How to Deal With Blisters on the Trail

Think blisters are a sure thing when you hike? Think again: Here's your ticket to preventing and treating the dreaded sores.
Foot

Consider your average ripe peach. Press your thumb against the juicy fruit and gently move it back and forth. What happens? The skin moves under your thumb. Now press harder and rub. The skin rips and wrinkles, and peach juice dribbles down your hand.

The same pressure-and-friction principle comes into play when you hike. The outer layers of your foot's skin can move more than the sensitive inner layers can. Boots and socks apply pressure and friction as you walk, causing these skin layers to separate and fluid to fill the voida blister.

Now, let's get back to that peach. Say you dunk it in hot water. When you rub it, it peels more easily, right? Again, it's the same with your feet: Warm, moist skin blisters quicker than cool, dry skin.

The obvious lesson here is to keep your peaches out of hot water. You might also want to keep your feet dry, cool, and friction-free so you avoid blisters. To that end, we consulted a slew of foot and boot experts and tested a host of blister preventives and remedies. The results follow.

Preventing Ball Blisters

  1. Place a long, wide strip of tape on the floor, adhesive side up, and set the ball of your foot directly atop it.
  2. Press down to make your foot as wide as possible. Pull the ends of the tape up around the sides of your foot to meet on the top of your foot.
  3. Trim the tape to conform to the shape of your foot so the tape doesn't contact your toes.

Recommended by John Vonhof, fastpacker, ultrarunner, and author of Fixing Your Feet: Prevention and Treatments for Athletes (Footwork Publications, 877-421-7323; www.footworkpub.com; $15.95)

Should You Pop?

To pop or not to pop is the big and hotly debated question. Even the experts disagree about when to drain a blister. Buck Tilton, Backpacker contributing editor and director of the Wilderness Medicine Institute (WMI) of the National Outdoor Leadership School, has treated hundreds of backpackers' backwoods blisters, so we consulted him for the final word.

"At WMI, we open and drain almost all blisters (the exceptions are those caused by burns), including the controversial ones: blisters filled with hazy, cloudy fluid and even blood blisters on the heel or ball of the foot. Our philosophy is that a blister in a high-stress area is going to pop if you keep walking on it. We'd rather drain it in a controlled setting than have it burst inside a sweaty, dirty boot and sock."

To properly drain a blister:

  1. Clean the area with soap and water, alcohol, or an antiseptic towelette. Dry thoroughly.
  2. Sterilize a needle or sharp blade, either by holding it over a flame until it's red-hot or submerging it in boiling water for 2 minutes.
  3. Puncture the bottom end of the blister so gravity can help drain it. The opening should be no bigger than is necessary to get the fluid out. Starting at the top of the blister, massage the fluid toward the opening.
  4. Apply antibiotic ointment to prevent infection, then wrap with the dressing or blister product of your choice.

-Kristin Hostetter

Friction Prevention

  1. Clean and dry feet thoroughly, then coat each blister-prone area with tincture of benzoin. Let feet dry for 3 minutes, spreading apart any toes that were treated.
  2. Apply a thin layer of lubricant over all sticky areas. Try Vaseline, Sportslick, Bodyglide, or a silicone cream like Hydropel or Avon's Silicone Glove. In a pinch, use cooking oil.
  3. Wear a sock liner to prevent your wool or synthetic socks from getting slimy.
  4. Change your socks and reapply the lubricant every 4 to 6 hours. Be sure to wipe any grit from your feet before applying another coat.

Recommended by John Vonhof

Heel How-To

  1. Pop and drain a heel blister (see "Should You Pop?" ).
  2. Apply antiseptic cream directly to the blister and a layer of tincture of benzoin around the wound to help the dressing adhere.
  3. Cut a circular piece of moleskin, Molefoam, or your covering of choice 1/2-inch bigger than the blister. Cut a hole slightly larger than the blister in the middle of the covering and place the "doughnut" over the blister to create a pressure-free pocket around the sore.
  4. Cover the entire doughnut with a second piece of moleskin, then secure it with duct tape. Run tape strips along the sides of your foot toward your toes, then secure the ends with a few loops around the instep.

Recommended by Buck Tilton, Backpacker contributing editor and author of Medicine for the Backcountry.

Stick-to-it-iveness

Tincture of benzoin, a balsamic tree resin, has antiseptic, aromatic, and adhesive properties. It can be found in many forms-impregnated in cotton swabs, in small vials as a liquid, and as a spray-at drugstores and medical supply houses. Keep a little benzoin in your first-aid kit and use it to:

  • Augment the stickiness of any blister treatment. Just apply it to your foot, let it dry until tacky (a few minutes), then affix your dressing of choice.
  • Protect your skin from friction. When applied to unblistered skin, tincture of benzoin dries to a hardened shield, like a second layer of toughened-up skin.
  • Seal an existing blister as a last resort.

-Kristin Hostetter

Foot Soldiers

The brave men and women who serve in our military, hiking with heavy loads for days at a time, also serve as guinea pigs for blister research. Here's what they've discovered:

n Antiperspirant applied to feet reduced sweating, but it didn't prevent blisters. In some cases, it even increased irritation.

  • Those who jogged regularly were less likely to get blisters on a 10-kilometer (6.5-mile) hike.
  • The sock-and-liner method worked best if the outer sock maintained its loft (and thus its cushion) when saturated.
  • Soldiers using foot powder had a higher incidence of blisters than those not using it. Once saturated, the powder clumps and abrades feet.
  • Cadets who wore their boots for a total of at least 20 hours in the 2 weeks prior to maneuvers had fewer blisters.

-Susan Newquist

6 Steps To Blister-Free Bliss

The easiest way to deal with blisters? Don't get them. Sounds obvious, but

many of us forget that prevention is the best medicine. Here's some advice:

  1. Clip and file. Keep your toenails short and file down calluses.
  2. Buy boots that fit, then break them in.
    Wear your new or almost-new boots around the house and town, then venture out on dayhikes with a light pack. Slowly progress to longer trips. Use duct tape to smooth rough spots or protruding seams inside the boot. Heavy, stiff boots require a lengthy break-in. If you're in a hurry, do like some cowboys do: wade in water to soak the leather, then wear the boots until dry. They'll conform to the curves of each foot. Boot makers frown on this because it dries out leather, but if you regularly condition and clean your hikers, one thorough soaking probably won't hurt. A bit of mink oil will soften the toughest of tough shoes, but use it sparingly since it can oversoften leather.
  3. Adhere to three rules for socks:
    1) No cotton; cotton holds moisture next to your skin. 2) Wear socks with smooth, flat seams. 3) Wear socks with a snug fit and no wrinkles or baggy spots. Then experiment with different types and thicknesses. A thin synthetic sock liner slides against your sock and boot so your skin doesn't have to. Rub a bar of soap across the friction points on the outer side of liners to make them slide even easier.
  4. Tend to hot spots the minute they develop.
    Let feet air dry, then apply your choice of blister shield (see "Blister Beaters" on page 88). Timely application of duct tape or moleskin often will keep a warm spot from becoming a red-hot, weeping blister.
  5. Try supportive insoles.
    Both custom- made and over-the-counter insoles reduce movement inside a boot, thus limiting friction.
  6. Keep feet cool and dry.
    Change into dry socks at regular intervals during the day, and let the soggy pair dry outside your pack. In camp, don sandals so your sweaty paws can air out.

-K. Hostetter

Tape tips

Always place a layer of toilet paper over the skin before applying tape. Or, create a bandage by placing a smaller piece of tape in the center of a strip-sticky side to sticky side-so a smooth surface lies against the sore.

Avoiding Toe Blisters

  1. Wrap a small strip of tape, sticky side down, from the base of the toenail over the tip of your toe and then underneath it.
  2. Wrap a second strip around the circumference of the toe, covering the ends of the first strip. Cut the ends of the second strip as close to each other as possible without overlapping them.Recommended by John VonhofTrouble Afoot Within 6 hours of damage, blistered skin begins to recover. Within 48 hours, a granular layer-the stuff that makes skin tough so it doesn't hurt when you touch it-forms. Complete healing typically occurs within 5 days.