What is the best way to treat a foot blister?
Answer by Ted Conbeer:
When Ben Franklin said, “An ounce of prevention is worth a pound of cure,” he was almost certainly talking about foot blisters. The absolute best way to treat a blister is to keep one from forming; once you have one, the best thing you can do is to leave it alone and let it do its job.
First, a disclaimer. I’m not a doctor. I have extensive wilderness first-aid training, but my most recent certification lapsed two years ago. Unless you’re in a wilderness area, if there’s something seriously wrong with your blister, you should seek professional help from a doctor. If you are in a wilderness area, get off your smart phone, and enjoy being outside!
What is a blister, and why does it form?
To summarize 's excellent answer ( ), a blister is a serum-filled sac that develops when stresses cause tears in the bonds between (typically) your dermis and epidermis. In the case of your feet, the shear (or heat) stress is often due to friction in some part of your footwear system, either between your skin and sock (which might be full of dirt) or between your sock and shoe.
While your blister is a result of this damage, it is also a pretty effective defense mechanism. Because the blister is full of liquid, and liquid can’t transmit shear stresses, an intact blister helps protect the layers of skin beneath from further damage. While blisters are unsightly and a bit uncomfortable, they’re basically nature’s Dr. Scholl’s gel inserts… think of them as a little extra padding where you need it the most.
When you’re “out of the woods” and you blister is no longer needed, your body will begin to heal by forming new layers of skin under the blister, and then re-absorbing the serum. At this point, the blister will collapse, and you’ll have a weird extra layer of thick skin that you can trim off like any callus, if you like.
Why you should never, ever pop a blister in the wilderness:
Your blister is a closed system. Your epidermis, as weird and stretched out as it is, is still intact. This means it won’t get infected. I can’t get infected… there is nowhere for those nasty little critters to get in.
As soon as you pop a blister, you’ve created an open wound. It doesn’t matter if you sterilize a needle or blade in order to do the popping: for the next several days, you will have an open wound inside of a dirty sock, where you’ll never see it and will have a hard time keeping it clean. If your blister becomes seriously infected, it will be unbearably painful to put on your shoes in the morning, to say nothing of walking the 20 miles back to the trailhead. Congrats, you’ve just taken a minor nuisance and created a wilderness emergency. Sure, there is maybe a 5% chance of that happening, but I won’t play those odds when I’m in the backcountry.
What you should do when you get a blister:
Nothing. Seriously. Don’t try to treat the blister directly. There are lot of products (notably, Mole Foam) that people try to use to build a “donut” around the blister to protect it. Try as you might, there is no way that donut isn’t rubbing against your skin, making the problem worse.
Instead, you should do all of the blister prevention tips listed below. Remember, if you pop that blister, you could be in a bad way. Time to start aggressively protecting your feet.
How to prevent the formation of a blister (or how to keep one from getting worse):
- Reduce the stress on your feet: your blister formed because your feet aren’t used to so much wear and tear. Slow down, reduce your distance, and/or carry less weight. Use trekking poles, especially when going downhill. Take breaks, and check your feet for “hot spots” (warm/red patches, the precursor to blisters) - when I led hikes for groups of novice hikers in college, we would literally stop after the first 800 yards of hiking and make everyone take off their shoes and socks - there was almost always one person who already had a blister by then, and many would have hot spots.
- Proper hygiene: dirt and dried sweat will increase the friction on your skin, and trenchfoot will destroy your skin’s strength. Try to keep you feet clean and dry, as much as possible. Carry two pairs of socks, so you can wash one pair in a river and let it hang to dry on the outside of your pack while you hike in the other. Use gaiters to keep dirt and rocks out of your shoes. Switch to camp shoes when you’re done walking for the night. Soak your feet in a nice, cool creek - just let them fully dry before sticking them back in your shoes.
- Proper footwear: your shoes and socks need to fit properly so you’re not sliding around inside, and so your toes aren’t crammed up against each other. Break in and test out any shoes and socks before a long hike. Size up by 1/2 to 1 size to let your feet swell. Consider trying a different shoe brand or style. You’re not still using old-school, heavy leather boots are you? Some people swear by sock liners; I hate them: you need to figure out what works for you.
- Lube up: Blisters are caused by friction, right? Then get some lube in there! I don’t really like lubing up my feet, but there’s nothing better than some Vasoline or Body Glide to handle those other chafing areas, like under your pack straps and in your undercarriage. Don’t have lube, or don’t want a gooey mess inside your socks? Strips of duct tape can be an awesome alternative if done right (although the edges can make things much worse!) - the silver side is pretty slippery.
- Train: Your skin will adapt over time. Don’t try to hike 100 miles over rocky terrain in 4 days without spending a few afternoons strolling on a dirt path first. Breaking in shoes is great; developing calluses is better. You will enjoy hiking more if your whole body is up for the challenge, including the bottoms of your feet.
Remember, there is no reason that blisters have to be an inevitable part of hiking, running, cycling, or any other endurance sport. Prepare a little and take care of yourself, and you’ll be one happy camper.
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