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If [[File:Blisters at Umstead 100.jpg|right|thumb|350px|I worked the aid station overnight at the Umstead 100, helping people with blisters. Here you get can see me fixing up my friend Charles on his way to his first 100 mile finish. (Thanks to Laura for the picture).]]When and how should you pop a blister? And how can you speed up the healing? The only reason to pop a blister is to prevent it spreading, otherwise leave it alone. Naturally, should it's better to [[Blister Prevention|prevent the blister]] in the first place. {{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; if the blister is not going to spread due to pressure, leave it? This alone. A wound heals faster in a moist environment than when dried out<ref name="FieldKerstein1994"/>. Likewise, 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 question blister is it introduces the possibility of finding infection. To make matters worse, a popped blister may refill with fluid, which is the least bad optionworst 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 there a cushion to protect the raw flesh under the blister, so once the blister is no ideal solutionpopped, other than preventing 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 first place (shape of the blister, forming a doughnut shape that reduces pressure on the blister if it is small enough.==Taping Blisters==Putting tape over a blister on your foot can help reduce the pain. Care must be taken to ensure the tape does not peel up, causing further blistering. See [[Blister PreventionTaping]])for more details.

==Don't Pop the [[File:Blister==Popping a blister is a bad idea. A blister will heal faster and better when left intact. The fluid creates a better healing environment; the idea of 'drying out' a wound is dated and wrong. Wounds need to be moist to heal correctly- FInished. The other problem with popping a blister is it introduces the possibility jpg|none|thumb|200px|An example of infection. Also, a popped taped blister may well refill, which is the worst of both worlds. Popping a blister may not reduce the discomfort in the way you expect, using Kineso-Tex and can make it worseMicropore. The fluid can act as See [[Taping]] for a cushion to protect the raw flesh under the blister. Once the blister is popped, the two surfaces will then rubstep by step guide. ]]

==How to Pop the a Blister==The If you have to pop a blister, your biggest risk is from infection. Bursting the blister will impair healing, but an infection will obviously make things far worse. Follow these steps...* Clean your hands to make sure they are sterile. * Sterilize the area first by wiping with an antiseptic wipe. Make sure you wipe the whole blister and the surrounding area.* Ideally you should have a sterile tool to burst the blister. If you are using scissors, or anything else that is not in a sterile package, you must sterilize it. I use hypodermic needles for bursting blisters as they are very sharp and quite long. (One caution: hypodermic needles can be considered 'drug paraphernalia'if you don'onlyt have a good medial reason for having them.) * Puncture the blister at the edge, ideally at the edge that will be lowest most of the time so that gravity aids drainage. Multiple punctures may be needed to provide sufficient drainage. * Use a sterile dressing to push out the fluid, taking time to ensure you remove as much as possible. You can use an antiseptic wipe for this, but getting any of the antiseptic into the blister can be quite painful. * Cover the blister with a dressing. An occlusive (waterproof) dressing will improve healing and reduce the chance of infection<ref name="Eaglstein-2001"/>.** Ideally, use a 'hydrocolloid'' reason dressing, such as [http://go.fellrnr.com?id=35454X937677&xs=1&xcust=band&url=http%3A%2F%2Fwww.amazon.com%2FBand-Aid-Adhesive-Bandages-Multi-Day-Protection%2Fdp%2FB000Y8W50G Band-aid Advanced Healing Blister Cushions]. A hydrocolloid dressing is one that is water and air tight, with a gel that absorbs fluids. This can keep the wound moist without becoming saturated (macerated). ** You may need an adhesive promoter such as tincture of benzoin to help keep things in place. Be careful with tincture of benzoin: If you put it near the punctures in the blister it can seep inside and be remarkably painful. **Putting an adhesive promoter on the blister itself will mean that the blister and the dressing are bonded. When you then try to remove the dressing, it will take the skin of the blister with it. If possible apply tincture of benzoin only to the surrounding skin.** Putting a small amount of antibiotic ointment on the blister itself will help reduce the chance of infection. It will also stop the dressing sticking to the dead skin, but care must be taken to avoid spreading the ointment and preventing the dressing sticking. * If possible, leave the blister alone. Do not change the dressing unless it starts to come off or leaks. You can leave the blister covered for up to a week.* Do not let the blister dry out, but keep it moist to pop improve healing. =Other Techniques=There are two techniques I will mention, but would not recommend. * Threading a strand of cotton through a blister is when pressure will make it more likely to continue to drain. However, this will also increase the risk of infection, reducing the number of bacteria need to cause an infection by 10,000x<ref name="ELEK-1956"/>.* Injecting tincture of benzoin into the blister after it is emptied glues the detached skin to the underlying flesh. Alternatively the blister can be cut open to spreadapply the tincture of benzoin. That's 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 intense, and the only reason; if overall pain of the blister is not going necessarily lessened, but it may allow continued movement. A similar practice is to spread due use superglue. =Speeding up healing=There are several ways of speeding up the healing process. ==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. [[File:Hot Hands.jpg|none|thumb|150px|Chemical Hand Warmer.]]==Continuous Protein Intake==I have found that keeping a steady intake of [[Protein|protein]] speeds up the healing process. It's particularly important to pressuretake some protein before bed time, as a lot of healing occurs while you [[Zeo Sleep Monitor|sleep]]. If the body does not have a supply of protein available, leave it alonecan't make repairs. Check out [[GOMAD Grazing]] for my approach to continuous protein intake. ==Omega-3==''Main article: [[Omega 3]]''

Omega-3 oils are important for wound healing<ref name="GuoDiPietro2010"/>. I take both [http://go.fellrnr.com?id=35454X937677&xs=How to Pop a Blister1&xcust=flax&url=If you have to pop a blister, you should sterilize the area firsthttp%3A%2F%2Fwww.amazon.com%2FNatures-Way-Super-Lignan-Ounce%2Fdp%2FB000F4WR16 Flax Seed Oil] and [http://go.fellrnr. Puncture the blister at the edge, ideally at the edge that will be lowest most of the time so that gravity aids drainagecom?id=35454X937677&xs=1&xcust=swirl&url=http%3A%2F%2Fwww. I use hypodermic needles for bursting blisters as they are very sharpamazon. Multiple punctures may be needed to provide sufficient drainagecom%2FBarleans-Organic-Oils-16-Ounce-Bottle%2Fdp%2FB002VLZ8BW Fish Oil]. Use I blend the Flax Seed Oil into a sterile dressing to push out protein shake, but the fluid, taking time to ensure you remove as much as possible. Cover with a sterile dressing; fish oil I have found Band-aid blister cushions work well for metake tastes great on it's own. You may need an adhesive promoter such as tincture of benzoin ==Calorie Intake==It's important to help keep things in placeyour calorie intake adequate. Be careful with tincture of benzoin: If you put it near the punctures in the blister it can seep inside and be quite painful. Alsoare dieting, putting tincture of benzoin on the blister itself then your body will mean that the blister and the dressing are bonded, making slow down the dressing harder healing process to remove. If possible apply tincture of benzoin only to the surrounding skinconserve energy.==Avoid NSAIDs==''Main article: [[NSAIDs and Running]]''

Ibuprofen, and possibly other NSAIDs, impair wound healing and should be avoided<ref name="StadelmannDigenis1998"/><ref name="GuoDiPietro2010"/>. (Tobacco usage also causes wound healing problems<ref name="StadelmannDigenis1998"/>.)==Take Vitamins==A number of vitamins and minerals are needed for wound healing, including<ref name="StadelmannDigenis1998"/>:* Vitamin C * Iron* Vitamin A* Zinc* Copper* CalciumOf these, Vitamin C is arguably the most critical for wound healing. In addition, Vitamin E may improve the strength of the wound and deficiencies in B vitamins may impair the immune system. Getting these nutrients from wholesome foods is ideal, but supplementation may be appropriate. ==Reduce Stress=Other Techniques=Studies have shown that stress will delay wound healing<ref name="GuoDiPietro2010"/> so reduce stress if possible. ==Bioelectric Wound Dressings==There are two techniques I will mentionsome 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 would the dressings are not recommend readily available and have never triedare expensive. One is to thread a strand (The use of cotton through a blister so electrical stimulation for healing wounds that it continues do not respond to drain. I feel other treatments has been shown effective and is medically approved<ref name="Kloth-2005"/>, but that this increases is outside of the risk scope of infection significantlythis article. )=Blister Color=The other technique is to inject tincture contents of benzoin into the blister after it is emptiednormally a yellowish clear liquid, which glues the detached skin to the underlying fleshblood or pus<ref name="Fitzpatrick"/>. I hear that this The clear, yellowish fluid is amazingly painful called serous and I am not sure of the risks in doing thisis similar to blood plasma. The alternative to popping a blister due to pressure difference between serous and blood is to build up that the area around latter means that some capillaries are damaged under the blister so that . The presence or absence of blood does not appear to be medically significant. If the pressure blister is filled with pus, this may indicate an infection, but this is relievednot always the case. =References=<references><ref name="Kloth-2005"> LC. Moleskin can be cut out Kloth, Electrical stimulation for wound healing: a review of evidence from in vitro studies, animal experiments, and clinical trials., Int J Low Extrem Wounds, volume 4, issue 1, pages 23-44, Mar 2005, doi [http://dx.doi.org/10.1177/1534734605275733 10.1177/1534734605275733], PMID [http://www.ncbi.nlm.nih.gov/pubmed/15860450 15860450]</ref><ref name="JAAD-2009">Assessment of the shape 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 of the blisterAmerican Academy of Dermatology, volume 60, issue 3, 2009, pages AB200, ISSN [http://www.worldcat.org/issn/01909622 01909622], doi [http://dx.doi.org/10.1016/j.jaad.2008.11.868 10.1016/j.jaad.2008.11.868]</ref><ref name="BlountFoster2010">Andrew Blount, Sarah Foster, Richard Wilcox, Use of Bioelectric Dressings for Faster Wound Healing: A Prospective Case Series, Plastic and Reconstructive Surgery, volume 126, 2010, pages 97, ISSN [http://www.worldcat.org/issn/0032-1052 0032-1052], doi [http://dx.doi.org/10.1097/01.prs.0000388820.96542.6e 10.1097/01.prs.0000388820.96542.6e]</ref><ref name="Eaglstein-2001"> WH. Eaglstein, forming Moist wound healing with occlusive dressings: a doughnut shape that reduces pressure on the blister if it is small enoughclinical focus., Dermatol Surg, volume 27, issue 2, pages 175-81, Feb 2001, PMID [http://www.ncbi.nlm.nih.gov/pubmed/11207694 11207694]</ref> <ref name="FieldKerstein1994">Charles K. Field, Morris D. Kerstein, Overview of wound healing in a moist environment, The American Journal of Surgery, volume 167, issue 1, 1994, pages S2–S6, ISSN [http://www.worldcat.org/issn/00029610 00029610], doi [http://dx.doi.org/10.1016/0002-9610(94)90002-7 10.1016/0002-9610(94)90002-7]</ref><ref name="StadelmannDigenis1998">Wayne K. Stadelmann, Alexander G. Digenis, Gordon R. Tobin, Impediments to wound healing, The best place for blister care supplies I found is American Journal of Surgery, volume 176, issue 2, 1998, pages 39S–47S, ISSN [http://www.worldcat.org/issn/00029610 00029610], doi [http://zombierunnerdx.doi.org/10.1016/S0002-9610(98)00184-6 10.com Zombie Runner1016/S0002-9610(98)00184-6]</ref><ref name="GuoDiPietro2010">S. Guo, L. A. I would also recommend the book DiPietro, Factors Affecting Wound Healing, Journal of Dental Research, volume 89, issue 3, 2010, pages 219–229, ISSN [http://www.worldcat.org/issn/0022-0345 0022-0345], doi [Book Review – Fixing Your Feet|Fixing Your Feethttp://dx.doi.org/10.1177/0022034509359125 10.1177/0022034509359125]</ref><ref name="ELEK-1956"> SD. ELEK, Experimental staphylococcal infections in the skin of man., Ann N Y Acad Sci, volume 65, issue 3, pages 85-90, Aug 1956, PMID [http://www.ncbi.nlm.nih.gov/pubmed/13363202 13363202]</ref><ref name="PersonalEmail"> Personal email communication with Army medic.</ref><ref name="Fitzpatrick">Fitzpatrick's Dermatology in General Medicine, ISBN 0071669043</ref></references>