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Decide whether to prick or not to prick. Once you have a blister, you have to decide what's best to do with it. That is, should you protect it and leave it alone, or should you prick it and drain the fluid?
"I think it depends on the size of the blister," says Suzanne Tanner, M.D., a private practitioner in Denver, Colorado, who specializes in sports medicine. "A purist will probably tell you not to prick it, because then you don't run any risk of infection. But I think for most people that's just not very practical."
While purists do indeed exist, our experts say you should prick large blisters that are painful, while leaving intact smaller blisters that cause no discomfort. "When you have a big blister that's in a weightbearing area, you almost have to drain it," says Clare Starrett, D.P.M., a professor at the Foot and Ankle Institute of the Pennsylvania College of Podiatric Medicine. "They can get so full they get like a balloon."
Also, blisters that are likely to break on their own should be drained by you, our experts say. That way, you can control when and how the blister is opened, instead of leaving it to chance.
Make a moleskin doughnut. One way to protect a tender blister without draining it is to cut a moleskin pad into a doughnut shape and place it over the blister. "Leave the central area open where the blister is," says Dr. Tanner. The surrounding moleskin will absorb most of the shock and friction of everyday activity. As long as the skin is clean and dry, the moleskin will adhere by itself.
Be wise and sterilize. For those who wish to drain a blister, the first thing to do is clean the blister and surrounding skin, and sterilize your "instrument," whether it's a pin (needle) or a razor blade (we'll get to that subject in a minute). "I recommend alcohol to clean both," says Nancy Lu Conrad, D.P.M., a private practitioner in Circleville, Ohio.
Other doctors advise sterilizing your instrument by flame instead of alcohol; that is, simply heat the pin or razor blade with a match until it glows red (let it cool before touching the skin, however). Either method seems equally able to kill germs, and both come equally recommended.
Stick it. "If a blister gives me pain," says Joseph Ellis, D.P.M., a private practitioner in La Jolla, California, and a consultant for the University of California, San Diego, "then I just go ahead and pop it." Use a sterilized needle and stick it in the side of the blister, Dr. Ellis says. "Just make sure the hole's big enough that you can squeeze out all the fluid."
Or slice it. "We use a sterile scalpel to drain blisters at our office," says Dr. Starrett. Not surprisingly, she recommends using a sterilized razor blade for doing the same at home. "Just make a straight incision," she says, "a little slice that's big enough to let the fluid come out."
Keep the roof on. "I think the biggest mistake most people make when treating their own blisters is that after they drain it they pull off the roof—the skin that goes over the top of the blister—and this is a terrible mistake," says Richard Cowin, D.P.M., director of Cowin's Foot Clinic in Libertyville, Illinois. Always leave that roof on, our experts advise. Think of it as nature's Band-Aid.
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