Treatment for Hand Blisters from Repetitive Paddling
For hand blisters caused by repetitive paddling, moisturizing creams are recommended rather than Thrombophob, Burnol, or Plaster Belladona, as these products are not indicated for friction blisters. 1
Understanding Friction Blisters
- Friction blisters result from mechanical separation of epidermal cells due to repetitive frictional forces, commonly occurring in active populations like paddlers 2
- Blisters form when hydrostatic pressure fills the separated area with fluid similar to plasma but with lower protein content 2
- Blisters are more likely to develop in areas with thick horny layers tightly held to underlying structures, such as palms of hands 2
Recommended Treatment Approach
Immediate Care
- If the blister is intact, consider draining it while maintaining the blister roof to reduce discomfort and infection risk 2
- For deroofed blisters, hydrocolloid dressings can provide pain relief and allow continued physical activity 2
- 2-octyl cyanoacrylate (medical adhesive) applied directly to the wound bed can be effective for hand blisters, creating a barrier while allowing epithelialization 3
Moisturization and Skin Care
- Apply moisturizer immediately after washing hands using two fingertip units of moisturizer for adequate coverage 1
- Choose moisturizers in tubes rather than jars to prevent contamination 4, 1
- For severe dryness, use "soak and smear" technique: soak hands in plain water for 20 minutes followed by immediate moisturizer application nightly for up to 2 weeks 4
Addressing Inflammation
- For inflamed blisters, a topical steroid may be applied to reduce inflammation 1
- Avoid using products containing topical antibiotics (e.g., neomycin, bacitracin) as they can cause allergic contact dermatitis 4
Why Not Use the Suggested Products
- Thrombophob (anticoagulant): Not indicated for friction blisters as these are not caused by blood clots but by mechanical separation of skin layers 2
- Burnol (topical analgesic): While it may provide temporary pain relief, it's primarily designed for burns and may not address the underlying issue of friction blisters 1
- Plaster Belladona (anticholinergic): Not recommended for friction blisters as anticholinergics are not indicated for this condition and may cause unwanted side effects 1
Prevention Strategies
- Consider wearing appropriate gloves or using padding on equipment handles to reduce friction 5
- Gradual conditioning of hands at the beginning of paddling season can help develop protective calluses 5
- Keep hands in moderate moisture conditions - very dry or very wet skin can affect friction levels 2
- Adhesive tape has shown better effectiveness for blister treatment compared to wide area fixation dressings 6
When to Seek Medical Attention
- If blisters become infected (though this is rare among athletes) 5
- For recalcitrant cases that don't improve with basic care 1
- If there is significant pain that limits normal activities 3
Remember that most friction blisters will heal within 1-2 weeks with proper care, as new stratum granulosum forms at 48 hours and new stratum corneum at 120 hours after blister formation 2.