The well-known retail example of a hydrocolloid blister plaster is Compeed.
Another is Band-Aid Advanced Healing.
I’ve used a clinical version called Duoderm or Comfeel.
More recently, I’ve released my own brand of hydrocolloid blister plaster - read why.
Hydrocolloid dressings are for deroofed blisters only!
Hydrocolloid dressings should only be used on deroofed blisters - blisters where the roof has been removed, leaving a red raw sore. Something like this (below).
As the raw blister base heals, it weeps. This weepiness combines with the dressing to provide the best environment for healing. And it prevents the dressing from sticking to the raw wound. That way it won't disrupt valuable healing tissue.
Do not use hydrocolloids on blisters with an intact or torn roof!
If you put hydrocolloids on a blister with an intact or torn roof, they will rip the blister roof off upon removal.
How to use hydrocolloids successfully
Hydrocolloid dressings are a must in the healing of deroofed blisters. But they suffer a poor reputation, as highlighted below:
"My crew have had a high number of bad experiences with Compeed. For a long duration event, it’s a nightmare to remove. And it usually brings a sizeable chunk of skin with it, unless removed with great patience and dexterity."
"My team have dealt with hundreds of cases of Compeed that has almost morphed into "one" with the skin. It's really difficult to see where the Compeed finishes and where the skin begins. We actually recommend against it for long events for that reason. And if we see it in use, we speak up and discourage it."
"Personally, my worst blister treatment experiences of all time have been removing this partially metamorphosed Compeed from badly blistered feet."
"The open skin under the dressing stinks and the skin goes all wrinkly."
I completely understand these concerns. I've witnessed them myself, many times. Here's an example (below).
This was from the 2015 ANZAC Ultramarathon in Canberra. This runner had applied Compeed when he saw a blister forming. The blister roof was intact at the time. Later, as he removed his sock, he realised the Compeed had melded with the sock and he couldn’t get the two apart. He also couldn't peel the Compeed from his blister. So as he took his sock off, the Compeed ripped the blister roof off.
If you've had a bad outcome with Compeed, there are three potential reasons why. I'm pleased to say, each is easily avoided.
1) Hydrocolloids are not for blister prevention
There is an expectation that the hydrocolloid dressing alone will prevent a blister from developing and/or prevent it from getting worse. This expectation is wrong. Don’t use hydrocolloids for blister prevention – they are a blister treatment.
2) Only use hydrocolloids on deroofed blisters
Hydrocolloid dressings have an adhesive which make them stick. For this reason, do not put them on a blister with its roof intact, or with its roof torn. It will tear the roof off when you come to remove the dressing. Hydrocolloids need a weepy wound base to work their magic. The weepy stuff does two good things:
It prevents the dressing from sticking to that part of the skin
It partially dissolves to provide a gel that promotes healing
In my university days (some 25 years ago now) I was on the grinder doing some heavy orthotic modifications when my hand slipped and the grinder took a nasty gouge from my knuckle. I grabbed some Duoderm from the student clinic and used it as directed until it was healed. Within a week or so, the deep gouge had filled in and there was a nice pink area of healed skin in it's place. Not only that, the skin remained flexible enough so as not to limit flexion in the finger during and after healing - something that wouldn't have happened if I'd allowed the wound to dry out and scab over. It was remarkable. I still have a scar but it is quite underwhelming considering the size of the initial injury. If you don't believe me, the next time you have a weepy wound, get one of these dressings and try it.
3) Don't expect hydrocolloids to stay on, on their own
Although hydrocolloids have an adhesive to make them stick to the skin, I don't expect it to work on feet - not well enough. On your arm, fine. On my finger, fine. But on your feet, not fine. Think about the in-shoe environment - it's sweaty in there, and that's a constant threat to adhesion. All it takes is for one edge of the dressing to roll-back a little and be exposed to the sock (annoyingly, it will stick like glue to the sock - see photo above).
I recommend Fixomull around the circumference of a hydrocolloid dressing. Leave the majority of the dressing area visible – we need to visualise the degree of weepiness to determine when to change the dressing. Plus, hydrocolloids allow wound gasses to evaporate through the dressing (whilst being waterproof from the outside).
How long do you leave a hydrocolloid blister plaster on for?
Good question! Hydrocolloids can be left on for a few days or even a week. It all depends on how weepy the wound is. It can take a bit of practice to get this right. You don't want it on for a week if your deroofed blister is very weepy because you'll run the risk of the surrounding skin getting macerated (water-logged, white, rubbery). But there's nopoint removing it if the weepiness is only light. The weepy gel-like substance under the dressing will track toward the edge of the dressing with time. It might take 12 hours or it might take a week, but when it gets to the edge of the dressing, change it.
For more information
BlisterPod Sterile Individually wrapped hydrocolloid blister plasters
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.
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".