From the Guidelines
To manage blisters, leave small intact blisters alone, but for large or painful blisters, gently pierce the edge with a sterile needle to drain fluid while keeping the skin intact, as recommended by the most recent guidelines 1. The goal is to prevent infection and promote healing. Key steps include:
- Cleaning the area with soap and water
- Sterilizing a needle with alcohol
- Gently piercing the edge of the blister to drain fluid
- Applying an antibiotic ointment
- Covering with a sterile bandage
- Changing the dressing daily
- Monitoring for signs of infection
It's also important to note that the detached, lesional epidermis may be left in situ to act as a biological dressing, and blisters should be decompressed by piercing and expression or aspiration of tissue fluid, as suggested by 1. Additionally, applying a greasy emollient and using nonadherent dressings can help with skin management, as recommended by 1. However, the most recent and highest quality study, 1, provides the most relevant guidance on blister management. Overall, the key is to prioritize preventing infection and promoting healing, while also being mindful of the specific needs of each individual case. For example, patients with certain conditions, such as diabetes or compromised immunity, may require special consideration and medical attention. By following these guidelines and taking a careful and nuanced approach, it's possible to effectively manage blisters and promote healing.
From the FDA Drug Label
Directions adults and children 2 years of age and older: clean the affected area apply a small amount of this product (an amount equal to the surface area of the tip of a finger) on the area 1 to 3 times daily may be covered with a sterile bandage The FDA drug label does not answer the question.
From the Research
Blister Management Overview
- Blister management is crucial to prevent infection and promote healing, as stated in 2.
- Proper care of the blister site is essential to ward off infection, which can be a complication of both spontaneous rupture and therapeutic draining 2.
Prevention of Friction Blisters
- Properly fitted shoes, socks, and athletic equipment can help prevent the formation of friction blisters 2.
- The judicious use of lubricants can also help prevent friction blisters 2.
Treatment of Blisters
- For friction blisters, larger ones generally respond better when they are first aseptically drained, while small ones are usually self-limited and amenable to conservative treatment 2.
- For burn blisters, debriding blisters larger than the patient's little fingernail while leaving smaller ones intact is generally agreed to be the best option 3.
- For fracture blisters, awareness of their pathophysiology and management options is crucial for orthopaedic surgeons to achieve a favorable clinical outcome 4.
Considerations for Blister Management
- The risk of infection is a consideration in blister management, and proper care of the blister site can help mitigate this risk 2, 3.
- Healing outcomes, discomfort, and costs are also factors to consider when deciding on a treatment approach for blisters 3.
- External factors, such as the size of the blister and the patient's overall health, can influence the choice of treatment approach 3.