Wednesday, February 11, 2009

Preventing and Treating Blisters













According to the folks at Adventure Medical Kits (http://www.adventuremedicalkits.com/) whom have been very informative and generous with me over the years, the most common complaint of hikers is blisters. A blister is essentially a reaction of your skin to heat, whether actual heat such as a flame or generated heat such as friction. A blister is actually a second degree burn. To protect against a blister, the body releases a liquid between the inner and outer layer of skin which forms a bump which is often red and painful. I’m going to assume very few of us hold our toes over open flames unless unless we’re trying to recover from severe cold or toe-kebabs is on the menu, so I think it is fair to say most of us receive blisters which are friction related. If our blisters are friction-related, that means we probably got them while walking or hiking. Let’s face it; it is awfully tough to hike when you’ve got a flat tire.

Friction blisters are essentially areas stressed by the constant rubbing of our shoes or socks. If our shoes or socks are wet, this softens or skin and makes our feet more susceptible to damage. Lightweight backpackers have long embraced the need to wear lightweight and breathable running shoes instead of clumsy hiking boots for many reasons. First, most hiking boots offer very poor air circulation (ventilation) and those which have a waterproof layer tend to hold body sweat and moisture even more. Second, boots take longer to dry than lightweight breathable running shoes. Lastly, lightweight running shoes are easier to maneuver and don’t stress our foot as much because they are cut lower and of made of thinner fabrics. It should go without saying that breaking in footwear before a hike is always a smart choice.

Apply Moleskin (http://www.rei.com/product/767416) to sensitive areas before hiking. Wear thin liner socks under heavier outer socks so the friction occurs between the two sock layers and less on your skin. Ensure all socks wick well and change them for a dry pair each time you stop and before you go to bed. Make sure your feet get some ‘sun time’ too to kill bacteria. If a blister does develop, stop immediately and treat it. First, don’t pop the blister if you can help it. If it is large or cumbersome, drain it with a sterile needed and massage the fluid out with a sterile alcohol wipe. Put a treatment over it such as the product Glacier Gel (http://www.adventuremedicalkits.com/product.php?product=84&catname=Blister&prodname=GlacierGel%20BLISTER%20AND%20BURN%20DRESSING) which adheres to your skin and offers a protective pad. It is made of 50% water which helps cool your blister and is as simple to apply as a band-aid. Switch out the pad a couple times a day and this should be sufficient. If the blister continues to drain and becomes more painful, discharges colored fluid, or otherwise just doesn’t look right, consider seeking professional medical help.

Other than using moleskin (http://www.rei.com/product/767416) on sensitive areas, I’ve also had luck with a couple different items. Body Glide (http://www.backpackinglight.com/cgi-bin/backpackinglight/body_glide_45_anti_blister_stick.html) looks like a mini deodorant and helps reduce moisture and chaffing both on the feet and elsewhere. It also has antibacterial aspects. Hydropel (http://www.backpackinglight.com/cgi-bin/backpackinglight/hydropel.html) is specifically good for people who sweat a lot or whose feet will be wet much of the time. Lastly, Leokotape http://www.backpackinglight.com/cgi-bin/backpackinglight/leukotape_p.html) can be used in place of Moleskin…course, so could duct tape. In either case, be sure to be careful how you apply it as you don’t want to rip off your blister or cause it to be too inaccessible for treatment. Course, before needing to jump on the first-aid bandwagon, “prevention” should be a high priority. Blister prevention should include applying anti-fungal/sweat-control options as described above and keeping your feet, footwear, and socks dry. It is always a good idea, if practical, to switch out socks several times a day and before you go to bed. In fact, most lightweight backpackers rarely carry two of anything including underwear – but socks are the exception. Long-distance hikers will no doubt agree that receiving a pair of new socks at each supply pick-up is near heavenly. Wearing a liner sock under a sock reduces friction on your skin. Using highly breathable and broken-in shoes ensures your feet stay drier and are more comfortable. A good orthotic such as those offered by Superfeet (http://www.superfeet.com/) are also a good choice for overall foot comfort and to prevent foot slippage from inside the shoe due to poor fit. Smartly crossing bodies of water and avoiding getting your feet wet will be the difference of 10 more miles versus just a few. To keep my shoes dry, I have been known to carry a homemade pair of Tyvek shoes which have felt on the bottom just to use to cross through water. They aren’t comfortable or terribly durable, but they get the job done, weigh nearly nothing, and save my shoes. Another preventative tip is to ensure socks and shoes receive adequate drying time. When possible, leave them in the sun during breaks. If you think you need a camp shoe to allow your hiking footwear time in the sun…but you don’t want the weight of bringing extra footwear, consider puncturing three holes (one between the big and second toe and one on either side of the front third of your foot – like a flip flop) in your shoe insole and add some yarn or rope. You’ll essentially have a pair of lightweight flip flops without any further appreciable weight. Course, you could always bring a pair of those God-awful Crocs clown shoes and hope no other hikers beat you for the sake of pure fashion sense.

You may not always be able to prevent blisters, but you can be proactive by reducing your risk and treating those you do get with proper first-aid so your hike can continue.