The effect of hydration on the risk of friction blister formation on the heel of the foot

Background Friction blister research has focused on prevention and treatment approaches rather than exploring the pathophysiology of the friction blister. Increased skin hydration has been purported to be a key risk factor in friction blister development. This study aimed to test the effect of increased skin surface hydration on the risk of friction blister creation. Methods The skin on one foot was hydrated by soaking the foot in water. Intermittent loading was carried out until an observable change of 3 degrees C was evident using infrared thermography. The contra lateral foot acted as a control. Skin hydration and elasticity was measured using electrical capacitance and negative pressure respectively. Results The rate of temperature change of the hydrated group was significantly greater than that of the non-hydrated foot group (P=0.001) and showed a strong positive correlation (r=0.520) with skin surface hydration. Weak negative correlations were seen between skin elasticity and rate of temperature change in response to load application (r=-0.166) and skin surface hydration and elasticity at baseline (r=-0.195). Conclusion In controlled experimental conditions increased skin surface hydration increases the rate of temperature change of the skin in response to load application and consequently increases the risk of blister creation.