Away from the Grind

BLISTERS: How to Prevent and Treat Them

by Roger Ludwig

BURNING BLISTERS

Nothing can turn the Sound of Music into the Batan Death March faster than blisters. The sure footed hunter or hiker can be reduced to a tender foot, limping, hobbling home.

The scientific formula to produce a blister goes something like this: Friction + Pressure + Heat + Moisture + Tenderness = Blisters. In other words, increasing any of the above, friction, pressure, heat, moisture and tenderness will increase the odds of blister formation. 

So what can be done?

1. Decrease friction with shoes that fit well, tied properly. The heel should be snug enough to stop slipping, possibly using a runner‘s loop at the ankles. The padding of good socks helps. Known trouble spots can be covered with moleskin in advance. Duct tape is OK if nothing else is around but it doesn’t stick too well as feel sweat.

2. Decrease pressure with shoes that give room in the toes for expansion. On a long hike feet swell. A width size larger than street shoes may do the job, lacing loose over the toes.

3. Decrease heat with well ventilated boots. Those new boot and shoe types with high tech fabric panels are a big improvement over leather boots for air flow and heat loss. Boot insulation should match the season, too, as should sock thickness. If it’s really hot it helps to take boots and socks off when resting. Cooling off feat in a cool stream can be good.

4. Decrease moisture with a pair of wicking sock liners under wicking socks. The liners really add a level of moisture reduction and are easy to wash on the trail over multi-day trips. Boot ventilation panels are great in this way also. They let perspiration out and keep water from coming in.

5. Decrease tenderness and increase skin toughness by wiping foot soles and heals with rubbing alcohol once or twice a day for three to four weeks before the season. Some people just have blister-prone skin. This idea comes from Colin Fletcher, the first man known to have hiked the length of the Grand Canyon without cresting the rim. He mentioned it in A Walk through Time. I’ve tried it and am convinced it works. At a dollar or two for a bottle of rubbing alcohol and scrap of fabric it’s a bargain.

When hiking, deal with a hot spot on the foot right away. Think about what might be causing it. If it’s friction, can the boots be tied to stop the sliding? Put on a good sized piece of mole skin or medical tape so the friction is on it instead of the skin.

Is it pressure? If so, loosen the lacing to make more room, or put on thinner socks. Heat? Cool the feet off. 

With more than a month away from the start of hiking season those who are tender feet by birth have time to toughen up with the alcohol. This is one time when “alcohol treatment” is accomplished by its liberal application. Feet, drink up!

Bound along happy and hearty this spring, summer and fall. 

What can be done if a blister has already developed? It is essential to keep it infection free. A nasty infection on a hike of two or more days can cause extreme pain and be truly dangerous. Because of this some would advise trying to keep the blister from opening, reducing pressure by padding the area around the blister with moleskin with a hole cut in the center for the blister.

Most don’t want the pain of the blister itself. This is where the elementary school trick of pushing a needle under your skin just a couple layers deep is useful. Using a sterilized needle, lance the blister by entering the skin about a quarter of an inch away from the blister’s edge. Push out the fluid. Doctor the opening and the blister with a dose of good antibiotic, such as betadyne. Cover it all with moleskin, tape or a bandaid.

It is likely to refill with fluid from and will need to be lanced again from time to time. Keep slathering on the antibiotics.

If the blister has already opened itself, apply the antibiotic and tape it over, loose skin and all, if any remains.

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