The Ultimate Hiker's Guide to Blister Treatment and Prevention

“Blisters are a painful experience, but if you get enough blisters in the same place, they will eventually produce a callus. That is what we call maturity”.

-Harry Herbert Miller

Blisters are one of the worst nightmares for hikers. One small tiny hot spot can throw off your game, cause excruciating pain and can prevent you from going back out on the trails. Some of us are more blister-prone than others and require blister prevention care before every hike while others can wear any type of sock and footwear and never worry about a blister. I am known to pop blisters on the trails, rub my feet in Vaseline, cover my feet in duct tape and spend way too much money on socks to keep my feet dry. After many years of hiking and after a couple of tearful breakdowns on the trails and many talks with outdoors experts, I have FINALLY found the best blister prevention and treatment for me. Keep in mind that every foot is different and therefore blister care may differ among individuals. For example I never get blisters in between my toes but I have many friends who are very blister-prone in this area. It may take you a few different attempts and treatment combinations to find your best blister solution so be patient, don’t be scared to spend some money and happy reading.

Why do blisters form?

The outer layers of your foot's skin can move more than the sensitive inner layers can. Boots and socks apply pressure and friction as you walk, causing these skin layers to separate and fluid to fill creating a blister. Warm, moist skin blisters quicker than cool, dry skin because warm, moist skin moves easily and therefore sheds easily. In order to prevent blisters we must prevent friction and keep our feet cool and dry.

Let’s talk about blister prevention…

Shoes

Hiking boots should fit snug everywhere, tight nowhere and offer room to wiggle your toes. Go and get your feet fitted by a footwear expert at REI or your local outdoor retail store and the rule of thumb, depending on the shoe, is to go up a half or one full size because your feet will swell on a hike. Every brand fits differently so try on different brands to see which ones fit your foot the best.

Socks

I recommend sock liners under wool socks. Used in conjunction with a thicker sock, sock liners feature optimum moisture-wicking capabilities and further protect your feet from irritation. For individuals who are blister prone in between the toes, try toe sock liners by Injinji.

Stay away from cotton socks. The best rule of thumb is to stay with wool socks. My favorite brand is People Socks because they do not cost an arm and a leg. Other, more expensive brands, such as Smartwool and Darn Tough are excellent choices as well.

Try supportive insoles 

Both custom-made and over-the-counter insoles reduce movement inside a boot, thus limiting friction. Make sure these insoles FIT YOUR SHOE or else they will CREATE blisters. For example, do not switch out your insoles into different shoes, I made this mistake and it resulted in tears and a six-inch fluid filled blister.

Lubricate

Whether you use deodorant, body glide, or Vaseline, cover your feet with lubrication before you put your socks on. I usually re-lubricate my feet after 10-12 miles and switch to a new pair of socks after 15 miles. I use Vaseline because it is cheaper and it works like a charm.

Cover your common blister areas

Whether it’s in between your toes, on your heel or on the balls of your feet, after enough hiking you WILL learn where you are blister prone. Cover these areas before you lubricate your feet. The following are great products and strategies to use. I personally use Liquid Bandage.

•  Liquid Bandage (When applied to skin, it dries to a hardened shield, like a second layer of toughened-up skin)
•  Moleskin (reinforce with duct tape over this)
•  Duct tape
•  Second skin
•  Gel elastic toes sleeves (to prevent blisters in between your toes)

**Avoid foot powder (it clumps and can increase blister formation due to friction)

Preventing “ball of your feet” blisters

•  Place a long, wide strip of tape on the floor, adhesive side up, and set the ball of your foot directly atop it.
•  Press down to make your foot as wide as possible. Pull the ends of the tape up around the sides of your foot to meet on the top of your foot.
• Trim the tape to conform to the shape of your foot so the tape doesn't contact your toes.

Preventing toe blisters

• Wrap a small strip of tape, sticky side down, from the base of the toenail over the tip of your toe and then underneath it.
• Wrap a second strip around the circumference of the toe, covering the ends of the first strip. Cut the ends of the second strip as close to each other as possible without overlapping them.
• Or use Gel elastic toes sleeves

Blister treatment

To pop or not to pop?

To pop or not to pop is the big and hotly debated question. Even the experts disagree about when to drain a blister. I personally say “pop,” many ER docs say “pop,” and many wilderness first aid experts say “pop.” So, therefore, the final answer is “POP.”

• Clean the area with soap and water, alcohol, or an antiseptic towelette. Dry thoroughly.
• Sterilize a needle or sharp blade, either by holding it over a flame until it's red-hot or submerging it in boiling water for 2 minutes. If you are in a pinch clean it with an alcohol wipe (this should always be in your first aid kit).
• Puncture the bottom end of the blister so gravity can help drain it. The opening should be no bigger than is necessary to get the fluid out. Starting at the top of the blister, massage the fluid toward the opening.
• Apply antibiotic ointment to prevent infection (this should always be in your first aid kit), then wrap with the dressing or blister product of your choice.

Blister dressing

• Moleskin
• Second skin
• Duct tape
• Liquid bandage

In order to dress a blister, it is important to reinforce the dressing, as the bandage will most likely fall off after a few hundred feet. I personally use second skin and then use duct tape as reinforcement. Make sure the duct tape is a ½-inch larger than the blister and the original dressing.

Reinforcing Moleskin

Cut a circular piece of moleskin, 1/2-inch bigger than the blister. Cut a hole slightly larger than the blister in the middle of the covering and place the "doughnut" over the blister to create a pressure-free pocket around the sore. Cover the entire doughnut with the second piece of moleskin, and then secure it with duct tape.

Do you have any blister prevention or treatment hacks? I would love to know!