Treatment of Blisters After Walking in Tall Grass
The most effective treatment for blisters caused by walking in tall grass includes cleaning the affected area, draining intact blisters while preserving the blister roof, applying topical antimicrobials, and covering with appropriate dressings. 1
Initial Assessment and Management
For Intact Blisters:
- Clean the blister area with an antimicrobial solution 2
- Pierce the blister at its base using a sterile needle with the bevel facing up 2
- Select a site where fluid will drain by gravity to prevent refilling
- Gently apply pressure with sterile gauze to facilitate drainage 2
- Do not remove the blister roof as it serves as a biological dressing 2, 3
- After drainage, cleanse again with antimicrobial solution 2
For Already Broken Blisters:
- Clean the area with antiseptic solution
- Leave remnants of blister roof in place if no signs of infection 3
- Remove remnants only if clinical signs of infection are present 3
Treatment Applications
Topical Treatments:
- Apply a bland emollient such as 50% white soft paraffin and 50% liquid paraffin to support barrier function 2
- For inflammation and itching, apply medium to high-potency topical corticosteroid (e.g., betamethasone valerate 0.1%) twice daily 1
- Consider bacitracin for small areas 1-3 times daily to prevent infection 4
Pain Management:
- Apply cold compresses intermittently for the first 24-48 hours to reduce swelling 1
- Consider over-the-counter pain relievers like acetaminophen or NSAIDs if needed 1
- For painful procedures, provide analgesia before beginning 2
Dressing Options:
- Apply a non-adherent dressing if necessary 2
- For painful areas, consider low-adhesion dressings such as Mepitel or Atrauman 1
- Plain petrolatum ointment with bandage works well for open areas 1
- Evidence suggests adhesive tape may be more effective than wide area fixation dressings for friction blisters 5
Prevention of Infection
- Daily washing with an antibacterial product can decrease colonization 2
- Monitor for signs of infection (increasing erythema, warmth, purulence, or fever) 1
- If infection is suspected, consider oral antibiotics (e.g., cephalexin) 1
Additional Considerations
For Severe Itching:
- Consider oral antihistamines (e.g., cetirizine 10mg daily) 1
Special Situations:
- If blisters are associated with tick exposure, be vigilant for signs of tick-borne diseases 2
- Avoid using alcohol-containing products on damaged skin as they can cause further irritation 1
Follow-up Care
- Document the size and appearance of lesions to track healing progress 1
- Monitor for complete healing, which typically occurs within 1-2 weeks
- Be aware that prolonged use of high-potency topical corticosteroids can cause skin atrophy 1
Prevention for Future Walks
- Wear protective clothing, including long-sleeved shirts and pants when walking in tall grass 2
- Consider applying DEET-containing repellents (10-35% concentration) on exposed skin if in tick-infested areas 2
- Wear light-colored clothing to easily spot crawling ticks 2
- Inspect skin frequently after walking in tall grass 2