Blistered hands are the calling-card of rowers everywhere. Managing them can become an athlete’s obsession.

WORDS DR ED WITTICH

Blister; a rounded elevation of the skin containing clear fluid, caused by a separation either between layers of the epidermis or between the epidermis and the dermis.

A simple sentence describing a rather vague bubble-like lesion between the upper layers of the skin, this benign sounding bubble affects every rower on the planet. While most blisters are just irritations that require no medical assistance, more serious or chronic blisters have the ability to cause severe pain, irritation, infection and even end a performance in extreme cases. At this year’s Australian Open Tennis Championship an incredible run of wins from newcomer Chung Hyeon was ended as he pulled out of his semi-final against Roger Federer due to serious blisters – the crowd booed as Hyeon limped off the court but anyone who has felt the wrath of an aggravated blister will sympathise. “I row, therefore I blister,” is an accurate synopsis.

Blisters commonly result from pressure and friction on sites such as the palms of the hands or soles, heels and toes of the feet. In most cases they are created when friction causes an upper skin layer to move back and forth over an underlying skin layer or when prolonged direct pressure impacts the skin enough to break it. Blisters may also occur as symptoms of contact dermatitis, viral infection, or an auto-immune disease. We are focusing here on friction or contacttype blisters.

The epidermis is the protective outermost portion of the skin. There are two layers of epidermis, the living basal layer, which is next to the dermis, and the external stratum corneum. Our skin is a complex organ. With friction or pressure applied to the skin, a small gap opens up between the outer layers of the skin and is filled with liquid, most likely in a clear form, called serum, caused from the initial inflammation. Blisters can also be filled with blood causing them to appear red, or sometimes they can be filled with dead blood cells or be affected by an infection – in this case they may be filled with pus and appear yellow.