So What is a blister exactly?
A blister is a pocket of fluid within the upper layers of the skin. With the repetitive movement associated with walking, running, and hiking, friction is most often the culprit. Within your shoes, friction can be caused by your footwear or socks rubbing against your skin. Anything that exaggerates that rubbing can cause a blister. They start out as hot spots, which are indicated by a sensation of warmth and reddened skin followed by burning or stinging. If untreated, a fluid filled blister can result. Heat and moisture are also factors.
- Socks rubbing against your skin
- Poor-fitting shoes
- Faster pace
- Foot abnormalities - Heel spurs, Bunions etc.
- Heat and moisture - These factors cause your feet to swell, intensify friction, and can also make your skin more fragile. (This explains why many runners only get blisters during a race where perspiration is raised due to increased pace and distances).
- Rocks, sand, and grit - Remove small particles that lodge into your shoe as soon as you notice them.
So how do you deal with them? The short answer is don't get them in the first place. Prevention is your friend and specifically, prevention of that feisty foe, friction! The following list are ways you can fight the friction:
If the Boot Fits
- Try before you buy - Before you hit the trails for a run or hike, try on different types and styles of foot gear to find the best fit for your foot (If it's uncomfortable when you first put it on, it will only get worse on the trail.) Check out our articles on How to Choose the Best Hiking Boots and How to Choose Hiking Boots for Women.
- Bring your socks along - When buying footwear, bring the socks that you plan on wearing.
- The boot - They should fit without additional products. If you need to buy additional items, like a different insole, the boot probably isn't right for you.
- Heel lift - Once you're all laced up, there should be a small amount of room in the heel area. (expect about a quarter inch of lift from the heel to allow for a natural foot stride). Make sure it doesn't move too much, however, because that can cause, friction and heat and then blistering. It's a delicate balance, but it's worth taking the time to find that sweet spot.
- Wiggle room - Your toes should have some wiggle room to prevent toe blisters under the toes and on the ends of the toenails. If the toe box seems snug, consider going with a half-size larger or perhaps choose a brand with a wider toe box.
- Kick a wooden post three times! - This may sound strange, but it's a great way to test the fit: The foot should move forward and then sit back. Your toes should not hit the front of the boot/ shoe until the third kick.
- Laces - Don't cinch down your laces too tight. It's important to feel support from the tension in your laces but not too much. Feet swell, and if the boot is too tight there's no room for the foot to expand.
- Take care of your boots - When you put them away for the season, make sure they are totally dry. Then store on a shoe horn or with newspaper inside so they keep their shape. At the start of the next season, stretch the boots out if they feel tight.
Socks: Friend or Foe
Socks can be a life saver or your biggest enemy. Check out The Best Hiking Socks Review and The Best Running Socks Review for expert suggestions.
- No cotton - This is the golden rule for prevention when it comes to socks. Cotton holds moisture next to your skin causing friction and, alas, blisters that need to be healed.
- Double layered socks - Some manufacturers minimize friction by creating a sock with more than one layer. The concept is that the friction will be between the layers and not between your foot and the sock. Check out the Wright Socks as an example.
- Wicking ability - Socks that wick, prevent friction caused by moisture. Our favorite wicking sock is Smartwool PhD Outdoor Medium Crew Socks.
- Smooth and flat seams - Choose socks with smooth, flat seams.
- Snug as a bug - Your socks should have a snug fit with no wrinkles or baggy spots.
- Toe socks - If you're prone to getting toe blisters, consider using toe socks to create that extra layer to absorb friction between each toe.
- Sock liners are your friend - Sock liners go between your shoe and next to skin sock to prevent friction. Tip: rub a bar of soap on the outer side of the liners to create more slippage between your shoe and liner and less friction between your skin and sock. Polypropylene, wool or wool-nylon blends work well.
- Change wet socks - Keep your feet dry! Wet, hot skin blisters faster than cool, dry skin.
Hot Spots? Nip them in the Bud!
As soon as you start to notice any type of discomfort on your feet, address the problem before it grows in to a full blown blister! A "Hot Spot" is a foretaste to a dreaded blister. Any spot where you feel pressure or tenderness may be signs of a hot spot. If you feel stinging or burning, you've probably missed the window for prevention. It might not have formed yet but it will. It can take up to 2 hours for the blister to actually fill with fluid. Ways to "Nip them in the Bud" are as follows:
- Change your socks - The hot spot may be developing due to fragile damp skin in sweaty socks or from poor fitting socks, so change them at the first sign of discomfort.
- Protect it - If you have a hot spot, cover it with tape, mole skin, duck tape, or a bandage. This barrier acts as a second layer of skin and should not be removed. Apply it directly, sticky-side down, and let it fall off by itself to avoid pulling off your skin.
- Very wet or very dry - Moist environments cause fragile skin to blister. Keeping the feet dry with some sort of powder or wet with some type of lubricant will protect the skin. Apply either treatment as a preventative measure or at any sign of a hot spot.
Treatment - How to Heal a Blister
So you've been so in to that run or hike that you missed that hot spot preventative window, and now you have a blister! Here's how to heal a blister:
To Pop or not? That is the question.
This is a question long debated, but we say the answer to that question is relative to size and infection potential. When the impending bursting is imminent, why not drain it in a clean environment as opposed to letting it burst in a dirty sock? If the blister is small, often times, the blister's own skin is the best protection and will actually heal itself through re-absorption.
If deemed necessary, Here's How to lance the sucker:
1) Clean the infected area thoroughly with soap and water, alcohol or whatever you may have on you in your med kit or at home.
2) Sterilize a sharp object such as a needle, safety pin, or a blade by torching it with a lighter until it's literally red hot. Alternatively, you use an alcohol swab to make sure your instrument of choice won't do more harm than help.
3) With clean hands, pop a small hole in the surface (preferably the side) and gently squeeze out the fluid.
4) Don't remove the skin over a broken blister. It protects the raw new skin underneath and allows it to grow.
5) Apply some sort of antibiotic cream or ointment. The application of Neosporin or triple antibiotic gel will kill off infecting bacteria after two applications and hasten the healing process.
6) Pay attention to signs of infection, such as white or yellow fluid, red streaks, or red and warm skin surrounding the blister site.
When taping up toes, heels, and other areas, follow the tips below: (Consider taping as a precautionary measure in blister prone zones, or, once a hot spot has formed).
- Use medical tape, moleskin, Leukotape, hypoallergenic silk tape (which is designed to even stick to moist skin) or whatever type of adhesive dressing you have with you. Be vigilant with switching tape out; a painful open blister can result when the tape is removed after a long period.
- TIP: Always place a layer of toilet paper over the skin before applying tape. You can create a bandage by placing a smaller piece of tape in the center of a strip, sticky-side to sticky-side, so a smooth surface lies against the sore. If you put tape directly on a blister, it will pull of any remaining skin when you remove it.
- For toe blisters, take one piece of tape from the bottom of your toe nail and bring it over the top of your toe, securing it underneath. Then take another piece and wrap it around the circumference of the toe, keeping that first piece of tape in place.
- For the balls of your feet, use a wide strip measuring several inches longer than the width of your foot where you're going to tape. Step on the tape, and wrap the ends around to the top of your foot. Then contour the tape to the shape of your foot.
- Tip: Tape adheres much better when your feet are warm and dry, so tape them up right when you get out of your sleeping bag in the morning or before you leave the house.
- Avoid wrinkles with your tape jobs, as they can cause blisters as well.
- You may cut a doughnut-shaped piece of moleskin that fits around the blister rather than directly on it. Gel pads, such as 2nd skin, are great to fill the doughnut with in order to help heal the wound. They also provide extra protection from infection.
- Benzoin is a sticky, alcohol-based substance that will disinfect and make tape or moleskin very sticky. It is especially useful if you're in damp conditions where adhesive tape loses its stickiness
On the go treatment kit
- Tape - (Leukotape/medical tape)
- Benzoin - (disinfectant/sticky adhesive)
- Needle or sharp object
- Lighter or alcohol to sterilize needle
Long distance hikers and runners will often advocate using superglue and duct tape for on-the-go blister healing. These are items which are often carried for many different purposes such as gear repair, and happen to double up as items for healing blisters in a pinch.
- Superglue- Superglue can heal blisters by bonding the roof of the blister to the skin beneath it. This can reduce the risk of infection as well as create a protective shell over the blister. Make sure that you have sterilized the blister before applying Superglue and be ready for some stinging.
- Duct Tape - This is a popular material used for prevention and treatment in the backcountry, as it's often a material which people have with them already. It is not breathable, so the skin tends to become saturated underneath. Duct Tape also tends to wrinkle, creating creases that cause further problems. If you do use duct tape, be vigilant with switching it out and consider putting something non-adhesive between the sore and the sticky part.
Additional Foot Care Considerations
- Toenails - It's important that you cut your nails before your hike or run. Trim the nail back to meet the tip of the toe, cutting straight across to avoid other problems, such as ingrown toenails. Make toenail clipping part of your pre-hike routine to help avoid pain and pressure when hiking on a decline. Nails that are too long are also prone to pressure from a constrictive toe box.
- Air out your feet - Any time you're stopped on the trail for 5 minutes or more, air out your feet to dry them out and to prevent fungus. While you're stopped, elevate your feet to reduce swelling.
- Take care of your skin - Use a callus file and an over-the-counter cream to soften problem areas on your feet. These creams can also help heal fissures and cracks in the skin that are typically found on heels. Left untreated, fissures can split open and expose underlying tissue to infection. Blisters deep under calluses are difficult to drain and treat.