I have recently been asked another emotive question. How to treat blisters.
The best advice is prevention is better than cure. However from personal experience I know prevention is often not possible. Especially if you are new to walking or doing larger distances than normal.
The first thing is to break in your feet. Once your feet have been toughened up you are less likely to get blisters. There are many ways to try breaking in your feet, including peeing on them and soaking them in white spirits. I suggest you don’t bother trying these. I suggest taping your feet with a good quality Zink oxide tape. Good quality tapes can stay on the skin for weeks, will not bunch up and breathe.
Secondly get good quality footwear that fit well after spending hours walking; your feet will swell up. Make sure they will accommodate your walking stocks. Take time to break in your footwear. I try to stay away from goretex lined boots because goretex boils your feet in a bag. Your feet cant breath and get moist with perspiration leaving you prone to blisters.
Thirdly is your socks. There is lots of advice about socks, such as wearing thick socks or wearing two pairs of thinner socks. Personally I have tried both and don’t like either advice. I prefer a medium thickness ankle sock preferably made of wool.
And finally we come to foot care. The most important thing I have discovered is to adjust your boots on the fly. People I walk with get upset because after a mile or so I will stop and retie my boots. In most cases I retie them a lot looser than they were. Change your socks daily and don’t sleep with socks on. Your feet need time to cool down, dry and air. At the end of each day remove your boots and socks wash your feet or if in snow rub your feet into the snow. Then the most important bit is let your feet air dry. This is invaluable and I have found it to work everywhere from the high arctic to the tropical rain forest. Air your feet for at least 15 minutes to help them dry out and cool down. Then sprinkle some powder on them. Best is an antiseptic talc but don’t waste your money on expensive medicated foot powders. Never talk your feet in the morning this only attracts moisture and germs.
There is a view that you must keep your feet dry. This has led to goretex lined boots and waterproof soaks. It should be allow your feet to breath. Footwear made of a natural material that cam breath is far more effective than manmade materials that attract and hold moisture. Saying that though many approach shoes are made of aqua phobic materials that reject moister which are great but sadly many use goretex inners. If you use these try to find a foot bed made of cork. Cork is natural and is less likely you become slippery when wet stopping your foot sliding around inside the footwear causing friction blisters or de-gloving of the sole of the foot.
If you get a blister, the advice says you should not drain it or remove it’s roof if intact. However I have found it is best to drain the blister, leave the roof intact and tape it with a good quality zinc oxide tape. One the tape is on leave it on, don’t try removing it; it may well rip off the roof of the blister. If the blister fills up again then drain it through the tape. I carry Hypodermic needles in my kit for this reason.
If the blister has de-roofed then clean the area and carefully cut away any lose skin. Cut a piece of gauze that will fit in the socket left by the blister and then tape up. The gauze will stop the tape sticking to the floor of the blister.
I try to make the above treatments one off treatments. I.e. I am aiming for the taping to stay on for the length of the trip and for a couple of days after the trip. The blister will start to dry out and white blood cells will start to protect the blister, gauze and tape from infection. Whereas if I were to remove the tape, I have the possibility of tearing weak tissues, introducing infection and generally effecting my general wellbeing.
It is still important to air dry and power your feet every evening though, even when covered in tape.
Ok this flies in the face of all the medical advice however that advice is for treatment in a hospital or more correctly a civil environment. When you are on the hill you need to promote recovery whilst limiting pain and discomfort to allow you to get home.
This is what I do; I do not teach this on my expedition courses however I do discus the many options beyond medical advice. If you choose to follow the above that is own risk and I am in no way responsible. I posted this as information only to invoke thought and conversation.
If you are interested on what medical advice has to say on the subject it can be read here
http://www.nhs.uk/Conditions/Blisters/Pages/Introduction.aspx and because this is best practice this is what I would have to teach you on one of my courses.
How do you treat blisters?