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{{DISPLAYTITLE:Should you pop a blister? How can you speed up healing?}}
=Don't Pop the Blister=
The '''only''' reason to pop a blister is when pressure will cause the blister to spread. That's the only reason; if the blister is not going to spread due to pressure, leave it alone. A wound heals faster in a moist environment than when dried out<ref name="FieldKerstein1994"/>. likewiseLikewise, popping a blister is a bad idea as a blister will heal faster and better when left intact. The idea of 'drying out' a wound is dated and wrong. Drying out a wound or bursting a blister can also increase the scar tissue that is left behind. The fluid inside a blister creates a good healing environment, far better than any dressing. The biggest problem with popping a blister is it introduces the possibility of infection. To make matters worse, a popped blister may refill with fluid, which is the worst of both worlds. Typically popping a blister will also make things more painful, so don't pop to reduce your discomfort. The fluid acts as a cushion to protect the raw flesh under the blister, so once the blister is popped, the two surfaces will then rub.
==Moleskin Doughnut==
The alternative to popping a blister due to pressure is to build up the area around the blister so that the pressure is relieved. Moleskin can be cut out in the shape of the blister, forming a doughnut shape that reduces pressure on the blister if it is small enough.
* Do not let the blister dry out, but keep it moist to improve healing.
=Other Techniques=
There are two techniques I will mention, but would not recommend them nor have I ever tried them. One is to thread * Threading a strand of cotton through a blister so that will make it continues more likely to continue to drain. I feel that However, this increases will also increase the risk of infection significantly, reducing the number of bacteria need to cause an infection by 10,000x<ref name="ELEK-1956"/>. The other technique is to inject * Injecting tincture of benzoin into the blister after it is emptied, which glues the detached skin to the underlying flesh. I hear that this Alternatively the blister can be cut open to apply the tincture of benzoin. This was a common practice in the US army in the 1980s, and while effective in the short term it caused issues with fissures and some cases of infection, and the practice has been abandoned<ref name="PersonalEmail"/>. The pain from the tincture of benzoin is amazingly painful intense, and I am not sure the overall pain of the risks in doing thisblister is not necessarily lessened, but it may allow continued movement. A similar practice is to use superglue.
=Speeding up healing=
There are two several ways I've found of significantly speeding up the healing process. I've used these techniques to reduce the healing time by a few days.
==Apply Heat==
Keeping the blister warm improves blood flow and healing. You can use a heating blanket like a [[Theratherm]], but this requires power and is inconvenient. Instead, using chemical hand warmers will keep the blister area warm for hours. I like to use the larger sized 'hot hands' warmers which keep warm for over 12 hours so I can replace them twice a day. I've found the hand warmers will not get too hot but be careful as a burn will obviously not speed up healing! For foot blisters, placing the warmer inside a thick hiking sock works well.
==Reduce Stress==
Studies have shown that stress will delay wound healing<ref name="GuoDiPietro2010"/> so reduce stress if possible.
==Bioelectric Wound Dressings==
There are some studies that have shown that a Bioelectric wound dressing improves healing<ref name="JAAD-2009"/>, with one study showing a 36% improvement in healing time compared with a semi-occlusive dressing<ref name="BlountFoster2010"/>. These Bioelectric wound dressings are not externally powered, but use embedded 'microcell batteries'. One provider is http://www.procellera.com/, but the dressings are not readily available and are expensive. (The use of electrical stimulation for healing wounds that do not respond to other treatments has been shown effective and is medically approved<ref name="Kloth-2005"/>, but that is outside of the scope of this article.)
=References=
<references>
<ref name="Kloth-2005"> {{Cite journal | last1 = Kloth | first1 = LC. | title = Electrical stimulation for wound healing: a review of evidence from in vitro studies, animal experiments, and clinical trials. | journal = Int J Low Extrem Wounds | volume = 4 | issue = 1 | pages = 23-44 | month = Mar | year = 2005 | doi = 10.1177/1534734605275733 | PMID = 15860450 }}</ref>
<ref name="JAAD-2009">{{cite journal|title=Assessment of the effects on wound healing and gene expression of a bioelectric dressing using a porcine wound model and real time reverse transcriptase-polymerase chain reaction|journal=Journal of the American Academy of Dermatology|volume=60|issue=3|year=2009|pages=AB200|issn=01909622|doi=10.1016/j.jaad.2008.11.868}}</ref>
<ref name="BlountFoster2010">{{cite journal|last1=Blount|first1=Andrew|last2=Foster|first2=Sarah|last3=Wilcox|first3=Richard|title=Use of Bioelectric Dressings for Faster Wound Healing: A Prospective Case Series|journal=Plastic and Reconstructive Surgery|volume=126|year=2010|pages=97|issn=0032-1052|doi=10.1097/01.prs.0000388820.96542.6e}}</ref>
<ref name="Eaglstein-2001"> {{Cite journal | last1 = Eaglstein | first1 = WH. | title = Moist wound healing with occlusive dressings: a clinical focus. | journal = Dermatol Surg | volume = 27 | issue = 2 | pages = 175-81 | month = Feb | year = 2001 | doi = | PMID = 11207694 }}</ref>
<ref name="FieldKerstein1994">{{cite journal|last1=Field|first1=Charles K.|last2=Kerstein|first2=Morris D.|title=Overview of wound healing in a moist environment|journal=The American Journal of Surgery|volume=167|issue=1|year=1994|pages=S2–S6|issn=00029610|doi=10.1016/0002-9610(94)90002-7}}</ref>
<ref name="StadelmannDigenis1998">{{cite journal|last1=Stadelmann|first1=Wayne K.|last2=Digenis|first2=Alexander G.|last3=Tobin|first3=Gordon R.|title=Impediments to wound healing|journal=The American Journal of Surgery|volume=176|issue=2|year=1998|pages=39S–47S|issn=00029610|doi=10.1016/S0002-9610(98)00184-6}}</ref>
<ref name="GuoDiPietro2010">{{cite journal|last1=Guo|first1=S.|last2=DiPietro|first2=L. A.|title=Factors Affecting Wound Healing|journal=Journal of Dental Research|volume=89|issue=3|year=2010|pages=219–229|issn=0022-0345|doi=10.1177/0022034509359125}}</ref>
<ref name="ELEK-1956"> {{Cite journal | last1 = ELEK | first1 = SD. | title = Experimental staphylococcal infections in the skin of man. | journal = Ann N Y Acad Sci | volume = 65 | issue = 3 | pages = 85-90 | month = Aug | year = 1956 | doi = | PMID = 13363202 }}</ref>
<ref name="PersonalEmail"> Personal email communication with Army medic.</ref>
</references>