. 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.