Blood blisters are something every athlete should know how to treat. Whether on the heel, forefoot, or under a toenail, these ornery blisters require special attention.
There are two schools of thought about blood blisters.
The Conservative Treatment
The conservative treatment is to not drain a blister when it is blood-filled. Doing so creates the risk of a serious infection as bacteria is easily introduced into the dermis layer of skin and into the blood system. Pad around the blister with moleskin or adhesive felt. As the blister heals, the blood will turn from bright red to a reddish-brown.
When to Drain A Blood Blister
There are times when it is appropriate or necessary to drain a blood blister. Here are a few occasions:
- If it is in a pressure point where it is likely to pop on its own.
- If it will likely pop on its own if you continue on in a race.
- If you can have it attended to by a medical team.
In these instances, clean around the blister with an alcohol wipe and lance the blister with a sterilized pin, scissors, or scalpel. After expelling the blood, apply a layer of antibiotic ointment, and then cover with tape or a blister patch.
Watch for Infection
Recheck all blisters daily for signs of infection. An infected blister may be both seen and felt. An infection will be indicated by any of the following: redness, swelling, red streaks up the limb, pain, fever, and pus. Treat the blister as a wound. Clean it frequently and apply an antibiotic ointment. Frequent warm water or Epsom salt soaks can also help the healing process. Stay off the foot as much as possible and elevate it above the level of your heart. If the infection does not seem to subside over 24 to 48 hours, see a doctor.
Studies have shown that StaphAseptic (www.staphaseptic.com) kills over 99.9% of staph and MRSA germs, preventing an infection without antibiotics. This new pain-relieving wound treatment should be used as part of a complete staph prevention program to provide protection from skin infections. An alternative ointment is Bacitracin. A prescription ointment is Bactroban.
Cloudy or Hazy Blisters
Do not drain the blister if the fluid inside appears to be either cloudy or hazy. Normal blister fluid is clear and the change indicates that an infection has set in. If clear, the fluid can be drained, an antibiotic ointment applied, and a protective covering applied. Recheck the blister three times a day for signs of the infection. Each time you check, apply a new coating of antibiotic ointment and change the dressing. Early treatment can keep the infection from becoming more serious.
Open Blisters
Once a blister is open, using soap and water, and an antibiotic ointment or Betadine is important for avoiding infection. Though you may not use these on an open blister during a run or in the middle of the day while backpacking, at the end of the event or day, take the necessary time to properly treat the open skin. Applying an antibacterial topical ointment will help the open blister heal up to 40% faster. Check your local drugstore for a broad-spectrum antibiotic ointment like Neosporin or Polysporin that provides protection against both gram-positive and gram-negative pathogens. Brave Soldier Antiseptic Healing Ointment is an excellent all-purpose salve to have on hand for blister care.
