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Deroofed Blisters: Why They’re The Worst Type

Marathon Des Sables race medic deroofing a competitors foot blister

Deroofed Blisters: Why They’re The Worst Type

Deroofed blisters are simply blisters whose roof, that skin that bubbled up, has disappeared. It has rubbed right off and is probably somewhere in your sock. This is the worst type of blister you can have because it’s more likely to get infected, takes longer to heal and of course, is damn painful.

What deroofed blisters look like

You know the feeling… You’ve got a blister but there’s nothing you can do about it. So you carry on, scrunching your toes, tilting your foot, limping a little, anything to take the pressure off it. But it gets worse and worse and when you finally take your shoe off… ouch… deroofed blister!

small deroofed blister
Small deroofed blister on back of heel

Or maybe even this… eeewww!

Bad deroofed blisters
Nasty deroofed blisters on back of heel

What causes a deroofed blister?

Quite simply, unabated blister-causing forces.

If you keep walking or running as a blister is forming, and you do nothing to reduce pressure of reduce friction levels or the amount your bones are moving within your foot, your blister is going to deroof. In other words, you’ll be left with a raw blister blase.

More raw deroofed blisters (Photo credit)

3 Ways to stop your blister from deroofing

1) Add a protective (but not adhesive) layer

This will serve as protection from anything abrading or rubbing on your raw blister.

Don’t put tape over your blister. While you’ll stop your blister from deroofing initially, when you come to take that tape off, it’s going to take the blister roof off with it, leaving you with the very problem you’re trying to avoid.

Use an island dressing instead, like a bandaid. The adhesive part sticks to the surrounding intact skin to keep it in place, but not the blister roof itself because there’s an island of non-adherent absorbing material in the middle.

Learn more about island dressings.

2) Eliminate pressure

The best way to prevent your blister from deroofing is by eliminating all pressure. For example, wearing shoes that don’t touch the blister (eg: thongs or scuffs) will allow the blister to resolve in its own time. However, in reality, this is not always possible. Like if you are in a race situation or miles from medical support. Or even if your blister is under the ball of your foot or between your toes – it’s difficult to take away all the pressure when you walk.

Alternatively, you can try and reduce pressure. For example, donut pads. By cutting a hole in a piece of thick orthopedic felt / moleskin and adhering it over the area so the blister is in the cavity, pressure and movement against the skin can be avoided or at least minimised. This will go a long way to keeping the blister roof intact.

Here are 10 ways to take pressure off a foot blister.

3) Lower the friction level

Reduce the friction level between your shoe and sock. This is blister prevention (and deroofing prevention) GOLD. Why? Because you allow the sock and skin to move as a single unit so the sock actually protects the skin. Watch this video to see what I mean. Or you can reduce the friction level between your foot and the sock (lubricants, powders, moisture-wicking socks). It’s not quite as effective but better than not addressing the friction level at all.

Learn more about reducing friction levels.

Treating a deroofed blister

In a word … hydrocolloid blister plasters! Watch this video below for more information. You can pick up hydrocolloid plasters at pharmacies. Above all, just make sure they’re sterile. This is important, considering they are treating raw weepy wounds that can otherwise easily get infected.

Learn more about hydrocolloid blisters plasters here.

Not sure if you’ve got a deroofed blister? Learn about the three types of blisters and how you can get rid of foot blisters from this article.

Is it ever a good idea to deroof a blister? 

I don’t think so. Not unless there is so much dirt or infective material under the torn blister roof that you can’t remove with a good flushing with water or saline (salt water).

blister deroofing
Marathon Des Sables race medic deroofing a competitor’s foot blister ©iancorless.com – all rights reserved

Learn how to treat ANY kind of blister – Download the Blister Treatment Blueprint

Rebecca Rushton

Podiatrist, blister prone ex-hockey player, foot blister thought-leader, author and educator. Can’t cook. Loves test cricket.

No Comments
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  • carl weil
    23 June 2013 at 4:09 am

    blister fluid like frost bite fluid appears to delay healing and should be drained according to the belief of some. Does any one have any studies in this regard?carl@wildernessmedicine.com

  • Rebecca Rushton
    23 June 2013 at 4:51 am

    Hi Carl,
    I don’t know a lot about frostbite blister fluid but as frost bite is an injury of necrosis (tissue death) and ‘friction’ blisters are a mechanical fatigue of the epidermis, they’re probably quite different.
    Knapik et al (1995) do say this of a study by Cortese et al. “They found that if blisters were drained 3 times in the first 24 hours, or once at 24 or 36 hours, blister tops adhered to blisters bases with the greatest frequency. This resulted in the least discomfort and presumably reduced the possibility of secondary infection. Removing blister tops before 48 hours resulted in the greatest discomfort, inflammation and, in one case, secondary infection. Untreated blisters were often accidentally ruptured.”
    I haven’t read anything about the fluid itself retarding healing, but I assume it could if it was under a lot of pressure. I’m in favour of draining blisters on the feet (in a clean environment and using a clean technique to minimise infection!) because there is a lot of pressure from shoes and weightbearing that typically ruptures the blister and brings with it infection risk. But just small nicks to allow it to drain while keeping the roof in place all that’s necessary.
    Thanks for the great question and I’ll keep an eye out for anything else in this regard.

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  • Melissa Claire WhaleRaven
    1 November 2015 at 7:38 am

    Okay so how would you recommend dealing with a deroofed blister? Should we just dress it and ignore the pain or is there anything to actually deal with it?

  • Rebecca Rushton
    1 November 2015 at 7:46 am

    As I mention Melissa, you should dress it with a hydrocolloid dressing (eg: Compeed). And that link under "Treating a deroofed blister" heading takes you to this page: https://blisterprevention.com.au/blister-blog/foot-blister-treatment which tells you the importance of reducing friction and pressure as important factors to making it less painful. Make sure you read this about friction and fast blister healing: https://blisterprevention.com.au/fast-blister-healingAll the best.

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