Blisters In PC, mutations cause the keratin filaments to form incorrectly, creating cell fragility. This results in painful blisters. Painful blisters are found under the calluses in PC patients.
This email from Dr. Sancy Leachman, MD, PhD was directed to the parent's question 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)
Tools or Medications
Topical care products
Patient Tips and Comments
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). 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.
- 3- On the blister apply celullase with mesmicin to prevent infection and help regimarating the skin.
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 Vaseline or Fucidin which contains Vaseline to keep the edges softer.
‘’’K17’’’ patient “I was getting blisters in this area constantly (heel)…and now thanks to Benzoin Tincture, I have no blisters and not even a sign of one forming. I treat my feet (hot spots), every morning with Benzoin Tincture as a preventive measure.”
K6a patient "I found a "bandage" that is PERFECT for blisters on the heel. It's called the Nexcare Opticlude Eye Patch. Obviously made for the eye, but absolutely superb for heel blisters. Nice sized padding in the center w/ think, flesh-colored tape all the way around the padding. The eye patch stays on all day even with the friction from the shoe. EXCELLENT product."
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