From the Guidelines
To treat a hand blister, it is recommended to leave small, intact blisters alone and for larger or painful blisters, gently cleanse the area with antimicrobial solution, pierce the blister at the base with a sterile needle, and apply a nonadherent dressing, as this approach improves healing, reduces pain, and minimizes the risk of infection 1. When managing hand blisters, it is essential to prioritize techniques that promote healing, minimize pain, and reduce the risk of infection. The approach should include:
- Gently cleansing the blister with an antimicrobial solution to prevent infection
- Piercing the blister at the base with a sterile needle to facilitate drainage, taking care to select a site where the fluid will drain out by gravity
- Applying gentle pressure with sterile gauze swabs to absorb fluid
- Avoiding the removal of the blister roof (deroofing) to prevent further irritation and potential infection
- Applying a nonadherent dressing to protect the blister and promote a moist environment conducive to healing
- Considering the application of topical antimicrobials for short periods if there are signs of infection, and using systemic antibiotics if there are local or systemic signs of infection
- Ensuring pain control through the use of analgesia, such as ibuprofen or acetaminophen, before and after blister care procedures Key considerations in blister management include the prevention of infection, which is crucial for reducing morbidity and mortality, especially in conditions like pemphigus vulgaris where infection can lead to significant complications 1. Regular monitoring for signs of infection, such as increasing redness, warmth, swelling, pus, or red streaks, is vital, and medical attention should be sought promptly if any of these signs are observed. Additionally, blisters caused by burns, chemical exposure, or those that appear infected from the start require immediate medical evaluation. By following these guidelines and prioritizing the most recent and highest quality evidence, healthcare providers can optimize the management of hand blisters, improving patient outcomes in terms of morbidity, mortality, and quality of life.
From the Research
Hand Blister Treatment
- Friction blisters are a common annoyance for active individuals, and small ones are usually self-limited and amenable to conservative treatment 2
- Larger blisters generally respond better when they are first aseptically drained, and proper care of the blister site will ward off infection 2
- To prevent the formation of friction blisters, properly fitted shoes, socks, and athletic equipment, together with the judicious use of lubricants, can be helpful 2
Infection Prevention and Treatment
- Infection is a possible complication of both spontaneous rupture and therapeutic draining of blisters, and optimal prevention and treatment of wound infection is crucial 3
- Topical antimicrobial agents can be used to prevent and treat wound infections, and antiseptic agents can be potential alternatives for the prevention and treatment of skin and soft tissue infections 3, 4
- A range of antiseptics, including chlorhexidine, triclosan, alcohol, and povidone-iodine, are used to prevent and treat skin and soft tissue infections 4