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Blisters and Skin Atrophy

Blisters and skin atrophy are a common part of day-to-day life, affecting everyone at some stage. Below we provide some information in the prevention and management of these conditions. If you have long-term issues with blisters and skin atrophy the best course of action is to make and appointment with a podiatrist at Pivotal Motion Podiatry to have your feet and footwear assessed. Book online or give us a call on 3352 5116.

Blisters

Blisters can be very debilitating and stop you doing the activities you love or from wearing the shoes you love. They can also be the beginning of complex foot problems for people with diabetes or sensation loss.

In day to day practice, it is not overly common for patients to seek treatment for blisters. There are a variety of treatment methods used by podiatrists and the success of each treatment depends on the individual.

If you have diabetes stop wearing the offending shoe or doing the activity that caused the blister and book an appointment with your podiatrist or GP as soon as possible. Blisters can quickly deteriorate and become ulcers and cause long-term foot disease.

Treatment of blisters

blisters and skin athropy Alderley

The main treatments are to minimise pain, keep the blister clean and if possible keep the blister intact. This provides protection against infection if there is no break to the skin. This is often not possible, however as blisters form at locations of high friction. As a result, those friction forces will usually eventually cause the blister to rupture.

Once the blister has ruptured clean the area with an alcohol swab or sterile saline wash. Carefully pierce the bottom of the blister with a sterile needle or scalpel to allow the fluid to drain. Always keep the roof of the blister intact as this provides a barrier between the outside and the dermis beneath. After the blister is drained, swab the area with an antiseptic like betadine. Dress the area with a sterile dressing. This provides both cushioning for the area as well as a barrier to prevent further friction.

If the roof of the blister has been lifted off, try to carefully replace it. If this isn’t possible, a ‘second skin’ dressing is ideal before dressing. Otherwise, dress it as you would a normal wound with antiseptic and a dressing that completely covers the blister. This ensures the best protection from contamination and infection.

What about blister prevention techniques?

There are mountains of ideas to prevent blisters, all with varied levels of success. In theory, the main strategy is to minimise the friction between the feet, the toes, and the shoes. It is important to keep the feet as dry and clean as possible, as any excess moisture will add to friction. Wearing two pairs of socks, changing socks regularly with an alcohol wipes in between changing, or strapping the feet are some strategies that may be used. A number of studies have found that 100% cotton socks are worse for holding in excess moisture than polyester or polyester blend socks. Finally, some people will also rub a layer of petroleum jelly over their feet to produce less friction.

If you are prone to callus build up, it is recommended that you have the callus paired back by a podiatrist prior to undertaking any significant walk, as it can contribute to pressure in an already over-used area.

Skin Atrophy

What is Skin atrophy?

Skin atrophy is a reduction in volume in the upper layers of skin, there are many reasons why this may happen. Prolonged use of steroid medication, endocrine changes and age. The skin to becomes fragile and prone to injuries that may lead to ulceration. The skin will start to look fragile with a shiny appearance.

In advanced stages of skin atrophy the blood vessels can become pronounced and visible to the eye. From a podiatric prospective poor toenail cutting techniques leaves sharp edges that can scratch this thin skin, particularly on the legs. In the elderly population it is important to keep the skin hydrated and supple with the use of a good moisturiser. If the skin is dry it is more prone to tearing with the slightest knock or scratch. Well hydrated skin is stronger and can withstand day-to-day bumps and knocks without causing breaking the skin.

Unfortunately getting older is a part of life but with some small changes to our skincare regimen will help protect out skin for the years to come. For example, using milder soaps and adding daily moisturising to our bathing regime. Patients with skin atrophy should be mindful of the condition as even prolonged use of a sticky plaster over the same area could cause a skin tear and lead to larger complications.

What can cause skin atrophy?

There are a range of comorbidities that can contribute to thinning of the skin:

  • Ageing of the skin
  • Dermatomyositis
  • Lupus
  • Scleroderma
  • Lipoid necrobiosis diabetic
  • Reaction to the use of medications including topical steriods