Blisters
From Trail-Finder -- Dedicated to getting you outside
Contents |
Overview
Blisters are caused by an accumulation of fluid, generally lymphatic fluid, occasionally including some blood, under the surface layers of skin. Blisters under callouses can be especially painful and hard to deal with. Blisters are generally non-serious medical conditions, but can be painful, even partially debilitating in a wilderness situation.
Causes
Blisters, as caused by outdoor activities, are usually the result of friction. Usually, this is friction between your foot and boot, but blisters are also common between hands and kayak paddles, even when wearing paddling gloves.
Blisters can also be caused by chemical irritants, such as poison ivy and from burns.
Treatment
Different people propose different treatments for blisters. Each comes with its own advantages and disadvantages.
Don't touch it
This is by far the easiest method. You get a blister on your foot, you just ignore it, hoping it will go away. Eventually, it will.
Advantages
- It's very easy. Just do nothing.
- As long as the blister remains closed, there's virtually no risk of infection.
Disadvantages
- Closed blisters will continue to hurt if you continue to apply friction or pressure to them.
- Can be partially debilitating, if it's too painful to walk far or paddle, for example.
- Can take a long time to heal.
- If you continue your activities, the blister will probably rupture, anyway.
Pinprick Method
This treatment involves using a "clean" pin or needle to poke a small hole in the blister to drain the accumulated lymph.
Advantages
- Draining the fluid will reduce pressure and prevent the blister from spreading.
- Immediate pain reduction
- Allows you to continue activities.
Disadvantages
- You now have an open wound, increasing the risk of infection.
- The fluid may build back up again, requiring you to repeat the procedure
- You need to have an ideally sterile pin or needle available.
Pinprick With Alcohol
This is an old runners' trick. The idea is that the sensitive tissue under the dead skin layer will continue to be sensitive until it dries out. Pouring alcohol on it will dry the wound quickly.
Advantages
- After the first couple minutes, further reduction of pain.
- Reduced chances of infection, since you just poured alcohol on the wound.
- Increased ability to continue normal activities.
Disadvantages
- You now have an open wound, increasing the risk of infection.
- The fluid may build back up again, requiring you to repeat the procedure
- You need to have both alcohol and an ideally sterile pin or needle available.
- There is quite a bit of pain for the first minute or two after pouring the alcohol on the wound.
Skin Removal
If the blister ruptures, you now have a large flap of dead skin over some very sensitive tissue. Sometimes this is done intentionally, as an extreme form of the pin-prick method.
Advantages
- The fluid won't build up again, since there's nothing to contain it.
- Immediate pain reduction
- Allows you to continue activities.
- Eliminates the dead skin, which will dry and cause pain if not removed.
Disadvantages
- You now have an open wound, increasing the risk of infection.
- More pain than if you had left the skin in place, since you now have very sensitive tissue exposed.
Skin Removal With Alcohol
A similar idea to the pinprick with alcohol method, this method caused the skin to dry faster, allowing a quicker healing.
Advantages
- The fluid won't build up again, since there's nothing to contain it.
- Immediate pain reduction
- Allows you to continue activities.
- Eliminates the dead skin, which will dry and cause pain if not removed.
- May heal faster and have less pain, after the initial few minutes, than just losing the skin initially.
Disadvantages
- You now have an open wound, increasing the risk of infection.
- The fluid may build back up again, requiring you to repeat the procedure
- You need to have both alcohol and an ideally sterile pin or needle available.
- There is quite a bit of pain for the first minute or two after pouring the alcohol on the wound.
Cleaning and Bandaging
Like most skin problems, the ideal situation is to wash the area with warm, soapy water, then keep clean and dry, exposed to air. Like most wilderness first aid, you will need to improvise. You should always have clean, drinkable water available, of course. If you're on a multi-day trip, you likely have some form of soap. Keeping it clean may or may not be possible, but do the best you can.
Typical bandages may not be usable, or stick, to anyplace with friction-induced blisters. Fortunately, there are two options.
- Moleskin: Moleskin comes in cut-to-fit sheets which have an adhesive layer on one side and a soft, fuzzy layer on the other. It's only about 1mm thick, so there's not much padding, but it will move the friction from your foot to the moleskin. Sticks only to clean, dry skin.
- Molefoam: Think moleskin with padding. The same top and bottom layer, but with a couple millimeters of padding in the middle. Molefoam works well when you still have an unruptured blister. Sticks only to clean, dry skin.
- Moleskin plus: Recently, moleskin plus has been easier to find than plain moleskin. It's virtually the same stuff, but has just a bit of padding in it.
Prevention
The most common cause of blisters in outdoor activities are wet or poor-fitting boots. Both can be partially addressed by wearing proper socks, providing both padding and wicking materials. If that's not possible (new boots, rain, etc), you do usually have some warning of a blister, in the form of a hot spot, a spot where you feel some pain starting. If you start to feel a hot spot, there are several things you can try.
- Tighten your boots. Loose boots allow your foot to slip around more.
- Put on some dry socks, if you have them.
- Take a break. Take off your boots and let your feet dry off. Dry socks after this feel especially good.
- If you have some, put moleskin on the area. Moleskin works better than molefoam for this, since you're really looking to move the friction, rather than pad an injury.
