An excerpt from the Family Camping Guide
Friction Blister Prevention
Ed Horner is not a medical professional. Any advice offered herein is anecdotal and should be used only as a reference for further investigation by the individual. Always seek professional medical attention when it comes to your health and safety.
Another common affliction for the hiking or camping family is blistering of the foot or “friction blisters.” These injuries, while not trifling, are rarely a major source of concern, when treated in a timely and properly. They are quite different from the blistering that occurs from poison ivy, noted in the previous section.
Friction blisters are (usually small) pockets of skin that fill with a clear liquid caused by frequent and prolonged rubbing. If small blood vessels are broken, then the fluid may also fill with blood and the result is often referred to as a “blood” blister, but the causes are usually the same – prolonged, irritable rubbing, esp. on damp skin, under warm conditions.
Typically the friction blister will drain in a few days and a new layer of skin will form under the old one. Eventually the old layer will fall off. If the source of rubbing isn’t addressed, the blister will continue to get worse, break the skin, cause seepage and may become infected, creating a deeper, more serious wound.
Because these friction blisters tend only to last a few days, simply keeping the area clean and dry is usually all that’s necessary for treatment. Don’t try to drain the blister or pick off the overlaying skin. If the blister breaks on it’s own, it’s general practice to wash the area with warm, soapy water, apply an anti-bacterial ointment and cover with a clean, sterile dressing – changing as required.
Now, recognizing that I’m no expert in this field, I do understand that people who suffer from diabetes may have greater difficulty treating friction blisters, as there may be underlying circulation problems and nerve damage. A greater level of preventative maintenance will be required and, should a blister develop which is not healing, professional help may be required.
Blistering that does not seem to be due to friction – such as blisters above the ankles and sock area, may be due to chemical irritations such as poison ivy or poison oak that may have brushed the skin while walking through brush. This is a different type of blister and is addressed in the section on Poison Ivy.
When it’s all said and done, the main (but not exclusive) cause of foot blistering is ill-fitting boots or shoes.
Break In Your New Boots
The good news is that the current generation of hiking boots generally require far less “breaking in” than the boots from the 80s and 90s. New light weight material, major advances in construction techniques and revised “fit” metrics all combine to make “breaking in” almost a thing of the past. “Almost” is key here. You still need to get into your new boots and do a bit of walking before you set out on any hike, just to be sure there are no “hot spots,” bad seams, or pinch points.
“Hot spots” usually develop into blisters if left unaddressed.
“Pinch points” might present itself by squeezing the toes together, causing the toes to rub against each other, causing blisters.
Finally “bad seams” may place unnecessary stress on any specific point of the foot, causing pressure points and possible blistering.
Stop using those crappy white cotton “athletic” tube sock from Walmart! Just stop! Cotton socks are fine when sitting on the patio swilling Margaritas, but for a hiking or walking sock they’re terrible. They absorb water from the foot, but don’t have the ability to move the perspiration away from the skin. This leaves a sloppy wet mass of cotton clinging to your foot, keeping your foot damp and more blister-prone than ever!
Switch to Merino Wool. Wool is able to absorb 20% it’s weight in perspiration before the material even feels damp! They have the almost unique ability to pull moisture off the foot and actually transport it away from the skin, leaving the skin dry – and keeping feet dry is key to blister prevention. Look for a sock where the inside is a “loop” construction. This loop configuration of the threads provides much more surface area upon which the wool fibres can suck moisture off the foot. Wool also has the added benefit of being naturally anti-microbial, which really helps to minimize odours.
Look for a “fitted” sock. This means there is an obvious heel, arch and toe area built into the sock that will perfectly conform to the foot. Be sure the seams in and around the toe are “flat-stitched” for a smooth fit around the toes.
Look for a bit of padding on the bottom of the foot (esp. in the ball of the foot and heel area) and partly up the back of the foot to help protect and cushion the Achilles tendon. Mind you, be careful not to buy a sock “too” padded as it may not fit in your existing boots – making the boot too tight. Most hiking sock manufacturers such as Point 6, Smartwool, Bridgedale, Ice Breaker and Lorpen, produce socks in “light,” “medium,” “heavy” and sometimes “extra heavy/trekking,” versions. Prices will start about $20 and range up to $40+.
For longer hikes, or if your feet are prone to friction blisters, try sock liners. These are very thin socks, usually wool and synthetic blend, that are worn next to the skin (under a standard hiking sock) and will wick moisture off the foot and out to the sock, leaving your foot dry and, again, less prone to blisters. Any movement between the foot and boot will then be experienced as movement between the two sock, minimizing and rubbing experienced - and that means fewer blisters.
Pay attention to your feet. Stop often and ask the kids how their feet are doing. You may even want to have a seat, pull off their shoes or boots and look for signs of rubbing or irritation to get an early jump on blister prevention.
If you’re walking along and you feel “hot spots” on, say, the ball of your foot, stop and attend to it. Hot spots are almost always precursors to blisters. If the spot is “hot” or “tingly” then stop, apply a bit of moleskin, some talc (Gold Bond foot powder is really nice) and put on a clean pair of dry socks.
Let the inside of your boots dry fully between hikes. Not always possible, but highly recommended. Most boots have a liner inside that will help pull moisture off the socks, further enhancing the wicking power of the wool socks.
Before any hike, I wash my feet (or dip them into a cool stream, ahhhhh), dry them well, and apply a little sprinkling of talcum powder (often Gold Bond as noted earlier). I then pull on the appropriate sock (sometimes a sock liner first) and lace on the boots.
Still, despite all my own advice and precautions I’ve had blisters form while on the trail and even break before I knew what was happening. I couldn’t just end the trip and go home, It was a matter of health and safety that we get off the (mountain) trail ASAP as threatening weather was closing in. Thankfully, Spenco had just developed a product called “Second Skin” for use on burn victims.
This product is some sort of plasticky matrix in which water is encapsulated. It has two sides that you peel off to reveal a gel-like membrane. The membrane is then applied directly over the blister. It’s anti-septic and sterile so it also helps reduce the chances of infection. The whole area is then covered with an adhesive, flexible bandage to hold it all in place. Socks went back on then the boots. Back on the trail in about 10 minutes and the pain had been reduced to almost nothing! Of course I had to stop a couple of times to inspect the arrangement and replace as necessary, but really, we made great time without any further damage to my foot.
Product similar to the above include “Glacier Gel” from Adventure Medical Kits