Blisters

[Phoenix Rising]

Ok, so I know this is a topic that is brought up all the time and normally I know what to do… but again my Turkey-Day backpacking trip has thrown me for another loop.

I haven’t had a lot of blisters in my hiking/backpacking/walking life, but enough to know if it is a clear fluid filled blister once properly prepped, it’s best to drain it (which I have done).

However here is the question… what if the blister keeps filling up? I have now drained it 3 times in the last 3 days. I have not been walking much or wearing the evil shoes, which caused the blister, so the fact it keeps filling up, is confusing me. Should I continue to drain it or should I leave it alone and see what happens? So any of you have experience with this situation?

[hopefulhiker]

Phoenix,

I would keep draining the blister and applying antibiotic, if it is not infected.. If it is infected go see a doctor and get antibiotics..
If it is not then eventually you will develop callouses.. Glad to hear that you are hiking,, and thanks for your help in 05...

[Appalachian Tater]

The fluid is bothersome but nothing to worry about if it's not infected, meaning that the fluid is clear or merely bloody but not cloudy or pus-like. The reasons to drain it are for comfort and to keep it from draining in unsanitary conditions. If it's not going to pop on its own and you've drained it several times and it's not infected, try leaving it alone for a couple of days. Most of the time uninfected minor injuries heal better if you don't keep screwing around with them.

Probably if it were my own foot, I would take sterilized scissors and cut it open enough that it wouldn't hold fluid but that would increase the risk of infection so it's not something to recommend to others. Of course, I drained my own post-operative blister after my surgeon refused. Twice.

[Summit]

Blisters are your body's natural way of repairing skin damaged from rubbing (in this case). According to Healthline.com and many other medical advice experts:

Unless they are hindering movement or are extremely painful due to their size and/or location, blisters should not be ruptured, or "popped," as doing so can introduce bacteria into the wound. If a blister does burst, the extra skin should be left intact. Blisters that are excessively large or painful should only be punctured using antiseptic procedures, preferably by or under the direction of a qualified healthcare professional.While hiking it is best not to drain them as the fluid is a better defense than anything you can apply. If popped, you then set yourself up for a compound blister, where the rub continues and separates the next layer of skin from below it and that is a very serious situation, not to mention 10 times more painful than a first-layer blister.

[Phoenix Rising]

Thanks for the ideas... Since I am not hiking right now I am going to let it be and see what happens. Of course if it gets really big and painful again I just might drain it again!

[mindi]

I found that if I made a bigger hole in the blister (using nail clippers for example) rather than just a pinprick, it kept it from refilling over and over.

[warraghiyagey]

I found that if I made a bigger hole in the blister (using nail clippers for example) rather than just a pinprick, it kept it from refilling over and over.

That is exactly how I do it. Works every time!! Better to drain.

[sasquatch2014]

Sorry for the long post but here it is.

I had a big issue with blisters this fall when I was out for a section. I had thought that I had put enough miles on the new boots but with a fully loaded pack and more climbing it proved not to be the case. As you can see from the pics these were nice sized ones. The one on the left heel came open when I had to try and re-tape the heel. I had used one of the Band-Aid blister care things. I am not sure how these really work but they seem to soften the skin and make it more prone to tear. The package says to let the patch come off naturally and do not try to remove it. Well the Duct Tape just pulled it mostly off. I had to cut away what was left with my pocketknife much to the horror of the guy who was also sitting on the bench in Cheshire Ma waiting for the bus.

I patched myself up and headed up out of town. I had done what I could and was unsuccessful in finding any large band-aids at the general store. It was getting dark as I headed south out of town. I stopped to put on my headlamp and as I was doing this the owners of the house that I had stopped in front of drove in to the driveway. They asked how I was and I told them about the lack of large band-aids. The guy said he had cut his hand the other day doing some work on his home and that he may have a few band-aids still in his pocket. I expected something for a finger. He pulled out two of the biggest most beautiful band-aids I have ever seen and gave them to me. I thanked him several times and hobbled off into the darkening woods. Not more than ½ mile up the trail I could tell things just went bad on my right foot and as the photo shows the blister on that foot had torn as well.

The big problem would occur two days later. If you look closely at the bottom of the left heel you will see how it too has a blister but not open. This is forming under the thick pad of the heel and proved all but impossible to drain. I could not force a needle through the callous on the bottom of the heel to get to the fluid. I was after two days unable to bear weight on the feet at all. I had to come off the trail short of the time I had expected. I rested the feet for a day and a half in Dalton at robs and soaked them to be able to drain them. It took three days before I could put full weight on them. To say that I address hot spots right away now is an understatement.

You have to just play with what works for you. In some cases this may be a liner sock for others its insoles or duct tape. Try different things and see what works. Right before he left a man named Lee who was wrapping up his last section down to HP showed me a wrap that “Weka” had shown to him that helps keep the foot from sliding in the boot on descents more. Like I said try it all and keep what works.

2720

2721

[take-a-knee]

The only thing I've ever found that worked on a heal blister is duct tape. Best applied to the hot spot BEFORE the vessicle fills. If you don't catch it that fast, apply a piece of duct tape larger than the blister to the sticky side of a larger piece of tape. Round the corners of the larger piece and apply it carefully, give the glue a few minutes to "set". If your feet are funky and they probably are, clean the area with some alcohol and let it dry beforehand. Once a blister gets as bad as the one in that picture, you need to stop hiking until it heals.

[warraghiyagey]

I hiked the last 6 days of the 100 mile with identical blisters. Used new skin, mole skin, duct tape, bandaids. They healed while I kept hiking.:)
Also, I changed from heavy hiking boots to trail runners.:) :)

[john gault]

I walked on pavement for about a month before my hike and never had a problem with blisters. Until I got to Pennsylvania, then I got them on the back of the heels, just like Sasquatch, which I attributed to the incredible heat and all the sweating. I also had large sores from my hip-belt. It was awful for about a week and a 1/2, but I just walked it off.

[take-a-knee]

I walked on pavement for about a month before my hike and never had a problem with blisters. Until I got to Pennsylvania, then I got them on the back of the heels, just like Sasquatch, which I attributed to the incredible heat and all the sweating. I also had large sores from my hip-belt. It was awful for about a week and a 1/2, but I just walked it off.

Good point, a blister is a thermal injury, the warmer it is, the easier they occur, or rather the more vigilant you need to be to prevent them.

[Greentick18d]

Pop or dont pop, whatever you place over it (moleskin, duct tape, etc) will stick better if you use some tincture benzoin. It is a surgical adhesive that looks like betadine but when it dries is very tacky. I keep some in a small dropper with some qtips cut in half in my medkit.

To use, let the area dry, apply some tincture, let it dry for a minute or so. Put your protection in place. THis technique works best on hot spots so stop early and stay blister free.

Of course if you are really hard-core here is an old school army technique. Clean the area. Drain blister with needle. Inject ToB into now empty blister. Scream. Alot. Now the skin will be glued down. I believe this is how break dancing was invented. I have never used this technique but have seen it done several times. Never have I seen so many grown men cry...

[mudhead]

Reading that made my backside puckerup. ouch.

[Marta]

I chop the top off my blisters and squirt Purell into them. Hurts like !@#$.

Of course, I tend not to get very large blisters anymore, since I switched from boots to shoes.

[take-a-knee]

Pop or dont pop, whatever you place over it (moleskin, duct tape, etc) will stick better if you use some tincture benzoin. It is a surgical adhesive that looks like betadine but when it dries is very tacky. I keep some in a small dropper with some qtips cut in half in my medkit.

To use, let the area dry, apply some tincture, let it dry for a minute or so. Put your protection in place. THis technique works best on hot spots so stop early and stay blister free.

Of course if you are really hard-core here is an old school army technique. Clean the area. Drain blister with needle. Inject ToB into now empty blister. Scream. Alot. Now the skin will be glued down. I believe this is how break dancing was invented. I have never used this technique but have seen it done several times. Never have I seen so many grown men cry...

I was taught this by a podiatrist at Ft Sam Houston who had done this dozens of times on German Volksmarches with good effect. I've done it to myself and quite a few team members through the years and never had a problem. It hurts...a lot, but once the pain stops in a minute or two you can walk without a problem, it destroys the dendrites in the skin. As Greentick said, tincture of benzoin applied to unbroken skin makes any bandadge/tape adhere much better. Duct tape is the only thing I've ever used that didn't require this to stay on. In the army we used to get little single-use applicator vials of tinc/benzoin, I guess you could buy them. Greentick is a working PA, maybe he'd know.

I would not be afraid to inject the benzoin into my own blister, you have to remember that, you got a blister there in the first place, so if you keep walking in the same boots/socks you are probably going to get another in the same spot. You may need to rethink your shoe/sock system. Having said that, it would be prudent to have a regimine of an appropriate antibiotic for soft-tissue injuries. I always used Keflex, I think Greentick reccomends Levaquin in his article.

The best technique for draining/injecting a blister I've found is as follows.

1)Clean the area with alcohol

2) Take a pair of iris scissors (these are small, pointed scisssors) and cut a small slit in the edge of the blister and drain it. Clean again with alcohol and dry it.

3) Inject the benzoin quickly with a small syringe (a TB syringe is ideal), no needle needed, just stick the tip of the syringe into the slit you cut in the blister.

4) Bite on a piece of leather or a stick or something, you'll need it.

Place a bandaid with antibiotic ointment over the slit in the blister, this is no a portal of entry for bacteria, you HAVE to keep this clean. Bandage/pad the area as best you can, it probably won't stay on but the area needs to be cleaned and bandadged every evening without fail.

If you see red streaks going up your leg, you have cellulitis, start the antibiotic and stop hiking until it gets better, seeing a doctor would be prudent at this point. Proper wound care described above will likely prevent an infection, if you neglect it, it'll likely get infected. Your foot is the farthest part of your body from your heart and has relatively poor circulation (ask diabetics or old people), you have to take care of your feet.

[Greentick18d]

...In the army we used to get little single-use applicator vials of tinc/benzoin, I guess you could buy them....
...I always used Keflex, I think Greentick reccomends Levaquin in his article.
....

The single-use applicator generates too much trash IMO. I found a 4oz bottle of Tincture of Benzoin on the web (a lifetime supply) and use a tiny dropper bottle and a few q-tips (break them in half).

AFA antibiotics, Keflex (generic is cephalexin) would be the first choice but IF you were going to carry an antibiotic and carry just one Levaquin will cover more bugs and you only take it once per day (as opposed to 4x per day with keflex) so there is less to carry.

Here is the link to my article:
http://www.whiteblaze.net/forum/showthread.php?p=183728#post183728

[mkmangold]

I pop (deroof) the blister by first sterilizing a needle with a flame and making two puncture holes: one close, one far. It drains better. Then I apply antibiotic lotion prophylactically and then duct tape. Worked great on my last pair of tight=fitting dress shoes.

[Phoenix Rising]

I also had large sores from my hip-belt.

This brings up another good question...

Let me begin this by saying I am working on getting a new pack but seeing as I am a jobless student right now I am trying to make due with what I have.

I have come to expect with my current pack (yes it's heavy and outdated) that within the first 4 miles I will have bloody hips if I do not tape up before I head out (which of course I forgot to do last time and I am still healing from.) I think my my next trip I will be investing in a pair of slik boxers to wear between my skin and pants in the hopes they will slide over my skin and not act as a grater like my pants or shorts do. Do any of you have any other suggestions while I save money for the new pack?

[warraghiyagey]

. . . Do any of you have any other suggestions while I save money for the new pack?
I would suggest looking over all your adjustable straps and then putting your pack on and refitting it (while it has some gear in it). Take your time and use each strap to snug it in. Especially around your waist. Also pay attention to where the hip belt rides. Blisters are a friction issue and if you can abate that without restricting you blood circulation and comfort you'll be better off. I did it with my external frame and it made ALL the difference.:)