Blisters

Blisters under the feet.

Blisters happen from time to time. Whether they form on the hands from hard work; on the feet from shoes; or just going barefoot, they’re an aggravation. Potentially, they are a gateway to more serious conditions, if left untreated. Here’s how foot blisters happen, and can be prevented.

Symptoms

Characterised by pockets of fluid, blisters form in the outer layers of skin. Usually raised above the skin, in cases of deeper ones, they may penetrate downward, and not appear above the skin. While most are filled with clear fluid, there may be blood, if they occur in deeper layers of skin, or inflammation is present. If infection occurs, they may also be pus filled. Depending on the cause or location, blistering may be accompanied by pain, redness, or itching.

Causes

Generally, when the outer layer of skin is subjected to repeated contact friction or shear forces, a blister typically results. The friction or shear forces cause tears in the second and third layers of the skin, and pressure forces fluid into the open spaces. Fluid fills up the open spaces in the deeper layers of the skin, while the top layer remains intact. In situations where blood vessels in the skin also break, blood drains, along with the fluid.

Blisters on the feet emanate from repetitive stress to exposed areas, particularly those that protrude or are raised, and on normal weight-bearing areas (pressure points). The main culprit is an improperly fitted shoe or boot. Sometimes the design (for example), a too narrow toe box; a too wide heel; raised seams in the shoe or boot lining, even when shoes/boots are properly fitted, are all factors that put the wearers at risk. Blistering is more frequent and more severe when the feet get wet; the skin softens, making it much more vulnerable to friction and shear forces. Areas prone to blisters are:

• the sides of the big toe and the fifth (baby) toe, when the toe box of the shoes or boots “squeeze” the forefoot;

• the tops and tips of the toes in situations such as hammer toes, where the feet or toes have changed shape due to other issues;

• the tops of the toes, often from raised seams in socks;

• the sides and back of the heels, when the heel area of the shoe or boot rubs and causes friction.

Prevention and Treatment

As a preventive strategy, it is suggested you wear properly selected and fitted shoes, as part of an integrated approach; padded socks with shoes with non-slip outsoles; and any inserts or orthotics prescribed or recommended by a doctor or podiatrist. Wearing padded socks can help protect against injuries to the skin/soft tissue of the foot, including blisters. Consider using bandages or protective coverings proactively for blister prone areas. Moleskin or other adhesive bandages are effective. Make sure they are applied securely.

Consider using powder or petroleum jelly to help lubricate and reduce friction and shear.

Don’t wait until a blister has fully developed to treat it. If you feel discomfort or pain from friction and shear, stop your activity and cover any “hot spots” with bandages or adhesive coverings, as a prevention measure.

On developing a blister, it is best to treat it immediately. Cover it carefully with a bandage, and re-tie or lace footwear to minimise friction and shear. In most cases, it’s best not to pop it.

Medical Considerations

Infection is a danger if the blister breaks, or if you deliberately break the skin. Although puncturing the skin is not recommended, there are some exceptions. If the skin does break, use antibiotic ointment to help prevent infection.

People with diabetes and / or neuropathy should never attempt to puncture or break blisters, but should see a health professional such as a doctor, podiatrist or dermatologist.

Over the longer term, blisters can cause changes in your walking or running gait, that can lead to more serious muscle, tendon, ligament and joint problems. Rarely they can be a symptom of more serious conditions that may be hereditary, or a hypersensitive reaction to infections or drugs.

Allergic reactions can also cause blisters that are accompanied by inflammation, redness and itching. Visit your doctor or podiatrist if you have soreness, pain, redness, swelling or other indications of foot problems that persist for more than a few days.

Your feet mirror your general health . . . cherish them!

Leana Huntley is a UK trained Podiatrist attached to Almawi Limited The Holistic Clinic, and Clinical Director-Fit Feet, Special Olympics Trindad and Tobago. E-mail info@almawiclinic.com or visit the website at www.almawiclinic.com.

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