Use of antiperspirants to prevent friction blisters
Date First Published:
April 22, 2011
Last Updated:
May 5, 2011
Report by:
Emmy De Buck, Staff member Expertise Centre (Belgian Red Cross-Flanders)
Search checked by:
Tessa Dieltjens, Belgian Red Cross-Flanders
Three-Part Question:
In [persons who are at risk for friction blisters] does [the use of antiperspirants] prevent [friction blisters]?
Clinical Scenario:
An 18 year girl went hiking for the first time. Unfortunately she had to interrupt the trip because she suffered from several friction blisters on her feet. When arriving at the emergency department with an infected blister, she asks you whether she could use antiperspirants in order to prevent blisters the next time.
Search Strategy:
Medline 1966-1 March 2011 using the Pubmed interface: "Blister"[Mesh] AND ("Antiperspirants"[Mesh] OR antiperspirant* OR "Aluminum Compounds"[Mesh] OR "Emollients"[Mesh] OR "Sweat"[Mesh]). 16 hits
Embase and Medline 1947-1 March 2011 via the Embase.com interface: 'blister'/exp AND ('antiperspirant agent'/exp OR antiperspirant* OR 'emollient agent'/exp OR 'aluminum derivative'/exp OR 'sweat'/exp). 78 hits
The Cochrane Library using the Wiley interface: “MeSH descriptor Blister explode all trees” AND Antiperspirant*. 1 hit
Embase and Medline 1947-1 March 2011 via the Embase.com interface: 'blister'/exp AND ('antiperspirant agent'/exp OR antiperspirant* OR 'emollient agent'/exp OR 'aluminum derivative'/exp OR 'sweat'/exp). 78 hits
The Cochrane Library using the Wiley interface: “MeSH descriptor Blister explode all trees” AND Antiperspirant*. 1 hit
Outcome:
95 papers were found of which 92 articles were irrelevant or of insufficient quality. The remaining 3 papers are shown in the table.
Relevant Paper(s):
| Study Title | Patient Group | Study type (level of evidence) | Outcomes | Key results | Study Weaknesses |
|---|---|---|---|---|---|
| Influence of an antiperspirant on foot blister incidence during cross-country hiking Knapik JJ, Reynolds K, Barson J. 1998 United States | 667 cadets with with 328 using an antiperspirant (20% aluminum chloride hexahydrate in anhydrous ethyl alcohol) and 339 using a placebo preparation (anhydrous ethyl alcohol) during 5 nights, followed by a 21 km hike | Intervention study (non-randomized controlled trial) | Blister incidence | 21% for antiperspirant group and 48% for placebo group (p<0.01) | Not stated if groups were randomized; high rate of noncompliance with the treatment schedule |
| Skin irritation after product use | 57% for the antiperspirant group and 6% for the placebo group (p< 0.01) | ||||
| Effects of an antiperspirant with emollients on foot-sweat accumulation and blister formation while walking in the heat. Reynolds K, Darrigrand A, Roberts D, Knapik J, Pollard J, Duplantis K, Jones B. 1995 United States | 23 healthy men using (1) an antiperspirant (20% aluminum zirconium tetrachlorohydrex glycine concentration plus water) with emollient additives, (2) emollient additives alone (placebo control), or (3) nothing (nontreated), followed by walking on a treadmill in a warm environment |
Intervention study (cross-over study) | Blister incidence | Antiperspirant with emollients vs emollients alone: 39% vs 52% (not significant) | Small study |
| Irritant dermatitis after product use | No irritant dermatitis observed for neither condition | ||||
| Efficacy of antiperspirants on feet. Darrigrand A, Reynolds K, Jackson R, Hamlet M, Roberts D. 1992 United States | 16 male soldiers using two types of antiperspirants or nothing, during five days followed by a 1-hour treadmill march in a warm environment | Intervention study (within subjects design) | Blister incidence | antiperspirant 1 (aluminum chlorohydrate): 0% for antiperspirant group vs 50% for control group (statistically significant according to own calculation and discussion of Knapik 1998); antiperspirant 2 (aluminum zirconium tetrachlorohydrex glycine): 18,75% vs 50% (not significant) | No placebo treatment was used; not clear if washing with soap was also performed on control days; small study; some data were reported not to be significant, but in fact are significant after recalculation |
| Irritant dermatitis after product use | antiperspirant 1: 43,75% for antiperspirant group vs 0% for control group (p<0.05); antiperspirant 2: 31.25% for antiperspirant group vs 0% for control group (p<0.05) |
Bottom Line:
Evidence could not show a significant decrease in blister incidence when antiperspirants together with emollients were used. Evidence suggests a decrease in blister incidence when using antiperspirants alone, however antiperspirant use would also cause skin irritation.
References:
- Knapik JJ, Reynolds K, Barson J. . Influence of an antiperspirant on foot blister incidence during cross-country hiking
- Reynolds K, Darrigrand A, Roberts D, Knapik J, Pollard J, Duplantis K, Jones B. . Effects of an antiperspirant with emollients on foot-sweat accumulation and blister formation while walking in the heat.
- Darrigrand A, Reynolds K, Jackson R, Hamlet M, Roberts D.. Efficacy of antiperspirants on feet.