Should you pop a blister?

Question

When I'm home running or on a day hike, I prefer to pierce the skin as soon as a blister forms and drain all fluid from a blister to reduce the pain and further irritation/inflammation. In this case, I know I can get antibacterials and a thorough wash to ward off infection as well as stronger measures if the blister does become infected.

Of course hiking with a tube of neosporin and some tape, moleskin, whatever you prefer is ideal, but I'm wondering what people feel is best for blister care when you are going to keep walking for a few days or more when you discover a nice blister has already formed.

Is there guidance on "pop it now" versus "let it pop itself" for friction blisters?

Answer 1

There's a lot of dubious assertions in the answers here, and frankly some bad advice regarding how long to wait before treating a blister. We just had a lecture on blister management in my WFR class yesterday, so I'll give this a go.

The answer to "should I deflate this blister" comes down to a very simple question: Will it pop itself if I don't? Any blister on the foot is likely going to pop itself if you don't. Blisters in other locations (typically the hands) may be less likely to.

• It's always preferable to deflate a blister under (relatively) clean and controlled conditions, rather than let it pop itself.
• A blister that pops itself is more likely to get infected, and more likely to spread pus around and infect other areas.
• An untreated blister or hotspot will grow larger.

It's important to understand why blisters form. Friction causes heat to build up in an area, and the body creates a blister to protect the underlying skin from this excessive heat. If you don't reduce the friction, the blister will worsen.

The first thing you want to do is treat any hotspot before it becomes a blister. When a blister first starts to form, before it is pus-filled, is the optimal time to treat it. Clean and dry the area, then cover it in athletic tape. When possible, wrap the tape all the way around whatever body part is blistered, so the tape adheres to itself and you aren't just relying on the tape sticking to sweaty skin. The tape is there both to cover the hotspot, and also to provide a lower-friction surface to prevent further damage from occurring. You should also readjust your footwear/gloves if possible to reduce that friction.

If a blister does form, time is of the essence. The long you wait, the larger the blister will grow, because that heat is still being applied. This is why you should not wait until they end of the day to treat your blisters – treat all blisters ASAP! If the blister is relatively small and in an area where you can simply stop causing friction, then you don't need to deflate it. This is likely only going to be practical for some hand blisters; foot blisters usually need to be popped.

To pop the blister:

• Wash your hands first.
• Wash the area on and around the blister with soap/water, iodine solution, or rubbing alcohol, and allow to dry. This will reduce the likelihood of introducing bacteria.
• Sterilize a needle, safety pin, or similar object over an open flame; or, use a packaged sterile needle if you have one available.
• Stab the base of the blister in a couple places, then gently press to deflate. Be mindful of where the pus drains to.
• Leave the skin in place.
• If you have moleskin, 2nd skin, etc. make a donut-shaped cutout to encircle the blister but not cover it.
• Fill the donut hole with 2nd skin, antibiotic ointment, etc. if available. A bit of sterile gauze with iodine on it is an acceptable alternative. This is mostly to prevent infection and cover the blister site.
• Cover the entire area with medical tape. Consider what motion was causing the blister to form, and try to apply the tape in such a way that the motion will not strip it off. When possible, wrap the tape around whatever body part the blister is on, so the tape can stick to itself and not just the skin.
• Inspect the blister at least every 6 hours! If you don't inspect the blister and replace the dressing, it may get worse without you noticing. Leave the donut in place, but replace the dressing in the donut hole and the surrounding tape.

Answer 2

If you are running long distances over multiple days with boots, packs etc., and you must complete the distance you should plan to pop a blister at the end of day, but then you need to be sure you add some sort of padding to replace the protection the blister is giving you. You also need it cleaned and sealed, so antibacterial cleaner, then compeed, fakeskin or similar.

For shorter distances, like the day hike you mention, just leave it - plan to wear more padding around it for a few days and it will go down nicely.

One exception - if you get a big blister under a toenail, get rid of it as quickly as you can or you may end up with the nail bed permanently damaged. This happened to me after one marathon and I ended up needing a lot of surgery and cauterisation to remove a nail bed that had become canted up at a 30 degree angle. Not fun!

Answer 3

My mother, who is a doctor, has always told me to let blisters be. Keeping them unpopped keeps them clean and sterile, and (if I recall correctly) the fluid in them actually helps them heal faster. If you're in the wilderness, you really don't want to pop them and risk infection. Even if you have antibacterials, a popped blister is likely to contact dirt and pathogens through use, you can't be putting antibacterial on it all the time.

And I never really thought a popped blister felt any better anyway.

Answer 4

I will share what they told me when I was on a one month group-organised trek through the Balkan Mountains in Bulgaria. This is what the leader / group medic did.

If you are going to end the trek soon, don't bother the blister. However, if you know that you will need to abuse that part of the body over the next days, and you know the blister is going to pop, do the following, to avoid popping the blister.

Get a clean sewing needle and several centimeters of sewing thread. Pierce the blister, put away the needle, but leave the thread in. This way you can squeeze out the liquid from inside, and the thread keeps the holes from healing and more liquid from accumulating. The idea is to have no liquid in the blister. Why - because this way it can't pop.

I haven't tried this.

Answer 5

I haven't tried @Vorac answer, but it sounds interesting.

I'm not going to say if popping a blister is correct or not. But, if you do, this is how I was taught to pop a blister:
Get a needle (sterile of course)
About 1/3 of an inch from the blister, insert the needle under the skin towards the blister.
When it reaches the blister, remove the needle.
There is now a small path that will allow the blister to drain. You may have to exert some pressure to squeeze the pus out, but not much.

Doing it this way greatly reduces the chance for infection.

Protect the now drained blister with a bandage, mole skin, or tape.

Answer 6

I wouldn't burst it, especially if I was going to be hiking for a few more days - if it does end up getting infected then this could end up making things a lot worse - and it's more likely to happen in the wild!

Instead, I'd advise reducing the irritation as much as possible by wearing multiple / thicker socks, and use blister plasters if you have them. If it's really unbearable then look at shortening your hike if possible, there's no point continuing if it's going to make things worse and just put you in more discomfort.

Answer 7

A blister can be drained with just a small pinprick using a sterilized device. However, do not remove the overlying skin. As it remains natures best Band-Aid to cover the wound. One exception would be is if develops red streaks and the pus has a foul odor. In that case you might require antibiotic ointment and medication.ALSO,KEEP IT DRY AS POSSIBLE!.This is what leads to many foot problems in military service referred to as “trench foot“.