What causes blisters on top of the foot?
These blisters are always caused by footwear, either being too tight or too loose, the skin is more fragile on the top of the foot and will easily blister and get to the roof torn stage quicker than other areas. It is important to recognise when a hotspot appears and treat immediately to stop this hotspot progressing.
Footwear that is too tight on the top of the foot exerting pressure on the skin increasing the shear and causing blisters, or a shoe that is too loose creating too much movement of the foot in the shoe.
Lacing that has been pulled too tight which then causes an increase of pressure on the skin beneath. If you have been active for a long day the foot can become swollen with fluid and the shoe can become tighter
High arched foot- people who have a very high arched foot have problems with the pressure from the top of the shoe as it is a struggle to find shoes that are accommodating in that amount of depth.
Preventing blisters on top of the foot
Lace locking helps stop the foot moving in the shoe too much therefore decreasing the repetition of actions of friction on the top of the foot. Lacing technique can help reduce the tension in the laces, decreasing the pressure on the skin from the top of the shoes.
Footwear material- the type of material used in the shoemaking maybe too hard, as a softer breathable material will be more forgiving and create less pressure on the skin.
Engo Patches– put on the underside of the top of the shoe, these will decrease the friction to the skin
Armaskin liner socks– are great at reducing the friction to this area.
2toms Blistershield powder is another solution to reducing the friction to this area, apply only to that area of the skin
2Toms Sportshield – is a liquid version of the powder , which also decreases the friction to this delicate area of skin
Hypafix Tape and KT pro tape are both very effective tapes used as a blister prevention regime, for extra staying power use skin tac on the skin as preparation before the tape and then apply 2toms Blistershield powder to the edges of the tape to prevent the edges rolling.
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. Use deflective pressure relieving padding as shown in the link 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.