Stanford Hospital's Grant Lipman on Avoiding and Treating Blisters

June 6, 2012

Courtesy of Grant LipmanGrant Lipman, MD, treating a blister
Grant Lipman, MD, a Stanford emergency medicine physician, treats a blister during a race in the Altacama Desert, Chile.

Most of us are famously not fond of our feet, perhaps because that sweet-smelling charm so evident at the toddler stage quickly disappears once we constrict them with shoes and transform them into playing fields for that most common of foot problems: the blister.

And while most of us would prefer not to think about blisters, Grant Lipman, MD, an emergency medicine physician at Stanford Hospital & Clinics, believes they are the most common medical problem we experience when we venture out of doors and into the wild. Lipman has become a nationally-known blister expert, in fact, and recently co-authored an entire chapter on blisters for Wilderness Medicine, the newest compendium of expertise by his Stanford colleague Paul Auerbach, MD.

The numbers Lipman has collected are staggering: An estimated 10 million Americans go out hiking each year, and at least one in seven will develop the classic blister caused by friction between foot, sock and shoe. The numbers also show that the less experienced hikers are more likely to develop a blister. 

What to do, then, to prevent the intense pain, possible infection and disrupted work and leisure that blisters bring? First, Lipman says, understand some basics. Blisters happen when the upper layer of the skin is rubbed so much that it begins to separate from the lower layers. So, smooth everything you can. File down calluses and trim toenails. Take defensive measures by applying simple, paper-like tape to typical problem points or where you’ve blistered previously — between the toes or at their tips, for example, or the back of the heel. Pads or padding, Lipman said, can often change the way your foot fits into a shoe and abet blister formation. Make sure that your socks and shoes fit properly. Wearing two pairs of socks, one thin nearest the skin and one thick nearest the shoe, can help create a protective layer. 

“I pop any blister that hurts,” Lipman said, “except if it’s filled with blood. That blood indicates a deep injury to the dermis.”  Use an alcohol-soaked pad to clean the prong of a safety pin and then puncture the blister; use the pad to wipe the blister clean. When a blister is on the sole of the foot, puncture it along the edge closest to your toes. Cover the blister with paper tape, then with another layer of stretchy tape, preferably made of cotton cloth.

Lipman said the best way to limit blister development and damage is to stop and take protective or repair measures as soon as you feel pain. “Even if you’re in a rainstorm or a snowstorm, stop,” he said. “That hot spot is a sign that you’re starting to delaminate those layers of skin.”

And once you’ve treated your blisters, he said, “Stay off your feet.” Unless, of course, you’ve got a hike to finish.


By Sara Wykes


About Stanford Hospital & Clinics
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