They are painful and annoying: blisters on the feet can make a hike or party night pure agony. However, if you know the causes, you can avoid the development of blisters on your feet.
What are blisters on the feet?
Blisters on the feet are small elevations of the skin that are filled with fluid. Depending on the thickness, blood flow, and moisture level of the affected skin area, they may appear pale or be very red. Blisters on the feet occur preferably in places that are exposed to strong friction and are insufficiently protected by a natural horny layer. The heels, toes or balls of the feet are often affected: The skin layers separate from each other, cavities develop between them, which fill with tissue water. A special form is the blood blister, a superficial bruise caused by impact injuries. Because the nerve cells of the dermis extend into the epidermis, blisters on the feet can be extremely painful.
Causes
The main cause of blisters on the feet is shoes that are too tight or ill-fitting. Poor workmanship of the material can also promote chafing. The formation of blisters on the feet is accelerated by a warm and humid climate in the shoe, which causes the skin to swell and makes it soft and sensitive. In some cases, too thorough pedicure also contributes to the development of blisters on the feet: If you file off the callus in the heel area too much, you lose a natural protection against blisters on your feet. In individual cases, however, it can also be a cornea that is too thick, which leads to the formation of blisters on the feet: If the corneal layer becomes brittle, it lifts off the dermis under stress and a blister develops.
Symptoms, complaints and signs
Blisters on the feet usually occur in three different forms. Thus, a distinction can be made between the water-filled blister, the blood-filled blister and the open blister. When blisters develop, this can already be noticed in the early stages by the typical pressure or friction pain that occurs. Visual inspection in the early stage usually already shows a reddened skin area. To prevent the blister from spreading, the pressure trigger – usually a shoe that is too tight or a crease in the sock – should be removed. In the advanced stage, the blister usually fills with water first. It then shows up as a clearly visible, soft bulge. The pain of pressure and friction now increases and is often felt to be unbearable. The affected person now usually tries to prevent the pressure on the bladder by adopting a protective posture while walking. If deeper layers are affected, blood can now also mix into the bladder fluid, so that the bladder appears visually blood-filled. This form of blisters are not more painful than water-filled blisters. If friction and pressure are not avoided, the blister continues to fill with fluid until the thin skin on its surface bursts open and water and blood drain away. The underlying tissue is now open as in a wound. The wound pain is felt as a strong burning sensation.
Diagnosis and course
The diagnosis of blisters on the feet is ideally made by the affected person at a very early stage, namely when a painful redness on the foot indicates that a blister is in the process of forming. Immediate and consistent treatment can sometimes prevent the worst. If you ignore a painful burning sensation on your foot for too long and wait until the blisters on your feet are fully formed, you can only wait for the healing process. This takes a few days and begins with the blisters on the feet bursting and the fluid coming out. The dead epidermis dries up and peels off. A wound becomes visible underneath before new skin forms. The healing process is usually uncomplicated, but diabetics should consult a doctor about blisters on their feet as a precaution.
Complications
Blisters on the feet usually result in pain and redness of the skin in the affected region. In case of an unfavorable course, further complications may occur. For example, pus blisters may form from the water blisters, increasing the risk of infection and the formation of larger cysts. If mentioned pus blisters are inadequately or improperly treated, fistulas and abscesses may develop. If the blisters break open inward, organ abscesses and severe bacterial infections may also occur, and in rare cases, life-threatening blood poisoning.Blisters on the feet also often lead to malpositions, which do not always recede completely after the symptoms have subsided. The malpositions can also cause further blisters and skin injuries to form. If not treated properly, the tissue can also scar, often accompanied by sensory disturbances and phantom pain. In addition, unhygienic handling of the blisters in particular leads to complications, as pathogens can penetrate the abscess in this case. Further complications: Secondary bleeding after opening the bladder, pain on movement and the development of fistula tracts and scar tissue. Most complications can be reliably prevented by early and professional treatment by the general practitioner.
When should you go to the doctor?
If blisters are on the feet, a trip to the doctor is not necessary in most cases. If the blister is properly cared for, it will regress on its own after some time and will not require follow-up care. However, there are a few situations that may require a visit to the doctor. If the blister becomes an open sore on the foot, a doctor should be visited, especially if it is unclear whether a tetanus vaccination is still active. The primary care physician will suffice as a point of contact. Also, if a blister turns into inflammation (often due to improper care of the blister or continued extra stress on the broken skin), medical intervention should be sought. Finally, inflammation between the layers of skin in the foot area can take a severe course. The hygiene and care possibilities are, especially on the sole of the foot and between the toes, worse than elsewhere on the skin. Accordingly, an inflamed wound requires the attention of a dermatologist or general practitioner. Even if the blister does not show any negative development, but does not recede, a doctor should be consulted. In most cases, the blister on the foot only needs to be properly cared for so that it can regress.
Treatment and therapy
Treatment of blisters on the feet should begin as soon as the first redness appears: A pack of blister plasters belongs in every hiking backpack. A modern blister plaster forms a protective cushion over the endangered area and relieves the irritated skin. It’s best to change your socks, too, to reduce skin moisture. Hikers should also make sure the foot is free of sand grains. If blisters on the feet are already fully formed, then they should be opened to relieve pressure. A needle and disinfectant will suffice for this purpose. Once the tissue fluid has drained from the blisters on the feet, they should be carefully closed with blister plasters to prevent infection. If the hike is to be continued afterwards, the plaster must be applied without wrinkles, otherwise new pressure points will form, leading to further blisters on the feet. If blisters on the feet are already several days old, they become dry and cracked and can be treated with some zinc ointment.
Outlook and prognosis
With blisters on the feet, sufferers have a very good chance of recovery. Depending on their size, the blisters can be opened by themselves or by medical help. It is important that they are opened sterilely and consequently there is no contamination of the open wound. After the blister is opened, it heals in the next few days. Within a week, the blister should normally be completely and permanently healed. If the blister is not opened, complete healing also occurs. The period until the patient is free of symptoms is in most cases within the next ten days. In exceptional cases the organism needs two weeks. The fluid in the bladder is removed by the body itself and it slowly dries up. If the bladder bursts, there is the greatest risk of infection. If there is contamination, pus can develop due to an inflammatory process. The inflammation should be treated by a doctor in order not to cause further complications. Within the next one to two weeks, the affected area is normally healed. If the blisters develop due to wearing tight or unhealthy footwear, the symptoms will recur. To prevent the blisters from forming again, the shoes should be changed. Alternatively, the feet can be protected by wearing hosiery.
Prevention
The best prevention against blisters on the feet is to choose high-quality shoes and break them in well before a long hike.Even on short walks, redness shows which areas could be at risk from blisters on the feet. High-quality cotton socks protect the foot from moisture, while coarse wool socks can quickly lead to blisters on the feet. If you want to avoid blisters on your feet for sure, you should use blister plasters as a preventive measure.
Aftercare
Blisters on the feet do not require aftercare if they are only superficial. A few days of rest and footwear that does not chafe, and everything heals well. The situation is different, however, if several layers of skin are affected by the blister. Here it can take up to ten days for the blister to heal completely. Aftercare must consist of avoiding further blister formation at the same site and protecting the new skin with padding. Aftercare and precautionary measures against further blisters are congruent here. Moreover, blisters on the feet of diabetic neuropathy are a dangerous thing. Blisters on the feet of diabetics require not only prompt and adequate treatment, but also expert follow-up care. Any untreated injury to a foot affected by diabetic neuropathy or otherwise related circulatory problems can result in amputation or even death. Therefore, follow-up care is of particular importance here. Blisters on the feet are usually harmless in nature. Blisters require follow-up care whenever they heal poorly, become infected or occur in a diabetic. In addition, burn blisters or blisters that occur after frostbite also require treatment and follow-up care on the feet. However, such blisters are likely to be rare on the feet.
What you can do yourself
Under no circumstances should small blisters be opened. The blister roof consists of intact skin and offers the best protection against infection. A padded band-aid provides protection and relieves pressure. Larger superficial blisters that are under tension can be pricked. For this, the needle must be thoroughly disinfected with alcohol. Otherwise, the blister may become inflamed. Then the fluid must drain and dry the skin. Finally, cover with a plaster that extends beyond the blister. Before that, the opened blister can be disinfected to be on the safe side. Because air promotes the healing process, the plaster can be removed for the night. It is important never to cut the skin over a blister because this can cause inflammation. Some medical professionals also advise that tetanus protection be checked and, if necessary, refreshed. Homeopathy recommends a homeopathic mixture (porridge) of Ferrum phosphoricum No.3 20 and Natrium chloratum No.8 30, which speeds healing. Others prefer Cantharis as a single dose in a high potency, which must be prescribed by a doctor. In the potency D12 Cantharis is available over the counter. In this case, it should only be taken until the blister has healed. Then stop immediately. Also a foot bath in Kaisernatron (no other sodium bicarbonate) helps. Afterwards rub the feet with olive oil. Diabetics and those who already suffer from diabetic foot should rather consult a doctor directly as a precaution, otherwise complications may arise.
