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They may be small, but few things can spoil a hill day as effectively as blisters. A bad case might even put you temporarily out of action. But you needn't let it go that far; take these few simple measures and blisters can be banished for good.
Warning: if you're of a squeamish disposition, look away now.
Here's the rub
A blister is basically a bag of clear fluid between layers of skin. Of various possible causes the ones we're interested in are pressure and friction. When subjected to excessive rubbing the upper layers of skin can shear away from the tissue beneath, allowing plasma from the cells to leak out. This fluid sack then acts as a cushion to protect the damaged tissue; in that sense at least it's a good thing, but of course by then the damage is done.
This isn't as good as prevention, as everyone knows, but if you've already succumbed to a blister then here's what to do...
If a blister bursts it can become infected and very painful, so in general it's better not to lance the boil deliberately. Should it burst accidentally then clean the affected area with old fashioned soap and water before soaking it in a salt water solution to reduce the chance of infection. If you're out on the hill at the time then you'll have to settle for plain water and perhaps some antibacterial cream.
'The official advice would be not to pop blisters' says Paramedic, Wilderness EMT and frequent site contributor Cara-Lyn Hadall.
'The fluid sac is the body's natural cushioning for the injury, and once popped the wound is no longer sterile and infection can get in. If the blister is only a hot spot, or fully formed but not burst, specialist dressings such as Compeed are very good, and should be left on until they fall off naturally. If the skin has already been broken leaving an open wound, cover with a non adhesive sterile dressing and try to avoid any pressure or friction over the site.'
'Well that's the textbook advice anyway; though some people will have their own tried and tested remedies too.'
...Hopefully you won't have let things get that bad in the first place. Here's a few tips for blister avoidance:
'Well-fitting footwear is fundamental in the battle against blisters, and without it you may as well stop reading this article here'
Fit footwear with care
Foot shapes vary hugely and ditto shoes and boots, so it can be harder than you might think to find decent hillgoing footwear that genuinely fits you well enough for a long tough day out. Well-fitting footwear is fundamental in the battle against blisters, and without it you may as well stop reading this article here. Hours (or even days) trying every model in every available shop will be time well spent. There must be enough toe space for a modest wiggle, but not so much room that your foot slides around - with obvious consequences. Tighter footwear may of course pinch somewhere or other, and that's a recipe for disaster too. Particularly (but not exclusively) with heavier boots, make sure that the points at which the uppers fold as the foot rolls forward match the flex of your own foot, or the repeated digging in is sure to cause problems. And whatever you do watch out for the dreaded heel lift, a fast route to guaranteed blisters.
For more advice see this UKH article on choosing summer footwear.
Don't neglect the socks
Use clean dry socks, and ensure they're well fitting too – neither too tight nor too baggy, but snug enough to stay up without sagging. Bulky seams can cause pressure points, so give them a miss. Hillwalking socks should be made of something that readily wicks away moisture. Design-wise, a bit of extra padding at heel and toes can work wonders, as can well-placed elastication. The sock should suit your choice of footwear for the day, so don't forego thickness if your boots are slightly loose - or vice versa. It must also match the conditions. Winter weight socks in a summer heat wave will be hot and damp, a fertile breeding ground for blisters. Some traditionalists advocate wearing two pairs of socks, a thinner inner and a red wooly knee-length outer, the theory being that any shearing can then take place between layers of sock rather than layers of skin; by all means experiment, but bear in mind how hot your feet may get.
Stay cool and dry
Skin tends to soften in the warmth, becoming more prone to blistering. In hot weather choose well ventilated shoes or lighter boots without a waterproof membrane in the lining (hard to come by, but excellent traditional leather boots are available from various manufacturers including Scarpa and Meindl). Try a cooling foot spa in a mountain stream, or at the very least removing your boots when you've stopped for lunch. Blisters love dampness too, so avoid getting socks and footwear soaked through if possible, and consider bringing a spare pair of dry socks to change into – particularly if out overnight.
If you're planning a long walk and know that certain spots are prone to blistering try protecting the offending areas with tape before starting (climber's finger tape works well), being careful to keep the wrapping neat and wrinkle-free. Alternatively you might try a dab of Vaseline to reduce friction.
To get the best fit from footwear it's sometimes worth tweaking the tension of your laces - slightly looser at the toe and tighter around the mid foot, for instance. An overhand knot in the laces can help lock off areas of different tightness. It may be worth experimenting even further with lacing configurations. Lacing downwards instead of upwards through a hook can give a subtly different pressure, and helps lock off slipping laces too. One good way to hold the foot securely in place is to run the laces downwards through the top couple of hooks, before tying them off above the instep rather that at the top of the cuff. Or if you're suffering excess pressure in the instep try missing out an eyelet over the affected zone, perhaps locking off the laces above and below this with an overhand knot. Pressure can also be shifted around the foot by forming a loop between two eyelets, through which the lace is then passed to create an improvised intermediate eyelet. You may end up with a veritable cat's cradle, but if it works then who cares how daft it looks.
Think about insoles
When there's too much volume in a boot try adding an extra insole, rather than doubling up on socks. It may even be worth spending money in this department. The footbeds that come with most boots and shoes tend to be thin, floppy and unstructured - OK for shock absorbing but not much good for supporting your foot and holding it securely in place. If you suspect the original insoles aren't doing the best job they could, try replacing them with a stiffer pseudo-orthotic insert.
When you feel the emergence of the characteristic hot spot that precedes a blister you may be able to nip the damage in the bud before it forms. Don't soldier on in discomfort until it's too late. Stop right away, removing boots and socks for a few minutes to help everything dry off and cool down. Now apply a protective dressing to the sore bit so that this rather than your skin bears the brunt of the rubbing. There are various options: a) plasters – OK for a bit, but generally rub off after a few miles; b) tape - less padding, but tends to last longer than a plaster and c) a dedicated anti-blister patch (aka second skin). As the name suggests, these act like an extra layer of skin, forming a cushioned barrier against further damage - smooth to reduce friction, and designed to create an optimum environment for healing. They're the most expensive option but also the most effective, and should stay in place longer than a simple plaster.
Don't delay. The consequences of inaction aren't pretty.
'I got this on a multi-day ski tour' says Kai Larson, of the gruesome picture below.
'Stupidly, I didn't pay attention to the signs that I was getting a blister, and didn't attend to it until it was too late. I had to ski the last day with the blister and it was rather painful. I had nine blisters on my feet at the end of the tour. That one was the worst.'
Good thing too, Kai.
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