Blisters are so small but can cause so much discomfort. They have been around for as long as man has been creating comfortable footwear with an abundance of different types of materials.
Today, along with chafing and bag straps digging into shoulders, blisters are probably one of the most common injuries to hikers. But thankfully as our design of footwear has evolved, so has our knowledge of blisters.
In this article, we are going to discuss the main three areas of dealing with blisters:
1. What causes blisters – Pressure, moisture and heat being the three main causes
2. How to prevent blisters – Correctly fitting footwear, adequate socks, dealing with any early signs that a blister may form
3. How to deal with blisters before they worsen – Cover the blister adequately, protect, and avoid poping
Remember: Safety is your responsibility. No article or video can replace the advice of a medically trained professional. Make sure you’re practised in proper techniques and safety requirements before you render first aid.
1. What causes blisters?
Blisters can be caused by an allergic reaction, a scold, a burn, skin conditions or even spider bites, but the most common culprit is friction. When you have enough friction in a focused spot, cell damage occurs. The serum (fluid) inside a blister helps protect and heal the damaged tissue. Red fluid found in a blood blister simply means that capillaries in the area of the blister have also been damaged.
With regards to hiking or physical exercise, three main factors make blisters more likely to happen:
- Direct friction: Any place where a shearing force nips or grabs the skin and slides can cause a blister. That might happen inside your boot heel or inside a glove where you grip the shaft of a trail tool. Eventually, the epidermis (upper skin layer) separates and fluid enters the space, causing a blister.
- Moisture: Moister (sweatier) skin is softer skin, which is more susceptible to damage when friction occurs.
- Pressure: A tight spot in your boot or a wrinkle in your sock can create a friction pressure point.
2. How to prevent blisters
Preventing blisters is all about knowing the tell tale signs, once you know these you can take the necessary steps ensure you minimize the risk of getting blisters.
To prevent blisters, follow these guidelines:
Make sure your boots fit and are broken in properly: To avoid pressure points, slippage or both, the foundation of blister prevention is getting the right fit when you buy your boots. You must slowly break in your new footwear, walking around the house, garden or neighbourhood first. Your fist voyage in new shoes should not be a 30 Mile hike.
Wear proper socks: When hiking, the number one rule is to avoid cotton, which is great at retaining moisture. Go with synthetic or wool instead and make sure they fit correctly (too big and you can have wrinkles; too small and you can create pressure points and sock slippage). You might also want to try wearing a second pair of socks such as a liner sock; these add a protective layer between the skin and your primary hiking socks and can help wick away moisture. Double socks can perform the same function. I have personally done this for years, and it works well.
Change to dry socks: Fresh socks get your feet back to the same low moisture level you had at the beginning of your hike. They can also come in handy if your socks get soaked during a stream crossing. So always keep an extra pair in your backpack, they are light and don’t take any room.
Deal with hot spots quickly: Pay close attention to how your feet feel as you hike. The minute your feet begin to feel uncomfortable then stop and take your boots and socks off. If the area is even slightly red, then dry it off and apply your preferred form of protection. Many companies sell blister kits that include a range of products for both treatment and prevention. Blister prevention kits usually include the following:
Tape: Studies suggest that inexpensive “tear-to-size” paper surgeon’s tape is effective and has a gentle adhesive; kinetic tapes also work very well; cloth and synthetic medical tapes are additional options, as is duct tape in a pinch.
Blister bandages with pads and gels: Products like 2nd Skin can be used on both hot spots for prevention and for blister treatment.
Moleskin: The classic cut-to-size blister-coverage product is durable and sticks well; similar products do the same thing but go by different names.
A personal recommendation is a talcum cooling powder called Snake brand
3. How to deal with blisters before they worsen
The NHS recommends that to relieve any pain, use an ice pack (or a bag of frozen vegetables wrapped in a towel) on the blister for up to 30 minutes.
- Apply a blister pressure pad (Link), and if you don’t have one for yourself, create one from a piece of foam or plaster and tape. For extra protection, you can add a layer of Moleskin or tape over everything.
- Drain the blister, only if necessary: Blisters should heal on their own in about a week. In general, the NHS advises against draining a blister due to the chance of infection when opening a blister to release the fluid: You’re creating a chance for infection, and you’re removing the protection and healing that the serum provides. However, if the blister has become too painful and you decide to drain it yourself, follow the steps below. If your blister pops on its own, then follow steps 4 and 5:
- Wash the blister and surrounding area with antibiotic soap or alcohol or an antibacterial wipe. Basically the best you can come up with in the situation.
- Sterilize your needle / or pin (or whatever you will use) with alcohol or heat.
- Insert the needle near the base of the blister.
- Dress the blister-like you would a wound, using antibiotic cream and gauze or a Plaster.
- Cut and place a blister pressure pad or equivalent around the area to prevent further irritation; for added protection, fill the hole with antibiotic cream, then add a layer of tape over the top.
While it’s rare for a blister to get infected, it’s important to keep a close eye on it. Evacuate to get medical care if the following symptoms develop: redness, pain, pus or red streaks travelling toward the nearest lymph node.
IMPORTANT: Do not ignore an infected blister. Without treatment, it could lead to a skin or blood infection.
One of the best places to contact. If you have a blister and feel you need assistance, is a local pharmacy a list can be found here using the NHS find a pharmacy page.