Wednesday, May 2, 2012

Dan Crane: Blisters Suck

Hikers’ sweaty feet are one of my favorite things.  Especially, when their hiking boots do not fit correctly or are not properly broken in.  Their soft, damp skin rubs against the sides of unyielding boots, giving birth to my nascent self.   Layers of skin separate, and the space between these layers fills with liquid.   This is when I take control.

I am a blister.  And I want nothing more than to ruin your outdoor experience.

Let’s face it, blisters suck.  There is just no getting around this fact.  Anyone who has ever suffered through a long hike with one or more on their heel or toe knows this all too well.  Once they begin to form there is almost nothing that can be done to reverse the process, short of several weeks of rest and an absolute absence of rubbing.  These conditions are nearly impossible to be had in the middle of the Adirondack backcountry, days from the nearest trailhead.

Blisters form when pressure and/or rubbing on skin forces the epidermis (the outer layer of skin) to separate from the more sensitive layers beneath.  The space quickly fills with fluid (called serum), whose purpose is to cushion, protect and heal the exposed inner layers of the skin.  Although a blight to every hiker, blisters are actually the body’s attempt at healing an injury between layers of skin.

Although blisters can form anywhere pressure and rubbing on the skin occurs, they typically form on the hands and feet.  For backcountry enthusiasts, blisters on the feet are more troublesome, although “white knucklers,” who grip their hiking poles too tightly are prone to them on their hands.

Hiking blisters most frequently form on the ball of the foot, around the heel or between and/or on top of the toes.  While those on the toes may be tolerable, blisters on any other part of the foot will result in teeth-gritting pain at best, and feet resembling freshly ground beef at worst.

But fear not, there is a solution better than lancing every bulging blister and applying multiple layers of gauze and tape over it until the feeling disappears in both feet.  Instead of dealing with the pain and inconvenience after the fact, try a little bit of preventive medicine first.

With blisters, as much else, an ounce of prevention is worth a pound of cure.  In other words, it is best to spend a little time on the trail (and before leaving home) preventing blisters rather than spending weeks pouting at home over sore and scarred feet.

Preventing blisters is pretty easy, but it takes vigilance and dedication.

Thwarting blisters starts at home, or more importantly at the store.  Proper fitting hiking boots keeps rubbing to a bare minimum, and therefore makes blister formation less likely.  Do not forget to give your shoes some time to break in.  Breaking in requires wearing the shoes around town at first (it’s a fashion statement!), followed by some shorter day trips.  These trips give the skin on your feet an opportunity to toughen up too.

Wearing thin liner socks made of wicking material, like polypropylene, allows for the rubbing to take place between sock layers instead of skin layers.   A thicker sock, made of wool or a wool blend, is an excellent choice for the outer layer.   Since it is important to keep your feet dry, the outer layer should be of the proper thickness for the expected temperatures, lighter ones during the summer, and thicker ones during the colder months.

Anyone with chronic trouble spots, where blisters are known to form, should consider taping these areas up from the get-go.  Why wait for blisters to form, if you are all but certain they will?  Be proactive and save yourself some trouble on the trail, tape these areas at the trailhead.  Or in the car on the way there, but only when not driving.

Typically, “hot spots” develop prior to full-blown blisters.  Immediately treating these sensitive, red areas is imperative for preventing blisters from developing and ruining a hike.  Any type of bandage that reduces the amount of friction is useful for treating hot spots, including plastic adhesive bandages (i.e. Band-Aids), moleskins or even.  See, your father was right, duct tape DOES fix anything.

Once a full-blown blister forms, the options for dealing with it are rather limited.  Moleskins can be cut to surround, but not cover the blister.  This is often difficult with large or irregularly shaped blisters.  The idea is to allow the blister to breathe but prevent rubbing, unfortunately this does not work once the blister is thicker than the moleskin.

There are a multitude of different bandages specifically marketed for blisters.  One of the most effective treatment solutions to blisters is Spenco 2nd Skin.  This bandage is a thick, gel-like pad placed over the blister, forming a second skin as a protective layer.  In addition, it is good for treating minor burns, scrapes, rashes, stings, bites, poison ivy, as well as blisters.  Do not go into the backcountry without it!

The only bad thing about Spenco 2nd Skin is the adhesive bandage that goes over the gel pad.  In my experience it almost always fails from the typical rubbing inside a hiking boot.  It is best to place a prodigious amount of duct tape over the adhesive bandage, just to be on the safe side.

Sometimes blisters get so big that it is impossible to fit your foot back in the hiking boots.  So as a last resort, the blister can be punctured and the serum drained.  This procedure is not for the faint of heart, and can easily result in infection.  So beware.

Draining a blister is disgusting, yet straightforward.  The blister, hands and needle should be thoroughly washed, and treated with isopropyl alcohol.  The blister should be pierced in multiple places at its base, and the fluid drained by placing pressure on the blister with your fingers, if necessary.  Leave the overlying skin in place to act as a protective layer over the more sensitive skin beneath.  Apply an antiseptic, and bandage the blister thoroughly to protect it from further irritation.  See a doctor if there are any signs of infection.

Blisters are a terrible blight on outdoor fun, and can ruin a backcountry adventure.  So, take the proper precautions, treat hot spots early and avoid blisters as much as possible.  If not, they will surely make you wish you did.

Photo: A nasty bushwhacking blister by Dan Crane.

Dan Crane blogs about his bushwhacking adventures at Bushwhacking Fool.

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Dan Crane writes regularly about bushwhacking and backcountry camping, including providing insights on equipment and his observations as a veteran backcountry explorer. He has been visiting the Adirondacks since childhood and actively exploring its backcountry for almost two decades. He is also life-long naturalist with a Master of Science in Ecology from SUNY ESF and 10+ seasons working as a field biologist, five inside the Blue Line.

Dan has hiked the Northville-Placid Trail twice and climbed all 46 High Peaks but currently spends his backpacking time exploring the northwestern portion of the Adirondacks. He is also the creator of the blog Bushwhacking Fool where he details his bushwhacking adventures.




7 Responses

  1. Josh says:

    I agree, blisters suck. I’ve had some doozies myself. But please spare us the disgusting foot picture. I just puked in my mouth a little.

  2. Jack says:

    Great article! (and photo)
    I agree vigilance is the key. Stop as soon as you feel an irritation and deal with it immediately. The only good blister is the blister that’s been prevented.
    The only caution I would add is to be careful with high quality duct tape. I’ve seen people rip off skin when trying to remove it. I personally avoid it. I like to use tape that is designed to be used on human skin.

    • Dan Crane says:

      If the duct tape makes it home still on my feet then I try to remove it in the shower. Typically, it wears off my feet way before then.

      I have never had skin come off while removing duct tape, but I did scratch a layer of skin off once while trying to remove a speck of dirt from my foot. Ouch!

  3. Allie says:

    Loved the article. Blisters do suck. For prevention I have found that vaseline on a telfa pad covered with moleskin works well. It all needs to be taped securely so the dressing itself doesn’t rub. For treatment, an antiseptic “liquid bandage” called new-skin is very helpful. It burns when 1st applied, but then forms a protective layer over the blister. If a large bandage is applied over that, relief is significant, and healing is accelerated.

    • Dan Crane says:

      Allie,

      Awesome blister treatment suggestions. I never thought of using liquid bandage before, although for a backpacker carrying a glass container of a liquid is a tad bit inconvient. That’s where Spenc 2nd Skin outperforms. Since it is a gel bandage, it can’t spill or break, but it still has many of the properties of liquid bandages.

      Keep the ideas coming.

      Blister suffers unite!