This is the most common question I get about blisters!
Pop. Burst. Puncture. Drain. Lance. It’s the same question. Should I open it up and get the fluid out?
Do a quick scan of the internet and you’ll find about 50% against and 50% for popping. And some recognise there's a place for both interventions.
What's missing is the practical information you need to decide whether your blister needs to be lanced or left alone. Here's the question you should be asking yourself:
"Should I pop this blister in these circumstances?"
Because it depends entirely on your blister (size, location, your foot) and your situation (for example, are you about to leave home to run a marathon, half way through the race or have you just finished?). I’ll demonstrate the point further. But first, it helps to properly understand the risks associated with popping a blister.
What are the risks of popping blisters on the feet?
Dealing with the pain of a foot blister, the inconvenience of blister treatment and the downtime in waiting for it to resolve is bad enough. But an infection is a whole different story. It makes your blister more sore, requires more of your attention and things can go nasty quickly. So you need medical help close at hand. And let's face it, while they're tucked away in your shoes, feet spend a lot of time in a dirty, dark, warm, moist environment that lends itself to bacterial infection. And when not in shoes, out feet are what connects us to the ground - a source of limitless germs. So foot blisters are particularly prone to infection.
Signs your blister is infected
- Increasing pain, swelling, redness and warmth
An infected blister requires at least a topical antiseptic (like Betadine) and possibly oral antibiotics.
What constitutes a medical emergency?
If you see red streaks extending around your blister and upwards, you need to seek urgent medical attention. This is a condition called lymphangitis (commonly but incorrectly referred to as blood-borne infection or blood poisoning). This is a serious medical condition! Left unchecked, an infection can even lead to severe systemic reactions and death.
How to pop a blister on your foot
If you are going to lance your blister, you need to do it in a clean environment using clean techniques and sterile equipment.
- Clean your hands and foot (soap and water or antibacterial hand gel).
- Lance with a sterile implement (sterile scalpel blade or hypodermic needle) – read How Not To Drain A Blister.
- Ideally, lance it in 2-3 places where gravity and foot function will help fluid escape (this is a tip from Fixing Your Feet author, John Vonhof).
- Apply antiseptic (eg: Betadine) and dress with a sterile island dressing – read How To Treat Your Foot Blister.
- Remove or deflect pressure.
- Reduce friction levels – read about how to cut friction levels for foot blisters.
- Then you need to keep it clean and monitor over the coming days for signs of infection.
Q: Should I pop my blister?
Let’s say this is the blister on your foot
Here are 8 scenarios with different answers to “Should I pop my blister?”
1. You’re about to walk down the street to a mates place in your thongs (flip flops).
A) No need. You won't be walking on it (it's on the side of the toe). And your shoe won't be pressing on it.
2. You’re about to leave the house to go for a run.
A) Yes. It's going to tear on its own otherwise.
3. You're half way through your run.
A) No. You don't have any equipment on you to do it.
4. You’ve just got back from your run, noticed this blister and you’ll be spending the rest of the day on the couch.
A) No need.
5. You’re a few hours into a hike. Your mate has a pocket knife and you have some tape.
A) No way! You have no idea what germs are on that pocket knife. You have no antiseptic and no island dressing.
6. You’re a few hours into a hike and you’ve bought your blister kit that has sterile dressings, antiseptic and a sterile scalpel blade to lance it.
A) Yeah sure. You're all set up to do what needs to be done.
7. Your hike takes you through river-crossings, the terrain is muddy and a bit swampy in some parts.
A) Nope! Water-logging of your dressing means your dressing is no longer forming a barrier against bacterial movement into your blister.
8. You’re diabetic or your immune system is low.
A) No, it's just too risky. And you need to consider modifying your activity (stop running) until this blister has resolved.
Same blister. Different scenario. Different answer.
Now let’s say these are your blisters
Of the same 8 scenarios, would you answer any differently?
I would give a different answer to scenario 1. No matter what shoes you wear, as long as you’re on your feet and walking, these blisters will hurt and probably tear anyway. When it's on both feet, you don't even have a good foot to lean on (not that that is a good thing to do anyway). So it makes sense to take the situation into your own hands and lance this blister in a clean and controlled environment. So yes, I would pop this blister in this situation. But only because I would have the right gear to do it safely.
Blister treatment is complicated. Prevention is so much easier!
To Get Prevention Right ... Start Here
Should you pop a blood blister on your foot?
Great question! The same answers apply. But you would err on the side of more caution. And monitor its progression more closely so you can pick up signs of infection right away. And take steps to address the cause of the bleeding in the blister. You must read this article about treating blood blisters on the feet.
- When it comes to popping blisters, judge the blister on its anatomical location, your activity, your health and the equipment you have available to you.
- There are definite advantages to taking the situation into your own hands and popping a blister. Put it this way, it beats ignoring it, putting your shoes back on and hoping for the best.
- But popping blisters comes with risks. If in doubt, leave it intact. Apply antiseptic and a sterile dressing. Reduce pressure and friction levels. And monitor regularly to ensure it hasn’t torn or become infected. Seek medical attention for specific advice on your situation.
WRITTEN BY REBECCA RUSHTON
Rebecca is an Australian podiatrist with over 20 years experience. She has spent a lifetime dealing with her own blister prone feet in her sporting and everyday life. Rebecca specialises in helping athletes and sports medicine professionals figure out how to manage foot blisters with ease. And for kicks, she enjoys providing blister care at multiday ultramarathon events.
Rebecca is the founder of Blister Prevention and author of both "The Blister Prone Athlete's Guide To Preventing Foot Blisters" and "The Advanced Guide to Blister Prevention".