Management of Hand Blisters from Repetitive Paddling
For hand blisters from repetitive paddling, drain the blisters by piercing them with a sterile needle while preserving the blister roof, apply emollient, and use non-adherent dressings to promote healing while preventing infection. 1
Initial Assessment and Blister Management
- Blisters at the junction of fingers and palm are friction blisters resulting from repetitive paddling movements, which mechanically separate epidermal cells at the level of the stratum spinosum 2
- Large blisters should be drained while preserving the blister roof as a biological dressing to prevent secondary infection and reduce pain 1, 3
- Follow this drainage procedure:
- Cleanse the blister with an antimicrobial solution before drainage 1, 3
- Pierce the blister at its base with a sterile needle (bevel facing up) 3, 1
- Select a drainage site that allows fluid to drain with gravity 3
- Apply gentle pressure with sterile gauze to facilitate drainage 3
- Do not remove the blister roof (de-roofing) 3, 1
- Cleanse again with antimicrobial solution after drainage 3
Wound Care and Pain Management
- Apply a bland emollient such as 50% white soft paraffin and 50% liquid paraffin to support barrier function and encourage re-epithelialization 3
- Cover with a non-adherent dressing if needed 3, 1
- Secure dressings with gauze bandages rather than adhesive tape to prevent further skin trauma 3
- Provide appropriate pain management before and during blister care 3
- Daily washing with an antibacterial product can decrease bacterial colonization and prevent infection 3
Prevention of Further Injury
- Temporarily modify paddling technique or use padding to reduce friction on affected areas 2
- Consider using specialized gloves designed for water sports that reduce friction 4
- Allow adequate rest periods to promote healing and prevent worsening of existing blisters 4
Monitoring and Follow-up
- Monitor for signs of infection including increased pain, redness extending beyond the blister area, warmth, swelling, or purulent drainage 3
- Document the number and location of blisters to track healing progress 3
- Systemic antibiotics should only be used if there are local or systemic signs of infection 3, 5
What a Doctor Would Recommend
- A doctor would diagnose these as friction blisters and would focus on both treatment and prevention 2, 4
- They would emphasize the importance of proper blister drainage technique while maintaining the blister roof as a protective barrier 1, 2
- For severe cases or those showing signs of infection, they might prescribe topical antimicrobials for short periods 3, 5
- They would advise against using topical capsaicin on open blisters as it is contraindicated for use on wounds or damaged skin 6
- For recurrent blisters, they might recommend gradual skin adaptation through controlled exposure to friction to develop calluses, which can reduce future blister formation 2
Common Pitfalls to Avoid
- Avoid removing the blister roof (de-roofing) as this increases infection risk and delays healing 3, 2
- Do not apply heat to the affected area as this can worsen inflammation 6
- Avoid tight wrapping or bandaging of the treated area 6
- Do not continue paddling without addressing blisters, as this can lead to deeper tissue damage, infection, or impaired performance 4