It's a deroofed blister!
Then rubbing takes the roof off . And takes pain and infection risk to another level!
What causes blister deroofing?
Shear causes the blister, which is painful enough.
Then rubbing takes the roof off (that is, rubbing in the presence of a high friction level). And takes pain and infection risk to another level!
3 ways to stop your blister from deroofing
1) Add a protective layer (tape / dressing / bandage)
This will serve as protection from rubbing. I favour non-adherent island dressings (the dressing sticks to the surrounding skin to keep it in place, but not the blister roof itself because there's an island of non-adherent absorbing material in the middle eg: in its simplest form, a bandaid). Don't put tape over your blister. When you come to take that tape off, it's likely to take the blister roof off with it, leaving you with the very problem you're trying to avoid.
2) Eliminate pressure (scuffs / donut pads)
The best way to prevent deroofing is by eliminating all pressure. By wearing shoes that don't touch the blister (eg: thongs or scuffs for blisters on the toes or back of the heel) or total nonweightbearing (eg: crutches for blisters on the ball of the foot). This will allow the blister to resolve in its own time. In reality, this is not always possible, like if you are in a race situation or miles from support.
Alternatively, you can try and reduce pressure. For example ... donut pads. By cutting a hole in a piece of thick orthopedic felt / moleskin and adhering it over the area so the blister is in the cavity, pressure and movement against the skin can be avoided or at least minimised. This will keep the blister roof intact. Podiatrist Emily Smith shows you how in this video. And you can get a sheet of this orthopaedic felt here.
Use 5mm semi-compressed orthopedic felt to make donut pads, toe-props and wedges. Felt can be cut to any size and shape and lasts longer than standard foams and paddings.
22cm (width) x 45cm (length) per sheet
Single sheet of Hapla mixture wool felt
Medical grade adhesive, hypoallergenic
Can be cut to any size or shape
Self-adhesive, but be sure to cover dressings and paddings such as donut pads with Fixomull Stretch tape to secure long-term
3) Lower the friction level (ENGO patch / lubricant)
Reduce the friction level between your shoe and sock. This is blister prevention (and deroofing prevention) GOLD. Why? Because you allow the sock and skin to move as a single unit so the sock actually protects the skin. Watch this video to see what I mean. Or you can reduce the friction level between your foot and the sock (lubricants, powders, moisture-wicking socks). It's not quite as effective but better than not addressing the friction level at all. Here are my two of my favourite ways to reduce friction levels.
These oval-shaped ENGO Patches provide versatility for any blister situation. The shape makes them easy to apply to any area of the shoe and the size provides perfect coverage for most blisters. Most commonly used for blisters under the ball of the foot, top of the toes and edge blisters.
4 x Large Oval Patches (4.4cm x 7cm) in each pack
Treating a deroofed blister
In a word ... Hydrocolloid dressings! Watch this video for more information.
I now have my own brand of hydrocolloid dressings called BlisterPod Hydrocolloid Blister Plasters. They’re a lot like Compeed - but importantly, they’re individually wrapped and sterile. This is important, considering we’re using these on raw weepy wounds that could easily get infected.
An Alternative To Compeed
Promote Rapid Skin Healing With 10 Sterile Individually-Packaged Blister Plasters In 3 Convenient Shapes (Large: 6.9cm x 4.4cm, Medium: 6.5cm x 2.5cm, Small: 6.5cm x 2cm)
3 Pack Options:
LARGE: 10 x Large plasters
SMALL: 10 x Small plasters
MIXED: 4 x Large plasters, 4 x Small plasters, 2 x Medium plasters
HOW THEY WORK: Hydrocolloid blister plasters are an exudate-absorbent hydrophilic gel dressing. They have a rubbery texture and are slightly translucent. As your raw blister base weeps, the plaster absorbs this moisture and forms a gel, turning a white colour. This shows that your blister is healing. Contrary to popular belief, this moist environment is the perfect environment for rapid skin healing - strong resilient skin will form instead of a dry, irritating, brittle scab. They ensure your skin heals and returns to full strength faster so you can return to full pain-free activity sooner.
AVOID SCABS: Scabs are not healed skin. They are simply a dry lump of wound goo that hides a raw sore underneath. Scabs are easily dislodged and they delay skin healing. Your blister can take twice as long to heal if it scabs over, so don’t leave it “open to the air” to dry out.
ONE PLASTER CAN LAST ALL WEEK: Change your plaster when the white gel reaches an edge of the plaster. This may take up to a week. It’s absolutely fine to leave the same plaster on for a whole week. In fact, it’s advisable – as long as it’s not too weepy and the edges haven’t loosened.
MAXIMUM DURABILITY: BlisterPod Hydrocolloid Blister Plasters are designed for athletes. They exhibit bevelled edges, good adhesion, a moderate amount of stretch, are 100% waterproof and provide cushioning and protection from further rubbing for up to a week. However, what other hydrocolloid brands won’t tell you that the edges of any hydrocolloid blister plaster can catch on footwear and stick to socks, even after applying it as best you can. It is advisable to secure the edges of hydrocolloid plasters with a thin flexible tape like Fixomull Stretch, especially when used for foot blisters. This will ensure a long-lasting seal even in the most extreme endurance athletic situations and challenging environmental conditions.
DON’T MAKE YOUR BLISTER WORSE: Hydrocolloid blister dressings work their magic on raw weepy wounds only - like ulcers and deroofed blisters.
Do not use plasters on intact blisters or torn blisters. Not only is this a waste of a plaster, you can actually make your blister worse, because when you remove the plaster, it will be stuck to your blister roof and rip it off! Watch the video below.
Do not expect hydrocolloid blister plasters to prevent blisters either. In spite of what other hydrocolloid brands recommend, this often does not work. It’s a waste of a plaster and a misuse of the hydrocolloid material technology.
A WORD ABOUT COMPEED: BlisterPod Hydrocolloid Blister Plasters are sterile and individually packaged. Combined with being waterproof, they are exactly what you need to ensure your blister doesn’t get infected. Do not use unwrapped non-sterile plasters (like Compeed) on your raw weepy blisters. They are not sterile and infection through the broken skin barrier is possible. BlisterPod Hydrocolloid Blister Plasters bring you the convenience of Compeed’s 3 plaster shapes, with the assurance of being free from infection-causing germs.
STERILE, HYPOALLERGENIC & LATEX FREE 100%: BlisterPod Hydrocolloid Blister Plasters won’t irritate your skin, no matter how long it stays on for.
Want to know more about treating foot blisters?
The Blister Treatment Blueprint shows you the 5 essential steps to making a foot blister hurt less and heal quicker, including:
Why foot blisters are different and need special treatment
How to choose the right antiseptic and blister dressing
How to manage pressure and friction for faster healing
What an infected blister looks like and what to do about it
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 "The Blister Prone Athlete's Guide To Preventing Foot Blisters".