Friction blisters create localized discomfort, but they should not be taken lightly because secondary impetigo may become a serious complication, with resulting cellulitis and sepsis.
Poorly fitting shoes are the most common cause. Heat, sweating, and maceration of the skin may predispose to friction blister formation. Moisture on the skin surface may either increase the friction force or, in the case of very moist skin, decrease it temporarily by providing lubrication. Lubricating agents also tend to reduce the friction force temporarily at the onset; however, friction tends to increase with prolonged application of the external force.
Friction blisters tend to occur in areas of thick adherent stratum corneum (eg, palms, soles, heels, dorsa of fingers). In regions of the body where the stratum corneum is thinner, a repeated friction force causes the stratum corneum to erode, and instead of a blister, an erosion or abrasion occurs. Children reporting a blister on the heel often present with poorly fitting shoes.
Management of friction blisters includes sterile drainage of the site while leaving the blister roof intact to serve as a dressing. This method helps relieve some discomfort and protects the site from superinfection. A donut of moleskin may also be applied to minimize additional trauma to the blister and to relieve discomfort. If the blister roof is already fully or partially removed, treat the site as an open wound with appropriate antiseptic and surgical bandage application.
A study comparing two different regimens, wide-area fixation dressing vs adhesive tape, evaluated 907 participants in Holland (aged 45 ± 16 years, 52% men) who received 4131 blister treatments. Owing to diminished effectiveness and satisfaction, use of wide-area fixation dressing was not favored over adhesive tape for routine first-aid treatment for friction blisters.
Paper tape has not been found to be particularly protective against blisters in marathoners, although this intervention was well tolerated and had high user satisfaction.
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Cite this: Richard H. Sinert. Fast Five Quiz: Annoying Medical Conditions - Medscape - Apr 25, 2022.