A sensitive subject for hikers: how to prevent and treat blisters.
Prevention: three key elements
The reason for blistering is simple: pressure and friction act on the foot, separating layers of skin. Fluid forms between the layers, causing the skin to bulge out. Prevention involves three main factors: properly fitting boots, the right socks, and taping before a hike. You'll want to buy a well-made boot that fits without riding up and down on the heel or squeezing the toes. Allow for a break-in period of a few weeks so you'll know trouble spots and can experiment making adjustments. If, for example, you have a narrow heel that slips in otherwise well-fitted boots, consider a heel grip, a smile-shaped piece of adhesive-backed suede, cloth, or foam that should help hold your heel in place without pinching. Your boots should fit comfortably over two layers of socks. Most experienced hikers recommend wearing a light inner and a thicker outer sock. Since perspiration helps blisters form, wear an inner sock, such as polypropylene or silk (cotton is not as good because it balls up and holds moisture), to wick moisture away from the skin. Then choose a cushiony wool or wool-blend outer sock. Some hikers dust medicated foot powder between sock layers to absorb moisture.
Pack spare clean socks and change as soon as the socks you're wearing get soiled or damp--even in mid-hike. It's also a good idea to remove socks and boots frequently and, if possible, to soak your feet on a tough, hot hike; it's not true that removing your boots makes it difficult to put them back on. Take comfortable sneakers or rubber sandals to wear at trail's end.
If you blister easily, the third key is to apply tape before beginning your hike. Use a breathable adhesive tape (sometimes labeled as first-aid tape), or use moleskin, an adhesive-backed cotton pad. Don't use white waterproof tape; it doesn't let skin breathe.
If you have calluses, remove them well before your hike. These hard spots are irritants, like a pebble under the skin. If they are large, you may want to consult a podiatrist, but small ones can be removed with an emery board, callus file, or softening cream; scissors or an open blade may cause infection.
Field-treating a blister
The instant you feel a hot spot on your foot, stop and treat it. Wash the area with soap and water or use an antiseptic ointment, spray, or towelette; let dry. (Never use alcohol; it stings and dries your skin.)
If the hot spot is small, you can cover the area with breathable tape. If it's red and tender, protect the area with moleskin or a new lightweight latex foam that's backed with adhesive. In a patch of one of these materials, cut a hole the size of the hot spot (some products are precut); place the hole over the red area. Then spray or daub an antiseptic on the area and cover with a gauze bandage.
On those areas that are difficult to pad--tops and undersides of toes, the ball of the foot--apply thin breathable tape to absorb the friction.
If a blister forms, make sure no padding touches it. If padding or tape is already on the blister, don't peel it off until you get home: removing it may cause the blister to break. Try not to pop the blister, as this opens the area to infection. But if it does pop or grow so large you an't walk without draining it, lance it with a flame-sterilized needle or pin. Poke the blister at the edge, not the middle, retaining the skin flap cover. Clean with soap and water or antiseptic.
Surround the blister with a doughnut pad and bandage (directions precede), or apply Second Skin, a new breathable product that helps keep germs out and promotes faster healing. This cool, gelatinous material sticks to the skin without absorbing the skin's moisture. Apply it directly to the blister area, then put your sock over it or a doughnut pad around it.
You can buy blister treatment kits in some camping equipment and sporting goods stores for $3 to $10; Second Skin ($4 for a package of 39 square inches) and the other materials we describe are found in some drugstores and camping equipment stores.
Blisters should begin healing within two to four days without irritation. Consult a physician if there is pus, constant drainage, or red lines moving up your leg, or if you have a history of diabetes or circulatory disease.
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|Date:||May 1, 1985|
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