Causes of Blisters Between Toes
These blisters are formed by pressure from the toes themselves, and are also known as interdigital blisters. Common causes of blisters between the toes are:
Short big toe causes friction
If each toe joint doesn’t slot into the fleshy bit of the corresponding toes and joints then they rub on another joint, which if there is no flesh for the joint to nestle into, that increases the pressure on that area which increases the shear and blisters are formed, this is often recorded in people who have short big toes, If you look at your fingers they have the same formulae, the knuckles nestle into flesh rather than the joint.
Narrow footwear constricts toes
Pressure of the footwear in the toe box area, so if the shoes are not wide enough where the toes are situated then the toes will receive an increase of pressure which will in turn cause shear and blisters. At the end of the day or in the summer, when your feet are warmer they can increase by up to one full size in the shoes, which means you could be wearing a shoe that is essentially a size too small!
Prevention of Interdigital Blisters
Wear the correct size and fit of footwear
Draw around your foot on a piece of A4 paper, when standing, you will probably notice that one foot is slightly longer and wider than the other but that is normal. Then place your shoes over that template of the foot and see which bits of the drawn foot, stick out from under your shoe. These are the bits of the feet that are compromised by the shoe and cause the pressure within the space in between the toes.
Lock laces to prevent foot sliding forwards
Lace locking– it is important to lock your laces correctly to prevent the foot slipping forward into the toe box area and getting compression from the shoes(link to lace locking)
Wear toe sleeves
Silopos sleeves help reduce the pressure between toes but any more than two on the foot increases the bulk in the toe box of the shoe and increases the pressure for the other toes.
Use silicone wedges and toe separators
Silicone wedges custom made by a podiatrist to separate the shoes that are struggling with interdigital pressure.
Wear individual toe socks
Injinji socks – these are perfect for blisters in-between the toes, especially for people who struggle with multiple toe blisters. The socks absorb the friction and therefore reduces the shear and then the blister formation.
Apply cushioning between the toes
Alpacca wool – This wool is the softest of all the animal wool and has virtually no lanolin in it, making it suitable to those who have sensitivity to lanolin. Wrap it around the toes in a figure of eight fashion around all the toes if necessary. The wool needs to be taken out after the activity has finished and caution needs to be taken if the wool gets wet, as it will shrink like your woolly jumper! Do not use on an open sore or wound.
Taping can help but time needs to be taken to get the tape in the right position and without crease and bulk.
Treatment of Blisters Between Your Toes
What is a blister “hot spot”?
Hotspot – If you have recognised a hotspot on the skin in time before a blister has developed then a simple island dressing will be enough to reduce the shear on the skin and hence reduce the blister from forming further and if you have them, apply an engo patch on the insole as explained in the prevention of blisters. Deflective padding works really well here to reduce the pressure on the joints.
Treating Bubble blisters
Bubble Blister – If the roof is still on then treat it in a similar way to a hotspot on the skin, by applying a sterile island dressing, if the blister bursts (pops) when the dressing is on, then you know the dressing is already sterile and will prevent an infection from getting into the open sore. If you decide to pop the blister, then follow the instruction on “how to pop your blister” and treat it as a roof torn blister. Use an Engo patch applied to the insole with deflective padding applied to the feet.
Treating broken blisters
Roof torn blister – now this type needs its roof (skin) to stay in place, the roof may be broken but your own skin is still important for healing, so use a sterile saline swab to clean the wound first, then apply the povidone iodine stick over the torn area as an antibacterial action and apply a sterile island dressing. A deflective pressure relieving padding as shown in the video to prevent any further pressure and friction.
Treating “popped” blisters
Roof off blister – Hydrocolloid dressing is the only option for this stage of blister, swab the area with saline to make sure the wound is clean and dry before applying the hydrocolloid, add extra hyper fix tape to anchor it down and apply deflective padding if continuing an event or activity. Hydrocolloid dressings are great wound healers and Podiatrists have been using them for a long time in the management of ulcers, with great success. They are not used at any other stage of the blister treatment and can cause blisters if not applied at the correct stage. I like to use some fleecy foam padding over the dressing as it just gives a bit of cushioning to the blister area, which is always very painful.
Treating infected blisters
Infected blister this is the stage of blister that you need to recognise quickly, a bacterial infection has invaded the blister and it could look red, swollen, there may be yellow or green pus in the blister and it could smell? Extending into the skin around the blister might be red and hot with red lines tracking away from the blister. You may feel unwell in yourself and swing from having the chills or feeling quite feverish. This is the time to get medical help as the infection can easily travel into the blood stream causing the infection to move into the leg and cause sepsis.