How to deal with blisters
K6a patient "My daughter has had thick callouses that we have managed to shave down with a callous remover and she does not really complain that it hurts. However, recently, she developed a blister on the bottom of her foot on top of a creased area. She has complained that it hurts but limits her complaining because of her fear of me touching it to do something about it. It's right smack on the bottom of her foot and I see her limping sometimes. In my past experience, early on, when she had other blisters I would pop them with a pin and let them dry out. In this case, she won't let me near it because it hurts and no way she will let me pop it. Any recommendations as to what I should do?
This email from Dr. Sancy Leachman, MD, PhD was directed to the parent's question above in helping a young child with a painful blister, but it has good information for all ages on blister care. "Relieving the pressure of the blister (i.e. letting the fluid out) while leaving the roof of the blister intact to help with healing will reduce the pain significantly. You can begin to train children at a fairly early age (4 to 6 years) to do the popping. Remember to always use a clean/sterile needle or clipper. Each child is different and as a parent you will know best whether the child is ready to learn to do this. I think you will find the child trusts their own ability with the needle more than trusting you to make the cut. Sometimes you need to open a little window in the blister in order for the fluid to keep draining - otherwise with just a pin, it closes back up again.
The roof of the blister is not innervated - it doesn't have any living nerves in it. The nerves are in the skin below -- that is what is so tender -- so poking a hole in the blister shouldn't hurt too much. A child won't believe you without testing it. The other thing that might help is to soak the blister before pricking or cutting it to soften it - the downside of that is that if it doesn't get drained, it might make it more painful and more swollen. You can always visit a dermatologist or pediatrician who will restrain the child, but frankly, I think that is probably more traumatic and would not be worth the pain relief. The major thing to watch for when a blister is really tender is to assure that there is no element of infection. If a red streak is coming out from it, if fever, chills start, or if the child starts acting irritable, you need to see a doctor quickly because it suggests that the infection has spread into the system and can be quite serious. I hope this is helpful." May 2009
PCers Techniques for dealing with blisters
K6a patient "Blisters (appear on every travel, christmas period which coincides with summer in chile, etc)
1-Puncture the blister with a needle and thread. Leave the thread to allow draining for hours.
2-Soak the feet in a solution with permanganate of potassium. Will leave the skin black*, specially the blisters, but will help to dry them in one day. (one time is enough)
3-On the blister apply celullase with mesmicin to prevent infection and help regimarating the skin.
- If you don't want to have your feet black, you can replace the permanganate with marine salt and you should repeat the soaking for several days.
K16 patient "This is how we treat blisters:
1-Wash the area with soap and water if it's very dirty (like it often is with kids)
2-Spray a disinfectant (Septidin, the spray in the picture) on the blister area and clean the needle with the same spray.
3-Pop the blister. Sometimes nothing comes out and it's necessary to wait a day or two for the blister to get bigger and the skin covering it thinner. Sometimes it's also necessary to pop the blister in several locations, because there are "compartments" in the blister and all the liquid does not come out from one single hole. You can see the liquid coming out in one of the pictures, I think.
4-Place a clean cotton pad on the area and ask the child to press it to get more of the liquid out. She knows best how much pressure she can handle.
5-Spray with disinfectant again.
6-Add Bacibact powder (pic) if the area is too tender to touch, or Fucidin cream (pic) with clean fingers if the area can be touched.The powder lets the fluid to come out better but does not stay in place for very long.
7-Don't let her walk without a clean sock on the foot until the blister is closed.We do this in the evening so she can sleep barefoot and the blister can have air to dry out better.
8-Repeat cleaning with Septidin and putting something on the area until the area is better.
9-If the area around the blister is red, warm and swollen, we go to the doctor to ask if we need antibiotics. Sometimes the Fucidin cream is all we need.
10-After the blister has popped and nice pink skin appears from under it, the crust that has covered the blister can be very hard. We use clippers to remove some of it (or she does it with her teeth if we're not there to see it), and, if necessary, use vaselin or Fucidin which contains vaselin to keep the edges softer.