Monday, September 3, 2012

Blister Prevention & Treatment for Hikers

No one is immune to blisters. However, blisters are preventable if you understand the conditions that cause them and they will heal faster if you know how to treat them properly. In the following article I begin by explaining what blisters are why they occur. I then discuss techniques to prevent them from occurring, followed by guidelines for treating blisters that will expedite the healing process.

What Causes Blisters?

Blisters can be caused by burns, allergic reactions, and fungal infections. The most common cause of blisters resulting from hiking is friction. When your feet get hot and sweaty, your socks stick to your feet and begin to rub against the inside of your shoes or boots. The skin at the point of friction becomes red and irritated. Lymphatic fluid flows to the friction site gathering between the layers of skin to protect the area like a small balloon, eventually forming a bubble of fluid known as a blister. Blisters can also occur when your socks, boots or shoes get wet from the rain, snow, or a stream crossing.

Why Blisters Form :

Blisters need 3 things to form:
So that means that if your foot gets hot and starts to sweat, and you’re wearing shoes that are rubbing against your skin just right, then you can get a blister.

Should You Pop Blisters?

Personally, I always pop my blisters with a sterilized needle, drain them and then put a bandaid with antibiotic cream on them to keep them from getting infected.
However, there are some people who say that you should never pop a blister. Why? Because the blister is "nature’s bandaid." It’s thought if you pop a blister, bacteria will have contact with the unprotected skin, which leaves you open to infection.
That said, there are some times when popping a blister is necessary — such as when it interferes with your being able to wear your shoes. Or, when the blister interferes with other things that you need to do in life.

How Blisters Form

Blisters are simply a build-up of fluid between different layers of skin.
A blister is created when something rubs the outer layer of skin and causes it to then rub the inner layer of skin. This, in turn, causes the outer layer to come loose from the inner layer. It is at this point that your body then fills up the space with lymph fluid.
When this happens, the outer layer loses any contact with oxygen and nutrients, and at that point  becomes dead skin.
If you pop the blister, or it pops on its own, then your skin is no longer protected since the outer skin is dead.

Blister Prevention

The key to preventing blisters is to eliminate friction. Shoes and boots should be well broken in and you should make an effort to keep your socks as dry as possible by changing them when your feet get hot and sweaty or by taking your shoes or boots off periodically to let your feet and socks dry out when you take a snack break. If this means bringing along one or two extra pairs of socks, it may be well worth a few more ounces of pack weight.

If you expect to do a lot of stream crossings you should consider bringing along a pair of sandal or crocs to wear instead of your boots to keep them dry. Bringing along a pair of camp shoes also gives your boots and socks an opportunity to dry for a longer period of time before you need to put them back on again. Conditions permitting, you may also want to re-evaluate a preference for leather hiking boots. Ultralight hikers who wear lightweight boots, running shoes or even sandals may experience less blisters because their footware drys more quickly when it gets wet. Gore-Tex lined leather boots, on the other hand, can take days to dry out completely.

Other effective ways to reduce friction include applying petroleum jelly to a hot spot or sprinkling foot powder or corn starch on your feet to prevent moisture buildup. If you feel a hot spot forming on your feet, you should stop to inspect it immediately and apply moleskin or tape to prevent it from turning into a blister later in the day. Some hikers also prefer wearing two sock layers, a liner which absorbs moisture and can be changed frequently, and a heaver outer sock. This moves the site of friction between the socks, away from your skin and a sock.

 Blister Treatment

Blisters come in different shapes and sizes. The first stage in determining how to treat a blister is to assess it. Broken blisters that are leaking fluid should be disinfected and bandaged. Unbroken blisters that are painful should be pricked with a sterile needle and drained. Small blisters that are not painful should be left alone because the best protection against infection is the blister’s own skin. These will heal by themselves and will be reabsorbed in a few days.

If a blister has broken, it should be cleaned, disinfected and then bandaged. You can disinfect the would by irrigating it with chlorinated water, wiping it with an alcohol swab, or rubbing it with a dab of Purell. If the skin over the blister is ragged and dirty it should be carefully cut off. Otherwise it should be left intact to prevent infection. Before bandaging the wound, an antibiotic oitment should be applied. Research has shown that the application of Neosporin or triple antibiotic gel will kill of infecting bacteria after two applications and accelerate the healing process.

Unbroken blisters that are painful should be drained. This is caused by the build up of fluid in the blister, so removing it will help relieve the pain. First swab the blister with alcohol to disinfect the area. Then, using your fingers, push the fluid to one side of the blister. Prick the side with the fluid using a needle that has been sterilized by alcohol, a lighted match or in boiling water. The needle should prick the blister horizontally at the point where the blister begins to rise above the skin. Leave the skin overlying the blister in place to prevent infection. Apply antibiotic gel to the site of the needle pricks and cover with a bandage. For small blisters, cover the entire blister with an adhesive bandage. For larger blisters cover the entire blister with a porous, plastic-coated gauze pad that will absorb any further drainage and allows the blister to breath and dry out. If the bandages get wet, reapply the antibiotic ointment and redress the blisters. After a few days, the skin under the blister should have healed and you can cut away the remaining dead skin.

Other Folk Remedies

If you hang around long distance hikers and backpackers long enough, someone will suggest using Superglue to help heal a blister or make it possible to keep walking with one. This suggestion is actually a lot less far-fetched than it sounds. Superglue is widely used by surgeons to bond together organs or parts of the body that respond poorly to stitches. It is also effective in closing skin shears like cracked calluses where the sides of a wound must be bonded to accelerate healing.

Superglue can be used to treat blisters by squirting it between top of a popped blister and the skin beneath it. This bonds the roof of the blister to the underlying skin reducing the risk of infection and creating a hardened shell over the blister site. The downside of this technique is that the solvents in the Superglue will hurt like hell when they are applied to the wound. To be on the safe side, make sure that you have sterilized the blister with alcohol before applying Superglue to it.
Tincture of Benzoin is another bonding agent that can be also be used to seal the roof of the blister to the exposed skin underneath. It already contains alcohol, so a separate application is unnecessary.

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