The FIRST AID modules provide information on caring for injuries and sickness in a backcountry environment when you are hours or even days away from definitive medical care, with focus on what is commonly encountered in the mountains. These modules only provide an overview, but are not meant as adequate instruction for beginners. While traveling in remote, wilderness areas ensure you group includes qualified wilderness medicine professionals, or get a WFA, WAFA or WFR certification yourself.
Isn’t it the worst thing ever when you’ve just crossed Auden’s Col or summited Kang Yatse, and your feet are killing you on the descent because of the big blister you’ve just developed under your foot?
Blisters are one of the most common and benign, yet also the most irritating, hiking injuries. This guide to blister management will tell you why blisters form, how to prevent them from forming, and how to deal with them once they form.
BLISTER FORMATION
Blisters form when the skin gets irritated or damaged by pressure or friction. When there is enough friction at a single spot, cell damage occurs and blisters are born. Blisters can also be caused due to burns, spider bites or allergies, but friction is the most common culprit for hiking blisters.
- Friction : The most common cause of blister-causing friction is ill-fitting socks. When your socks don’t fit well, they’ll form wrinkles in the fabric - these wrinkles will rub against your skin when you walk, and create hot spots which eventually turn to blisters.
- Pressure : Tight spots in ill-fitting or badly laced boots will put pressure on a single spot where a blister will form.
- Moisture : Moisture trapped inside your boots and socks, due to sweat or from a stream crossing, will make your skin softer. Softer skin is more prone to friction and pressure damage.
BLISTER PREVENTION
The basic principle of blister prevention is awareness - blisters don’t pop up all of a sudden. If you’re careful about minimising the factors that cause friction, you can easily achieve your goal of having blister-free feet.
- Hot spots : Blisters always give you a warning before they appear in the form of hot spots. Hot spots are exactly what they sound like - some part of your skin will start feeling uncomfortable, hot and turn red. When you feel a hot spot forming, take off your shoes and socks and use any of the following methods to prevent the hot spot from turning into a blister -
- Tape : Any sort of tape - surgical, fabric, synthetic, or even duct tape - placed over the hot spot will stop it from turning into a blister. Simple and easy.
- Blister Bandages or Moleskin : There are specific bandages meant for blister prevention like Moleskin or 2nd Skin - these provide more cushioning and friction reduction as compared to regular tape.
- Boots : The easiest way to stop blisters is to make sure your boots fit well, and are broken in. Well fitting boots will avoid formation of pressure or friction points that cause blisters. A week-long, 100 km glacier trek is not the right time to wear your new boots.
- Socks : While hiking, the number one rule is to avoid cotton. Cotton is the worst fabric for moisture management, and despite how good it feels against the skin, it will cause blisters faster than any other fabric. Use synthetic or wool socks for hiking, and make sure they fit properly. Too tight, and they’ll create pressure points. Too loose, and they’ll create friction-causing wrinkles.
- Moisture Management : Make sure your feet are always dry, and you’ll have a much lower chance of having blisters. Keep the following tips in mind for efficient moisture management -
- Air out your feet : Whenever you take a break, take off your socks and shoes and air your feet out. This will help keep them dry.
- Change your socks regularly : Switch out your socks with new ones whenever you get to camp. You don’t have to carry two pairs of socks for each hiking day - just keep the wet ones in your sleeping bag at night, and they’ll be dry in the morning.
- Plan for stream crossings : Carry a pair of closed-toe sandals or Crocs for stream crossings. If you must wear your boots, change your socks the moment you get out of the water. Do not cross stream barefoot - sharp rocks and pebbles on the riverbed could cause injuries that are just as bad as blisters.
- Lacing Techniques : It’s not as simple as tying a knot at the top of your boots. Learn different lacing techniques for ascending and descending that relieve and create pressure at appropriate points on your feet.
- Toenails : Keep them trimmed.
BLISTER CARE
Following the proper techniques for blister prevention and catching hot spots at the right time will ensure you almost never get blisters. However, if you still end up with one, try one of the following options -
- Create padding : Use a bunch of thick bandages bunched together and tape them over the blister. Improvise with the padding - you can cut off a small piece of a foam sleeping mat, create a hole for the blister, and tape it over the area. This will protect the blister from getting worse.
- Drain, only if really necessary : This should be your last resort. The fluid inside a blister helps protect and heal the damaged tissue. Draining also increases the risk of infection. If it’s too painful to leave it as is, follow the following steps :
- Wash the blister and surrounding area with antibiotic soap.
- Sterilize your needle with alcohol or a flame.
- Insert the needle near the base of the blister, and drain the fluid.
- Dress and bandage the blister like a wound.
- Keep a close eye on the wound.
