I recently treated a twenty-year old female patient who went to Las Vegas and spent an evening in ill-fitting heels. She developed a series of blisters that covered all her toes on both feet, and she was suffering from extreme pain as she hobbled into our office. The blisters had become infected and she developed aggressive red streaks going up her leg, which is cellulitis (blood poisoning) and a medical emergency.
Hundreds of years ago, before the discovery of antibiotics, she would have probably developed wet gangrene and most likely would have been dead within the next twenty-four hours!
Luckily, things are quite different nowadays. Our treatment consisted of lancing the blisters, performing wound care to the remaining open ulcers, applying bandages and placing her in surgical shoes and prescribing oral antibiotics. She left our office much more comfortable and was healing within a week.
Blisters are one of the most common foot problems that people experience. A blister is a pocket of fluid in the skin, which develops because of shear stresses on high-stress areas of the foot. These stresses are caused by either the ‘structural abnormalities’ of the foot (i.e. bunions, hammertoes) or because of ‘biomechanical dysfunction’ as you walk or run (i.e. hyper-pronation or supination). The fluid within a blister can be serum, plasma, blood or pus.
The best treatment for blisters is to prevent them from happening in the first place. The best way is to make sure you wear properly-fitted, high-quality shoes and excellent socks. Surprisingly, research shows that the best known treatments – such as petroleum jelly, skin powders and moleskin – can actually make blisters worse. The military has done extensive studies on the prevention of blisters and their studies show that, although these topical treatments can often help prevent blisters in the first hour of activities, they actually do more harm than good after one hour of activities.
I recommend shopping for shoes after 2 p.m. when your feet are more swollen, and be sure to ask the salesperson to measure your feet to make sure you are getting the proper size. I also recommend wearing sports socks made of man-made materials rather than cotton socks. Man-made fabrics are made with special fibers that decrease friction, which aid in decreasing the chance of corns, calluses and blisters. You can also wear two pairs of thin sports socks, which can be highly effective in preventing blisters. Since abnormal biomechanics can cause blisters, I recommend either a custom-molded orthotic that you can get through your Podiatrist or an excellent over-the-counter insert. These will help biomechanically control your foot during your activities, which will prevent abnormal stresses that lead to blisters.