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Causes | Prevention | Treatment | Products | Links

Causes:
Friction or burns.
We are concerned about friction blisters here.

Some Causes:

  • New boots not broken in
  • Conditioning on flat surfaces instead of "steep" hills with a pack
  • Wet feet (Hot weather => sweaty feet, cotton socks retain moisture)

It has been estimated that up to 39 percent of marathon runners experience a blister during the race. In military training, friction blisters will affect over 40 percent of soldiers while over 50 percent of active backpackers and hikers will be hampered by this condition. Source Podiatry Today.

In "Hiking & Backpacking - A Trailside Guide", Karen Berger says,
"I'm not afraid of snakes or bears, I've never met a criminal in the woods. "For a long time I was very, very afraid of blisters."
"Blisters are probably the number-one cause of backcountry misery"

Only where skin is hardened is it thick enough (heels, toes, soles, palms) for blisters to form. Loose skin just wears away. The tough outer layer of skin separates from the sensitive inner layer. The body reacts to the abuse by secreting water into the area of trauma. They start out as "hot spots", which if treated soon enough avoid the formation of blisters.

Prevention:

  • Break in your boots.
    It is important to break in your boots. Walking 50 miles (5 miles on steep slopes) before an extended outing is the standard recommendation. (Carry a blister kit and a pair of sneakers with you on your break-in hikes) Trails in places like the Sierra Nevada, Rockies and Adirondack's are much steeper than those in your local park. (The steepest grade on the Bright Angle Trail in the Grand Canyon is 16%, The steepest grade on the Appalachian Trail in NC is 82%). 100% = 45°
    Foot dynamics are different on steep trails. You heel may rub on the way up and your toes may be jammed into the front of your boot on the way down. You can't simulate this by going up and down stairs.
    Treadmills at your local gym can usually only go up to a 20-30% grade and they only simulate uphill travel.
    It may require a little searching and ingenuity on your part to find an adequate hill.
    See Hiking boots in recreation.
  • Lace your boots to avoid extra movement of your foot causing friction.
    See lacing tips
  • Wear wicking hiking socks.
    A sock liner under a thicker outer sock and help with wicking moisture away from the foot and reducing friction.
    (however, blistering can be increased by the presence of two socks, which can enhance foot slippage and apply extra force to the foot in areas in which the second sock 'bunches up').

    A report at "Sports Injury Bulletin" says that "investigations reveal that acrylic or polyester socks are better than cotton or wool ones. They also show that thick socks maintain their bulk during sweating and compression better than thin socks and thereby absorb more force at the skin surface, reducing blister probability (this is only true, of course, if the thick socks don't make the feet fit too tightly within the shoes)."

    Wash your socks several times before taking them on a trip.
    Don't use cotton socks which will retain moisture.

    The WRIGHTSOCK™ Anti-Blister Double Layer Socks claim they allow slight movement between the CoolMax® inner layer and Merino wool outer layer to absorb friction. Wrightsock at Campmor
    See How to Choose Socks: Expert Advice from REI

  • Try to keep feet dry. Wet feet are more prone to blisters.
    Take your boots off to let your feet dry when you take a break from hiking.
  • At CMH Adventures they recommend, In rougher terrain a long stride causes us to press onto our toes as we move to the next step, and as soon as you lean onto the toe the heel comes into contact with the back of the boot and causes friction - especially walking up hill.
      Also, we can prevent blisters by changing our heel-to-toe, rocking walking style, and instead place the foot down parallel to the slope and picking it up parallel to the slope for the next step without getting up on to the toes. This way the foot comes straight up rather than rocking onto the toe and moving in the shoe causing friction.
  • Taping trouble spots before you start.
    See: Taping for the prevention of blisters at SportsInjuryClinic.net.
  • Orthotic inserts - Inserts such as those by Spenco or Superfeet may stop excessive foot motion in the boot and reduce the chance of blisters, however they could create pressure points increasing the problem. You just have to experiment.
    If blisters routinely form on the bottom of the foot sometimes adding an orthotic insert with a Spenco topcover will reduce the friction.
  • Anti-friction balms such as FootGlide by BodyGlide, or Avon Foot Works Friction Control Anti-Blister Balm
  • There are even Antiperspirants to keep feet dry. The Aug. 1998 Journal of the American Academy of Dermatology reports on a military study showing that using a special heavy-duty antiperspirant on the feet reduced the incidence of blisters. The incidence of foot blisters was 21% for the antiperspirant group and 48% for the placebo group. However, reports of skin irritation were 57% for the antiperspirant group and 6% for the placebo group.
    An earlier study using antiperspirants with emollients (Skin softeners) showed no difference.

    Some hand and foot antiperspirants are:
    GhostGrip Antiperspirant
    Klima Health Solutions

    Corn Starch and Talcum Powder: First, plain old corn starch (yep, just like you use in cooking) in your socks and shoes can keep your feet dry. Reapply it at least once in a long distance event. Baby powder or talcum powder both smells nice and also acts to keep the feet dry.

  • Lotions and Powers:
    A report at "Sports Injury Bulletin" says that "the research indicates that lubricating agents are effective for only brief periods of time and may actually enhance the possibility of blisters in the long run."
    The author, Owen Anderson, doesn't site the source of the studies and seem to be pushing Spenco insoles, which he promotes in other places on the web.
Toughen your feet:
I don't know anyone who does this, but there are several web sites promoting it.
At Foot blisters and their care they say, "apply tincture of benzoin liquid (not the spray; too messy) to the area, let it dry for a minute or so. It will become “tacky”. Then take any dry skin lotion and rub it into the sticky area. Do this on a regular basis and the skin should become hard enough that it will stop blistering.

Tannic acid to toughen: Marathoners and long distance walkers may want to toughen the feet with 10% tannic acid (can use strongly brewed tea). Apply the tannic acid to your feet, or soak in strong tea, twice daily for two to three weeks.

Treatment:

  • Mike Abbott recommended the following at the May, 2015 Sierra Club National Outings Meeting:
    He doesn't believe in molefoam HypaFix Tape - thin for toes
    Kinesio-Tex - or Strength Tape - thicker
    Micropore - thin and smooth - good for taping edges of other tape so it doesn't get caught on your sox.
    Leukotape - Inflexible - Best for shoulder problems prior to putting in a sling.

    Adhesive promoters are nearly always needed to get tape to stick well. Tincture of Benzoin (friar’s balsom) is cheaper than Mastiol, but not as strong.
    Mike likes the bottle rather than ampules, which don't have enough.

  • Hot spots - Change your sox, fiddle withh your laces, or cover the sore area with smooth surface tape, gel dressings, or moleskin.
    If you ask five Sierra Club leaders you will get 4 solutions. The standard issue first aid kits have moleskin, molefoam (thiker version of moleskin), 2nd skin, duct tape and athletic tape.
    Moleskin was the old standby, but athletic tape and gel pads are more popular now.
    Note: We had a rash of blisters on a Introduction to Backpacking trip in 2013 and molefoam with a hole in the center worked better than the gel pads for several people.
  • You can cut a hole in the molefoam pad and put it over the hot spot or blister to relieve pressure. Some put moleskin without the hole over the molefoam.
  • To drain or not. Some people say never pop a blister. Most agree you should pop large blisters with a sterilized needle and put some antibiotic on the puncture.
  • 1" breathable athletic tape is more popular now. You put it on and leave it for days. Place an anchor strip around the forefoot and tape from the heel up to it, to keep it from coming loose. (Tip courtesy of Francy Rubin)
    See Sierra Club Trails - Anatomy of a Blister
    and Fixing Your Feet - Lancing Blisters

  • Duct tape is used in a variety of ways:
      Some put it directly on the skin to reduce friction, but others say it is too sticky and can remove the skin over a blister (it depends on the brand, some are more sticky than others). The adhesive could irritate the skin.
      Some put it on the outside of socks or inside of boots to reduce sock to boot friction.
  • There are a variety of gelpads like 2nd skin, but your foot must be dry for most of them to stick.
  • Tincture of Benzoin, Pre-Dressing Skin Protectant (Helps Bandages Stick)
  • Sierra Club doctor, Gus Benner, says, "If you get a blister, put the tape directly on the blister. If you get a big blister that's going to break anyway, drain it at the edge carefully with a sterile needle (e.g. passed through a flame), then put the tape directly on the blister. If the blister breaks, and you have raw blister base, put the tape directly on the blister base. Because it is porous and breathes, the tape often stays on easily for days.
    See Sierra Club Trails - Anatomy of a Blister
  • Penny Pan posted an article about Stanford research showing paper surgical tape worked for ultra-marathoners.
    Francy Rubin a retired professional physical trainer said duct tape also works.

Books:
Fixing Your Feet: Prevention and Treatments for Athletes, John Vonhof

Products:
FootGlide by BodyGlide is an lubricating balm you put on to reduce friction.
Taping your feet to prevent or treat blisters - Fellrnr.com, Running tips
Blister Taping Tips — Blister Prevention
Band-Aid Friction block is similar
new-skin LIQUID
Engo Blister prevention patches
ZombieRunner Store - Foot Care
Gel Pads:
These look like a blister itself with a collapsed "bubble" between laminated plastic sheets which allows the sheets to glide freely when pressure is applied.
In "Hiking & Backpacking - A Trailside Guide", Karen Berger says,

"As far as I'm concerned it's a miracle product: It relieves pain, it helps it heal - and you can walk in reasonable comfort."
"It does not adhere as well as moleskin, so your foot should be dry and then you may want to cover it with tape.

Unlike moleskin, you'll need to remove this dressing every night and reapply it in the morning."

Spenco 2nd skin blister kit
Blist-O-Ban
Band-Aid Advanced Healing Blister, Cushions - Ampoules
GlacierGel
Foot Blister Care & How to Prevent Blisters | Dr. Scholl's®

Blister Kits:
Contain pads and adhesive strips in a variety of sizes.

Blister Kit from RacingThePlanet.com $36
Adventure Medical Kits Blister Medic II at REI.com $10

Links:
Sierra Club Trails - Anatomy of a Blister
  The above article mentions BursaTek; I couldn't find it but Blist-O-Ban seems to be the trade-name.
Blister Taping — Blister Prevention
Cheap Paper Surgical Tape Can Prevent Painful Blisters : Shots - Health News : NPR
Prevent Blisters With Athletic Tape | LIVESTRONG.COM
walking.about.com articles:
  Before You Get a Blister - Preventing Walking Blisters
  Blisters Begone - Seven Strategies to Prevent Walking Blisters
  Top 5 Blister Bandages for Prevention and Treatment
How to Prevent Blisters and Chafing - TheWalkingSite.Com
Foot blisters and their care
Skin blisters - causes cures and treatments | Sports Injury Bulletin
Foot Blisters - preventing and treatment at HikingDude.com
Socks to Battle Blisters - How Socks Prevent Blisters
Foot Blisters - Preventing & Healing Skin Blisters at abc-of-hiking.com
Foot blisters and their care at foot-pain-explained.com
Fixing Your Feet - Blister Prevention
  Taping for Blisters Part 1 Stop Blisters Now | Backpacker Magazine
Taping for the prevention of blisters at SportsInjuryClinic.net
How To Manage Friction Blisters | Podiatry Today
Foot Blister Prevention: What You Can Recommend To Athletes | Podiatry Today
Blister Prevention
eBookLPG — Blister Prevention
Foot blisters and their care
Blister Prevention Tips for Mountain Adventures at Canadian Mountain Hollidays
blister prevention - About.com : Walking


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last updated 18 May 2015