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When I'm home running or on a day hike, I prefer to pierce the skin as soon as a blister forms and drain all fluid from a blister to reduce the pain and further irritation/inflammation. In this case, I know I can get antibacterials and a thorough wash to ward off infection as well as stronger measures if the blister does become infected.

Of course hiking with a tube of neosporin and some tape, moleskin, whatever you prefer is ideal, but I'm wondering what people feel is best for blister care when you are going to keep walking for a few days or more when you discover a nice blister has already formed.

Are you a "pop it now" person, or a strict "let it pop itself" person?

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I wish I was good enough with taping/moleskin/whatever to protect a blister and prevent it from popping. For me, they always pop, and usually before I notice that I have them... –  Ryley Jan 31 '12 at 22:00
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5 Answers

I wouldn't burst it, especially if I was going to be hiking for a few more days - if it does end up getting infected then this could end up making things a lot worse - and it's more likely to happen in the wild!

Instead, I'd advise reducing the irritation as much as possible by wearing multiple / thicker socks, and use blister plasters if you have them. If it's really unbearable then look at shortening your hike if possible, there's no point continuing if it's going to make things worse and just put you in more discomfort.

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My mother, who is a doctor, has always told me to let blisters be. Keeping them unpopped keeps them clean and sterile, and (if I recall correctly) the fluid in them actually helps them heal faster. If you're in the wilderness, you really don't want to pop them and risk infection. Even if you have antibacterials, a popped blister is likely to contact dirt and pathogens through use, you can't be putting antibacterial on it all the time.

And I never really thought a popped blister felt any better anyway.

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I very much appreciate the input. My experience from military training when I was young and induced into all manner of uncomfortable situations has guided my thinking about popping and taping to reduce the swelling immediately. I never had issues with infection and felt getting the skin closed up quickly induced a faster healing time than leaving the fluid intact. I certainly am not medically trained and much prefer being older, wiser and more willing to stop and slow down in the first place. –  bmike Jan 31 '12 at 21:30
    
Interesting - my unit medical officer wouldn't let us burst blisters intentionally... –  HorusKol Feb 1 '12 at 2:11
    
A recommended technique with one squadron was to burst it, then fill with a kind of petroleum jelly. Which seemed to burn the nerve endings so there would be no pain :-/ –  Rory Alsop Feb 1 '12 at 12:36
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Pretty sure this is the recommended approach by just about every wilderness medicine authority these days. If you can keep it closed, keep it closed. Do what you can to protect it. A blister IS a bandage. If it opens on its own, clean and treat as you would any other wound. –  LBell Feb 2 '12 at 1:21
    
I danced pointe for years (ouch), and this was the advice teachers gave to the dancers, as well. Pad it, keep it clean, and let it heal on its own. –  Clare Steen Feb 3 '12 at 20:49
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If you are running long distances over multiple days with boots, packs etc., and you must complete the distance you should plan to pop a blister at the end of day, but then you need to be sure you add some sort of padding to replace the protection the blister is giving you. You also need it cleaned and sealed, so antibacterial cleaner, then compeed, fakeskin or similar.

For shorter distances, like the day hike you mention, just leave it - plan to wear more padding around it for a few days and it will go down nicely.

One exception - if you get a big blister under a toenail, get rid of it as quickly as you can or you may end up with the nail bed permanently damaged. This happened to me after one marathon and I ended up needing a lot of surgery and cauterisation to remove a nail bed that had become canted up at a 30 degree angle. Not fun!

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Excellent advice and the running aspect is most welcome to know from experience how to think about the tradeoffs. –  bmike Jan 31 '12 at 21:27
    
That nail thing sounds nasty. Was the damage down at the base of the nail or just in the middle of the nail plate? –  Mr.Wizard Jan 2 at 17:03
    
The base of the nail- the actual growing bed. I had to get it completely cauterised to prevent the nail growing ever again. –  Rory Alsop Jan 2 at 17:11
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I will share what they told me when I was on a one month group-organised trek through the Balkan Mountains in Bulgaria. This is what the leader / group medic did.

If you are going to end the trek soon, don't bother the blister. However, if you know that you will need to abuse that part of the body over the next days, and you know the blister is going to pop, do the following, to avoid popping the blister.

Get a clean sewing needle and several centimeters of sewing thread. Pierce the blister, put away the needle, but leave the thread in. This way you can squeeze out the liquid from inside, and the thread keeps the holes from healing and more liquid from accumulating. The idea is to have no liquid in the blister. Why - because this way it can't pop.

I haven't tried this.

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I've tried this- or rather, an experienced friend did this for me in the beginning of a multi-day trek. It worked fine. (I should mention that he sterilized the area around the blister afterwards) –  Eyal Jun 29 '12 at 2:49
    
Thanks you very very much for the conformation of the technique. Maybe I should try it some day ;Ppp –  Vorac Jun 29 '12 at 8:11
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I haven't tried @Vorac answer, but it sounds interesting.

I'm not going to say if popping a blister is correct or not. But, if you do, this is how I was taught to pop a blister:
Get a needle (sterile of course)
About 1/3 of an inch from the blister, insert the needle under the skin towards the blister.
When it reaches the blister, remove the needle.
There is now a small path that will allow the blister to drain. You may have to exert some pressure to squeeze the pus out, but not much.

Doing it this way greatly reduces the chance for infection.

Protect the now drained blister with a bandage, mole skin, or tape.

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Haven't tried this but it sounds very useful in my opinion. The area apart the blister won't be distracted so much through the needle pin. Side question: Why is it so likely to get an infection through a popping blister? An abrasion on the arm or leg (which I regularly get) never is a problem. Is the foot more sensible in general? –  bashophil Apr 4 at 18:29
    
There's 2 reasons why a popped blister is more likely to get infected. Let's say you have a 1/2" blister. If any dirt gets in it, that's 1/2" of raw, unprotected flesh, and whatever made the blister could also get the dirt in, especially if the skin covering the blister tears. With the above method, the only exposure is 1 tiny needle prick. –  Tom Collins Apr 4 at 22:20
    
yes but why can it be such a problem on the feet? If you get a similar wound with 'raw flesh' on you arm, it's not so likely to give you an infection. –  bashophil Apr 14 at 17:15
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