5-8
- Cleanse with Betadine and cover with moleskin.
- Leave the “roof” of the blister in place to act as a biological dressing. This will decrease tenderness until
new skin forms and matures in a few days. - Do not inject blister with benzoin (no longer the preferred method for blister treatment).
- If infected, the blistered skin covering should be removed using a scalpel or scissors. Cleanse the area
and apply a thin layer of Neosporin or Bacitracin followed by a thin non-adherent dressing. Then apply
moleskin over the dressing and adjacent skin to hold everything in place. - Coban and Elastoplast also work well for holding dressings in place on the foot.
- Avoid bulky coverings if an operator is in the field (in boots) and must continue with the mission.
Alternative:
Option 1: If the blister is already open as a result of repetitive irritation, the underlying skin is usually clean
and red. Remove remaining loose skin, cleanse and treat open area as above. Place felt “donut” around
blister to decrease pressure and irritation.
Option 2: Apply tincture of benzoin topically to toughen the skin and hold moleskin in place. Drain fluid with
fine gauge needle (27-30). Apply an antibiotic ointment, a layer of DuoDerm over top and a doughnut pad to
prevent rubbing. Blister roof may reattach to underlying skin, allowing rapid healing and return to duty
Primitive: Pop the blister if large and painful. Cleanse if conditions permit. Place moleskin or duct tape
over the area and continue with the operation.
Patient Education
General: Continue with activities if possible. If infection or deeper ulceration develops, rest feet and
eliminate pressure to allow healing.
Prevention and Hygiene:
- Make sure boots/shoe are the right size and width (fit the larger, longer foot). Try shoes on and stand to
check fit. If orthotics or other shoe devices are used, remember to try shoes on with the orthotics in them
before purchasing. The longest toe should be one thumb width from the end of the shoe Try a short test
run and then check your feet. Avoid wearing new boots for the first time on a field exercise. - Always carry extra socks in the field. Wear synthetic moisture wicking socks (i.e., polypropylene) next to
the skin and wool as a second layer because it retains insulative properties when wet. Fit boots with the
two-layer sock system at the time of the boot purchase. Do not wear cotton socks. Cotton retains
moisture and increases the coefficient of friction. Change socks often to keep them clean and dry. - For hyperhidrosis, apply products such as alum or Drysol (drying prevents skin softening) to the soles of
the feet three times a week as needed. - Apply moleskin patches to areas that previously blistered.
- Pad hammertoes and other prominent areas with Silipos or other padding devices.
An optional method: spray clean, dry feet with Aerozoin (40% tincture of benzoin, 60% alcohol), let dry,
then apply thin layer of hydropel. Use a single sock with this method.
Follow-up Actions
Return evaluation: Only if needed
Evacuation/Consultation Criteria: Evacuation is not usually necessary. Refer to dermatology or podiatry
(structural foot abnormality) for evaluation of underlying foot or skin problems.