Blisters—we all seem to get them at one point or another, and they often appear on parts of the body that nail technicians work on the most: hands and feet. Though certain cases may signal a larger health issue, blisters are typically not dangerous. However, when blisters are present, it does require you to take several precautions during services to ensure that you don’t worsen the situation or put yourself in harm’s way. In this month’s Nail Clinic, we examine the most common causes of blisters and how you should handle them in the salon when you spot them on your clients’ skin.
Blisters develop due to friction, which is the most common cause of blistering on the skin, and may be a common occurrence for clients who wear poorly fitted shoes for long periods of time. "A blister is a small pocket of fluid that forms within the superficial layers of the skin, typically caused by forceful rubbing or friction from shoes," explains Jacqueline Sutera, DPM, who has private practices in New York and New Jersey. "Sometimes a strappy shoe, a tight or loose shoe, a shoe that is ill-fitting or just ‘rubs the wrong way,’ can cause them," she says. “You can get blisters anywhere on the feet, including the heels, toes or balls of the feet."
Although friction blisters are the most common, blisters can form for a variety of other reasons. According to the National Institutes of Health (NIH), blistering on the skin may also be caused by:
Some people are more likely to get blisters than others due to health reasons. "There is a condition called epidermolysis bullosa, where the skin blisters much more easily than normal," notes Robert Brodell, MD, professor of internal medicine, dermatology, at Northeastern Ohio Universities College of Medicine in Rootstown, Ohio. "In some cases, the disease is very severe; in others, rather mild, with blisters developing only when there is a fair amount of friction." The NIH reports that clients who have this condition may also suffer from nail loss or deformed nails. However, this condition is hereditary and usually present from birth, so your client should be aware of it. As always, having new clients fill out questionnaires that inquire about health issues will make you aware of this condition—and prevent you from agitating it with excess friction during services.
Bursting the Bubble
As a nail tech, you aren’t allowed to break a client’s skin. However, a client can safely break her own blister at home to help it heal. To aid your clients, you can suggest some tips for properly caring for blisters. First, clients must start by thoroughly cleaning the area to prevent infection. "For most blisters, heat a needle with a match to sterilize it, or use a sterile disposable needle or pin, and poke the blister from the side," suggests Brodell. "Drain it and let the roof fall down on the base as a natural dressing. Once poked, it cannot continue to expand," he says. “Then apply Polysporin or bacitracin ointment until it heals." Brodell adds that freshly healed blisters are more easily blistered than normal skin, so the client should protect the area for a few months to prevent the recurrence of blisters.
Breaking the blister isn’t always recommended, though, and in some cases it may be harmful. The severity of a blister’s implications relies heavily on the type of blister and the client’s overall physical condition. "It is recommended that only clear blisters be handled in healthy people," says Sutera. "People with poor circulation, diabetes or blood or pus blisters should be seen by a physician as soon as possible. In these people, popping a simple blister can result in serious infection, sometimes leading to an abscess or even amputation."
In certain cases, medical attention may be necessary due to infections or complications. Sutera recommends that even an otherwise healthy client should see a physician if a popped blister begins to show signs of infection, such as swelling, redness, heat/inflammation, pain or pus. Brodell further adds that a medical professional should check recurring or widespread blisters to rule out more serious autoimmune diseases or underlying conditions.
Working Around Blisters
If the skin around your client’s blister has already broken, you must treat the blister as you would any other open wound: with extreme care and caution. "Broken blisters need special attention to not be opened up further," says Sutera. "On that area, avoid massage, using a pumice stone or harsh scrubs and prolonged soaking. These can all lead to the introduction of dangerous bacterial, fungal and viral infections."
In addition, you must take the proper precautions while servicing these clients to protect your own health. "Certainly, the nail technician should wear gloves when exposed to any fluids from a patient, including blister fluid, to protect themselves from hepatitis, HIV and other infectious processes in the blood," warns Brodell. "For clients with blisters around the fingernails that are not friction blisters, I would send the client to a dermatologist to make sure a specific diagnosis is made and appropriate treatment initiated."
Like mosquito bites and bee stings, blisters are relatively common annoyances that sometimes cannot be avoided. However, to make sure that you protect yourself and your client, treat blisters and the skin around them with care. After all, the spread of infection is a serious danger to which you don’t want any of your clients—or yourself—exposed. By taking a few simple precautions, you can help ensure that your client’s blister doesn’t transform from a minor inconvenience to a major health scare.
Tracy Morin is a freelance writer and editor based in Oxford, MS.
An Ounce of Prevention
Are your clients prone to foot blisters? Many of these blisters can be prevented with a few simple habits and lifestyle changes—starting with shoes that fit correctly! Jacqueline Sutera, DPM, who has practices in New York and New Jersey, shares a few tips to help your clients ease the pain in their tootsies.