What are blisters?

Blisters (Bulla) are described as circumscribed elevated lesions greater than 5mm in diameter (distinguished from a vesicle, which is less than 5mm in diameter).

What causes blisters?

There are many common causes including contact with a primary irritant, allergic contact dermatitis, sunburn, insect bite, viral infection (e.g., herpes simplex and varicella) or drug eruption. Blisters form when the skin rubs against another surface, causing friction. First, a tear occurs within the upper layers of the skin (the epidermis), forming a space between the layers while leaving the surface intact; then fluid seeps into the space.

Soles and palms are most commonly affected for several reasons. The hands and feet often rub against shoes, skates, rackets or other equipment. Blister formation usually requires thicker and rather immobile skin that is found on extremities. In addition, sports shoes provide an ideal environment for increased friction, especially when they are new or used for an unaccustomed or
prolonged activity.

Keeping blisters at bay

By far, the most effective treatment is the institution of prevention strategies. This is especially important with regard to new athletic footwear, and it is wise to observe a wear-in period if there has been a predisposition to blistering.
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Choose footwear carefully

To prevent blisters, you need to minimise friction. For the feet, this begins with shoe selection. Shoes should fit comfortably, with about a thumb's width between your longest toe and the end of the shoe. Narrow shoes can cause blisters on the big toe and little toe. A shallow toe box can lead to blisters on the tops of the toes, while loose shoes can create blisters on the tips of the toes.

Choice of material for footwear is also important. Many of the new synthetic fibres have superior 'breathability' characteristics and moisture reducing capabilities than natural fibres. Mesh uppers, especially in running shoes, will also allow airflow and moisture exchange. An added benefit is weight reduction in the shoe.

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