BLISTER ADVICE FROM THE NET Here are responses to a question I posted to rec.backcountry in 1990. Since that time I have tried many of the recommendations. You will find my comments about some of the following suggestions in [brackets] after the posting. Here are some general tips I have learned in 15 years of backpacking: *Prepare you feet ahead of time. Go barefoot or wear sandals as much as possible. You can toughen your feet with tincture of benzoin or rubbing alcohol. *You must have good boots that fit. Break them in before a long hike. Get them at a reputable outdoors store to make sure they are right for you. *Protect your feet ahead of time with Moleskin at places where you normally get blisters. Some hikers use duct tape instead. *At the first sign of trouble, stop! Don't go that extra mile to the campsite or lake. Let your impatient hiking buddies go ahead. *If you get blisters, try to get a rest day as soon as possible. The rest can give your chewed up feet a chance to recover. Tom Griffin griffin@u.washington.edu Updated September 8 >From: moore@Neon.Stanford.EDU (Rebecca T. Moore) Newsgroups: rec.backcountry,sci.med Subject: Re: Blisters Date: 24 Apr 90 04:33:08 GMT In article <6752@blake.acs.washington.edu> griffin@blake.acs.washington.edu (Tom Griffin) writes: >What are your personal tips for preventing blisters? Having soft skin, I used to have a lot of trouble with blisters. No more. There are definitely things I've learned which prevent blisters. Some of them are pretty obvious, but I'll list them anyway: Wear boots that fit well, especially not too tight. Leave the boots tied somewhat more loosely for uphill hiking. Tighten on the downhill when you need more support. At the first even subliminal sensation of a "hot spot", stop, take off your boot, let your feet dry out and apply moleskin (miracle blister prevention felt-bandage available from drugstores.) In the days when I had a pair of boots that always caused me to blister in a certain place on the heel, I'd put moleskin on my heel before even starting the hike. Try to keep your feet as dry as possible. I have found that when my feet get damp, the skin softens up and is much more likely to blister. Wear a thin, wicking inner sock under a thicker sock. Let your feet air out when you stop for a break. If your liner socks get really damp, put on a fresh pair and let the wet ones dry. Foot powder can also help. Before the hike: I'd always heard that the best thing to do before a hike is to wear your boots around to "break in your feet". Even more useful than this, I think, is to toughen the skin of your feet by exposing them to air. If you go around all day in shoes, your feet stay more damp and your skin stays more soft. Try to keep your feet drier by going barefoot or wearing sandals as much as possible. This has made an enormous difference for me. I start a couple of weeks ahead of time. If I'm really in a fanatic mood, I'll put rubbing alcohol on my feet at night to toughen the skin. You can also use "tincture of benzoine" or "friar's balsam" (which boxers apparently use to toughen their hands.) This stuff works but is sticky. [I used tincture of benzoin before my last trip, a 55 miler on the Pacific Crest Trail for 7 days. The stuff did seem to toughen my feet. I still got two blisters, but they were minor compared to the hellacious fiends that have plagued me in the past. Both my hiking partners also had blisters and both cases were worse than mine. You can get this stuff at any drug store.--TG] Some of these may seem like a hassle. Yet blisters can ruin a trip faster than anything - I have found it to be worth the extra effort to keep my feet happy. -- Rebecca Moore moore@cs.Stanford.EDU >From: howard@53iss6.Waterloo.NCR.COM (Howard Steel) Newsgroups: rec.backcountry,sci.med Subject: Re: Blisters Date: 24 Apr 90 12:36:58 GMT In article <6752@blake.acs.washington.edu> griffin@blake.acs.washington.edu (Tom Griffin) writes: >Last year I had a bad case of blisters while backpacking. I >bought new boots with a Goretex lining, but I want to make sure I >don't repeat last year's disaster. Can anyone explain why blisters form? >Is rubbing the key, or do heat and moisture contribute to blister >formation? >From experience rubbing is the key, but heat & moisture do contribute to the formation. >What are your personal tips for preventing blisters? What I have found to be the most effective prevention is a two layer approach. I wear the foot out of a nylon (or some of those nylon sockets that some of the ladies wear), covered with a good quality wool sock. It seems that the two surfaces slide over each other and limit the abrasion on the foot; works for me. [Liner socks are praised by many, but I have found that they don't work for me. They make my feet hotter. On my last trip, 2 miles from the trailhead my feet were burning. I swear I could feel the weave of the liner sock on the soles of my feet. I took them off and my feet got better immediately. I do wear Therlo socks now. They cost a lot and have a blister-free 'guarantee,' but I still get blisters wearing them. They are better for me than wool, however, since they are padded in places that take abuse and not as hot. Be sure to rinse them in fabric softener after you wash Therolo socks. Something in the softener helps them prevent blisters. At least that's what it says on the label. --TG] >And also, when you get them, how do you treat them and still hike >out whe you are 30 miles from the trailhead. There are some topical sprays that can be used if the blister has broken that seem to cover it very well and reduce pain. If it hasn't broken, pad the area with some cotton and limp a lot. -- Howard.Steel@Waterloo.NCR.COM NCR Canada Ltd. Product Safety E & M Waterloo (519)884-1710 Ext 570 580 Weber St.N Waterloo, Ont., N2J 4G5 (519)884-0610 Facs >From: kab@cs.washington.edu (Karen Bartlett) Newsgroups: rec.backcountry,sci.med Subject: Re: Blisters Date: 24 Apr 90 18:54:11 GMT > >And also, when you get them, how do you treat them and still hike > >out whe you are 30 miles from the trailhead. Spenco Second Skin is great once you have blisters. It seems to be some type of gel layered between thin plastic (baggie like). You cut a piece of this and stick it to the blistered (open or not) area with a slightly larger piece of Spenco's variant of moleskin (which some people think is better than moleskin -- its a little thinner). It can be found at most backpacking stores -- not cheap -- think you get 2 3x5" pieces for about $5. Too expensive for prevention but worth it when you really need it. [I highly recommend Second Skin. It has saved me from agony on at least three backpacking trips. Placing the gel directly on the blister creates instant relief. Yes, the gel is messy and usually it squishes out from its bandage due to the pounding of your feet, but the mess is definitely worth it for the comfort it provides. Don't leave home without it if you suffer from blisters.--TG] On the prevention front, - if your blisters are due to your boots not quite fitting correctly you may be able to compensate for this with some inner soles which are available in various widths. - two layers of socks -- light (nylon, polypro, ?) inner and wool outer - use moleskin on the problem areas ahead of time. >From: djl@mips.COM (Dan Levin) Newsgroups: rec.backcountry Subject: Blisters: Prevention and Cure Date: 24 Apr 90 18:47:44 GMT Just a couple of bits... When you first begin to feel a "hot spot" is the time to take action. If you wait until the skin begins to separate, you have already suffered damage. A "hot spot" is a discolored and tender area of skin. Moleskin, which is certainly trademark someone (Dr. Sholls?), is a miracle preventive. As already noted in another article, it is put to best use on areas known to be prone to blister, or on early hot spots. Moleskin is a self-adhesive, felt-like material, that works by transferring the friction to the surface of the material, instead of your skin. Once you have separation between two layers of skin, fluid begins to build up and you have a true blister. At this point, you need to both remove the source of the irritation, and help the skin to heal. The first is best accomplished with a new product from Spenco, called Second Skin(tm). Second Skin is a high water content product, not unlike extended wear contact lenses. It comes packaged between two layers of plastic film, and if left in that form serves to remove all friction between skin and sock or boot. Simply apply the second skin to the blistered area, and secure in place with Kling or some other adherent gauze. Second Skin will also be very helpful to more advanced hot spots that have not yet blistered - whether it works better than MoleSkin is a matter of personal opinion. To help the blister to heal, if things have gotten to the point of a fluid filled area, you must first drain the fluid by puncturing the dead skin covering. This is best done with a #11 scalpel, but a sterile needle will work just as well. Leave as much of the covering skin in place as possible, it helps to protect the sensitive underskin and encourage healing. Here again, you should cover the blister with Second Skin, but this time peel the side closest to the skin. The Second Skin will protect the wound, while permitting drainage. It also cools and soothes the injured skin. Again, secure the second skin with some type of adherent gauze or thin tape. You do not have to just limp and bear it. Second Skin is amazing stuff, you can't really comprehend the magnitude of its benefit until you have to hike out with a nasty blister and someone convinces you to try it. NB: The above information is mostly derived from a book on Wilderness Medicine, the name of which escapes me at the moment. I am not certified to practice any type of medicine, and offer the above as friendly advice... Second Skin was originally developed as a burn bandage, and its use in blister care is an unlikely side benefit. Yours for more fun outdoors, >From: sgilley@cbnewsl.ATT.COM (The Idealistic Cynic) Newsgroups: rec.backcountry Subject: Re: Blisters: Prevention and Cure Date: 25 Apr 90 18:45:42 GMT In article <38198@mips.mips.COM> djl@mips.COM (Dan Levin) writes: >Once you have separation between two layers of skin, fluid begins >to build up and you have a true blister. At this point, you need >to both remove the source of the irritation, and help the >skin to heal. > >The first is best accomplished with a new product from Spenco, called >Second Skin(tm). > >To help the blister to heal, if things have gotten to the point >of a fluid filled area, you must first drain the fluid by >puncturing the dead skin covering. I don't know anything about the product mentioned, but if you do puncture the blister and let the fluids drain, remember that infection is a lot more likely. *Do* use a sterile needle or scalpel. *Do* try not to remove any more of the outer skin than absolutely necessary. If possible (as I said, I've never used this "Second Skin" stuff) put a little antibiotic on the wound before covering. If possible, anytime you change the dressing wash with clean, sterile water and add more antibiotic. A lot to do on the trail, huh? As many people have pointed out, often wearing an undersock solves the problem... it certainly did for me. Sean. --- Sean L. Gilley attunix!oac!slg attmail!sgilley 201 805 9088 (h) 201 457 5403 (w) "Oh, what fools these mortals be..." >From: lasala@svax.cs.cornell.edu (Steve LaSala) Newsgroups: rec.backcountry,sci.med Subject: Re: Blisters Date: 27 Apr 90 15:34:38 GMT In article <6752@blake.acs.washington.edu> griffin@blake.acs.washington.edu (Tom Griffin) writes: > >Last year I had a bad case of blisters while backpacking. I >bought new boots with a Goretex lining, but I want to make sure I I like GT garments, but I'm sort of down on it for boots. Yes, it has kept my feet dry for about a day in light boots, even in deep snow and slush. Over longer periods, the boots gradually got wet anyway, and stayed that way. On the other hand, when the leather stretched, the GT didn't, but tore instead, and there is no way to replace it, or to clean it when the pores get full of foot-sweat. There exist GT socks. Perhaps they would work better, but I haven't tried them. When the weather is dry, I find the GT does not breathe enough to let my feet stay even moderately dry. They get sweaty and blister- prone much faster than in a non-GT boot, which is good for neither foot nor boot. When my lightweight GT boots wear out, I'm going to get regular day- hiking boots and water"proof" them with silicone/Biwell/Sno-seal. For a day hike with light load and no snow, I will deal without full waterproofness to get better breathability. For anything more, I really should wear "real" (TM) leather boots anyway. But then, I'm somewhat of a traditionalist in these matters. ;-) Your mileage may differ. >don't repeat last year's disaster. Can anyone explain why blisters form? >Is rubbing the key, or do heat and moisture contribute to blister Blisters come from friction. Friction produces heat. Feet produce heat and moisture. Heat and moisture soften skin and make it more prone to blistering. And so on, and so on... >formation? What are your personal tips for preventing blisters? I wear a thin synthetic inner sock (polypro is good) to keep a reasonably dry layer next to my foot. A wool sock or socks outside this will absorb about the same amount of moisture as cotton (~30% of its weight), but will not lose all loft, insulation, and cushioning in the process, as cotton would. Change socks when they get wet. (This may be quite often in humid weather.) Try to dry out the pair just removed (tie on outside of pack in warm weather, put inside shirt in cold). Save a virgin pair for the evening and night. While changing socks, air the feet to dry them out. In fact, air- dry feet, socks and, boots whenever you can (as at a lunch or rest stop). Washing the feet will make them feel better, but prolonged soaking may soften the skin. The most important guideline, which some others have mentioned, is to listen to your feet and tend to them *immediately* whenever you feel a hot spot or fold in the sock. Don't push on "one more mile" or "to the next view". By that time the sore spot will be more so, and nothing is worse than sore feet when you are far from home with a heavy load. [I second this advice. Stop at the first sign of a hot spot. Let your firends hike ahead if they don't want to wait. Frankly, a silent walk in the woods can be a refeshing change from a discussion of baseball standings or microbrew beers.--TG] >And also, when you get them, how do you treat them and still hike >out whe you are 30 miles from the trailhead. Thanks Moleskin is great. I haven't tried Second Skin. (BTW - Has anyone noticed that Moleskin has gotten thinner sometime in the last ten years or so? I don't mean the "Molefoam" stuff. There used to be a thicker felt variety, and I used up my last sheet only reluctantly.) In a pinch, or on a budget, cloth athletic tape works well for prevention, although it comes off with perspiration, which Moleskin will not do. If a blister has already formed, puncture it with a sterile needle (keep needle and matches in first-aid kit), drain the fluid, and leave the skin on for protection. Then add Moleskin. I've also heard of (but not had to try, thankfully) the method Tom H. mentioned about framing the blister with Moleskin, lubricating with vaseline, and then adding a second layer. It sounds like just the ticket for desperate cases, though. >From: schwalbe@pinocchio.Encore.COM (Jim Schwalbe) Newsgroups: rec.backcountry,sci.med Subject: Re: Blisters Date: 27 Apr 90 18:46:02 GMT Contrary to what many people believe, blisters are caused by heat, not by rubbing. Of course the most common way of generating that heat is by the friction of rubbing. If you can avoid excessive rubbing or at least minimize it and dissipate that heat properly, then you won't get blisters. Obviously, the best thing to do is to avoid getting them by wearing comfortable well broken in boots. Wearing two pairs of socks will also help tremendously by allowing most of the rubbing to occur between the socks instead of at the skin and therefor most of the heat of friction can be dissapated by the socks instead of the foot. People have different preferences but I prefer a thin polypro sock with a thick wool sock over that. With boots that are not fully broken in yet, bring extra pairs of wool socks and change them periodically as they get wet and tend not to slide as well across the polypro. Also, you can liberally use "Mole Skin" or "Mole Foam" (from your local Drug Store) on areas where you think you may get the most rubbing as a preventative measure. You should periodically examine your feet, like when you're changing your socks to see if you're getting any "hot spots" which usually show up as smooth red areas. They will many times show up even before you can actually feel any discomfort. If you can catch them at this stage, you can usually prevent any further problem by using Mole Skin. If you have gone too far and actually developed a blister, then the best thing to use is something called "Second Skin". Most outdoor stores will carry this stuff. Put it directly over the blister without breaking the skin and try that. I've hiked many a mile in comfort this way after developing bad blisters with new boots even after doing all other precautions. If that is too uncomfortable, then your last resort is to pop the blister. The danger here of course is infection. You should clean the area very carefully first, use a serile needle or knife blade, and cover the area in antiseptic before applying a sterile piece of gauze. Finally, cover over with Mole Skin or better yet, with Second Skin. Others may have differing opinions but these methods have always worked for me for 25 years of hiking experience. .---------------------------------------------------------------------------. : Jim Schwalbe .----------------. Mail: {linus,allegra,ihnp4} : : Hardware Research Group .--+-------------. | !encore!schwalbe : : Encore Computer Corp. | | E N C O R E | | Phone: [508] 460-0500 : : 257 Cedar Hill Street | `-------------+--' : : Marlborough, MA 01752 `----------------' "But I live in NH!" : `---------------------------------------------------------------------------' >From: ead@tmsoft.uucp (Elizabeth Doucette) Newsgroups: rec.backcountry Subject: Re: Blisters Date: 1 May 90 01:04:23 GMT In article <11758@encore.Encore.COM> schwalbe@pinocchio.UUCP (Jim Schwalbe) writes: >Tom Griffin writes: >> >>Last year I had a bad case of blisters while backpacking. I >>bought new boots with a Goretex lining, but I want to make sure I >>don't repeat last year's disaster. Can anyone explain why blisters form? > > [...] >Wearing two pairs of socks will also help tremendously >by allowing most of the rubbing to occur between the socks instead of at the >skin and therefor most of the heat of friction can be dissapated by the socks >instead of the foot. This method works for me. I tried "Double Lay-R, HiTech Sport socks". They are $8 a pair and have a money back guarantee if you experience blisters or the sock wears out within 1000 miles. They are made in the U.S. and are made out of rayon. I was sceptical at first but thought they were worth a try. I bought them originally for running and have never gotten another blister. When I went hiking in the Grand Canyon in November, I didn't want to risk a blister so I used Moleskin, these socks and then a heavy pair of wool socks. I didn't get any blisters. Elizabeth >From: Phil.Thwing@f507.n161.z1.fidonet.org (Phil Thwing) Newsgroups: sci.med Subject: Blisters Date: 9 May 90 19:42:14 GMT You asked about how blisters form, and how to avoid getting them on your next backacking trip. I have thought lots about this as I am a backpacker myself (and a doctor with *lots* of goodies at my disposal). First of all, blisters are caused by trauma (burns, rubbing) which disrupts the adhesive layer between the outer layer of skin and an inner layer (where the growth of new skin occurs). Once this "glue" is interrupted (e.g. by rubbing), a pocket develops and clear extra-cellular fluid accumulates. The skin continues to grow (from the floor of the blister) and eventually that outer layer breaks and sloughs off, leaving you with a patch of relitively young and tender skin. Prevention: There are several "tricks of the trade": one is to wear two socks, a thin polypropylene liner and a thicker woolen sock. This way, most of the rubbing happens between the two socks, and the wool wicks the sweat away (moistness speeds the whole process of blistering up). If you paint the "hot spots" (places where blisters are likely to form) with benzion (a sticky, aromatic liquid that you can get at a big drug store), the liner sock does an even better job of protecting your foot. As you hike, if you can feel a hot spot start to develop (small patches on your foot actually feel hot), stop immediately and place some moleskin over the area. And I mean *immediately*. If a blister has already developed, cut out a patch of moleFOAM with a circle cut out where the blister is, and place it around the blister. Many will say not to "pop" a blister as the skin provides a sterile bandage. If the blister is not large, I agree, but frankly I have never seen a blister site get infected. If the blister is large and painful b/c it's so tense, I would drain it with a sterile needle or very clean knife point, and try to keep the area clean (most folks probably will argue this point). Once you no longer need the protection of the flap of skin, I would trim it off, to decrease the chances of infection. Hope that helps (sorry it got to be so long!) Phil From: Rob Ridley! Newsgroups: rec.climbing,rec.backcountry Subject: Re: Blisters... Date: Tue, 25 Jul 1995 09:02:44 -0600 On 21 Jul 1995, Brian Cox wrote: > Yea, always seems like about the time you think that you should tape up, you > already have em' Try Compeed. It is intended for use either before or after the blister forms. Sterile, comfortable and durable enough to last several days without replacing. I've used them for both running and alpine mountaineering on myself and others with great results. No I don't own or work for the company. I just like the product! Rob Ridley, Cochrane, Alberta [I tried Compeed on my last trip and was disappointed. I put it on a blister developing on the heel of my left foot. It did not relieve the pain the way Second Skin works. Instead, I could feel the pressure through the Compeed bandage with every step. However, Compeed may work well as a prevention measure like Moleskin. Because of its high cost, I would recommend trying Moleskin instead, but that's my own opinion.--TG]