Blister Prevention and Foot Care

[Icacos]

........ I listened very carefully to what falcon269 had to say.

And ..........................???

 

[ShellsG]

In regards to the question of how to treat blisters I am answering not a seasoned peregrino but a seasoned walker and health care professional. I cringe when I hear people draining blisters, it just increases the risk of infection 10 fold and yes, I have seen some serious infections from draining blisters. I use moleskin and blister band aids. I got a blister on the ball of my foot at my big toe, I felt the hotspot, stopped and put a piece of moleskin on ... finished the 4 km walk home and by the next day I couldn't tell I had a blister, I keep the moleskin on until it falls off. I will, depending on where I get blisters, preventively put moleskin on. I tend to get them on my right heel, so double layered wick away socks and a piece of moleskin and 23 km later no blisters (last weekend). So I highly recommend moleskin, have used duct tape in an pinch but I put it on me not my boot and shy away from draining any blister.

 

[Hélène Cholette-Lacasse]

I would say that your footwear does not fit. Blisters are from friction. Your shoes are rubbing.

I have walked hundreds of kms in my lowa boots without a blister but the blisters appeared with the summer heat here. My blisters are on the inner part of my small toes.

 

[Anemone del Camino]

For your curent blisters you are not able to get rid of use Compeede, now sold here by Liposporin. For prevention vaseline, Vick's or Proshield plus, rubbed in between your toes. Also start thickening you skin with Tano, or lemon juice.

 

[Hélène Cholette-Lacasse]

For your curent blisters you are not able to get rid of use Compeede, now sold here by Liposporin. For prevention vaseline, Vick's or Proshield plus, rubbed in between your toes. Also start thickening you skin with Tano, or lemon juice.

Merci. I am currently using NOK cream to thicken the skin. Will look into Vick's and Proshield plus. Have been using the Bandaid Advanced Healing Blister plasters for toes but still hurts and gets worse following hicking.

 

[Deleted member 3000]

My blisters are on the inner part of my small toes.

Lubricate, then. This ointment has silicone in it.

http://www.amazon.com/dp/B0007OC0A2/?tag=casaivar02-20

 

[annakappa]

Soak your feet several times daily in a strong tea solution for at least two weeks, to harden your skin. ( ballet dancers tip)!

 

[Robo]

OK, here's my 2 cents worth........

If you are getting blisters in training, you are doing something wrong. Prevention should be the aim, not treatment.

Many people get blisters on the Camino, and everyone has their pet methods for avoiding and treating them. I would take advice from those who managed to avoid blisters, rather than those who have great ways to treat them I followed the 'generally accepted' advice here, and only got one tiny blister in 800 kms. And that was only because I didn't notice it! (I thought it was Achilles pain) It was 'fixed overnight by cleaning and draining.

As an aside, many people I walked with were using Compeed. And they got blisters on blisters........ Personally I wouldn't use it.

But, we are all victims of our own experiences. We only know, what we know..... (and I have only walked one Camino to date)

The 'generally accepted' advice I gained from this Forum, that served me well was:

1. Buy boots/shoes a size larger than normal.
2. Make sure the boots are well worn in. Though mine were like bedroom slippers from day 1...
3. Wear two pairs of socks. thin 'wicking' liner, wool outer.
4. Shower at night only, not in the morning. Keep feet dry!
5. Use loads of Vaseline on your feet every day.
6. Air your feet and socks every couple of hours. They get sweaty and hence wet. Maybe even change socks. ( I usually had my second pair airing pinned to my backpack)
7. If you get a hot spot. Stop immediately and treat it. Basically stop the friction occurring.

The one 'magic' thing I added was this. Hikers Wool! Ordered online from New Zealand. But some people use the raw wool that gets caught on fences.

I gave out Hikers Wool to a few Pilgrims and they say it worked great. Only after about 500 kms I found myself needing to use it too.
Here's more information about it. http://robscamino.com/foot-care/
http://www.hikerswool.co.nz/

 

[wendyrose]

Great advice Robo, thanks for that.

Really glad to hear good things about Hikers Wool, as I've got some and plan to take it with me on my first Camino in September. So far I've only had the chance to try it once on a small blister, and it seemed to work very well.

Did you use it to prevent blisters, or only if a hot spot developed?

 

[Robo]

Really glad to hear good things about Hikers Wool, ................................

Did you use it to prevent blisters, or only if a hot spot developed?

Same thing really.

As soon as a hot spot develops, use the hikers wool. Then it won't turn into a blister.... Of course as long as you are following all the other guidelines as well re boots, socks etc! I think looking after your feet has to be 'all or nothing'. i.e. each part of the regime is important.

 

[Anemone del Camino]

Merci. I am currently using NOK cream to thicken the skin. Will look into Vick's and Proshield plus. Have been using the Bandaid Advanced Healing Blister plasters for toes but still hurts and gets worse following hicking.

The proshield plus is wath they use at the Jewish for their patients to prevent bed wounds. I found it on Amazon.ca. Tano is.a great product, but it serves the same purpose as vaseline,proshield, vick's: anti-chaffing. It will not harden your skin. Bonne chance!

 

[Kanga]

Wear hiking sandals instead of shoes! Works for me. Although I admit this does not work for my husband.

 

[LauraK]

I have walked hundreds of kms in my lowa boots without a blister but the blisters appeared with the summer heat here. My blisters are on the inner part of my small toes.

I have walked four caminos in Lowa Boots. (I love these boots.) However, they do have gortex and I noticed during a very warm week on my camino last March that my feet got really sweaty. I think the heat is probably a contributing factor to your blister problem.
On my first camino I got blisters between my small toes just like you described. My small toes kind of overlap a bit and rub together - add sweat/friction and you get a blister. Here is the solution that has kept me blister free: 1) I use a product called "Glide". It is like a deodorant-type stick you rub all over your feet and between your toes (a lot less messy that Vaseline). It reduces friction. 2) I wear a liner sock. The one that has really worked in preventing the blisters between my toes are "Injinji" socks. They have five individual toes so they keep the toes from rubbing together. 3) I wear Smart Wool socks (light weight for summer). They absorb sweat. 4) If I feel a hot spot, I stop immediately to inspect my feet and put some mole skin on the affected area. This system has kept me blister free. I really recommend the five-toe Injinji socks for the problem you describe. A regular liner sock will not stop the rubbing between your toes. If you don't use the toe socks, then put mole skin or some other preventative barrier between your toes before you walk. You can find the products mentioned at both sporting goods or runners stores.

 

[movinmaggie]

Hi Helene, I am not a seasoned walker but did the Camino Frances in 33 days. I had blisters firstly for failing to wear two pairs of socks - as advised by numerous forum members, and secondly from walking boots that turned out not to be waterproof, as their description (and price) had indicated. What worked for me was a good quality tee tree oil rubbed into my toes. not only did it dry the blisters, but it also toughened the skin.

Not sure this will help, but some time ago, I saw this suggestion in the forum and tried it when I began training and so far, works great for me. I'm training quite a bit on 4-6 hour walks. After I swathe my feet with Vaseline, I put on knee high (or ankle) stockings, then one (or two, depending on thickness) pair of socks. I haven't had a blister yet. I might also stop mid way and take my socks and boots off, cool my feet and do a mini massage. After my walk, I soak my feet in Epsom Salts for abut 15 minutes. So far so good. I do hope you find some relief.

 

[jsalt]

OK I know this must sound like a very stupid question AND I know that there are many 'recipes' to try to deal with BLISTERS but...I really wouldn't mind getting your input for that miraculous one that works fast. I have been dealing with the ones I get during my practice walks as follows: prick, drain, antibiotic ointment, bandaid/tape. I stop every 2 hours or so to change socks and air my feet, etc. But aside from putting up with the pain of walking with a blister, I don't seem to get much success in getting rid of the damned things unless I stop walking for a few days. Any miraculous tip from a seasoned perigrino out there???

As said in some posts above, if you get a “hotspot” stop immediately and fix it. It doesn’t matter where I am, or who I am with, whether it’s pouring with rain, or baking sun, if I feel some friction starting, I sit down, take my boots off and put some moleskin on. The secret is not getting a blister in the first place. Jill

 

[Dan the Man]

Helene:

I got blisters in between my small toes 3 times during training walks. I stoped my training for a few days to let them heal. I then used Vaseline inbetween my toes for a few days and nothing...no returning blisters. I found the Vaseline very messy but it worked. A fellow experienced Camino walker told me about Hikers Wool. She saw many New Zealanders using it during their Camino.

Currently I wrap Hikers Wool around each toe and I have not had 1 blister or hot spot appear. I also put it on once I feel a hot spot. It adheres to my merino woll socks which have also been GREAT for anti blister formation.

http://www.hikerswool.co.nz

Buen Camino

 

[Bozzie]

I am wearing Lowa boots - been wearing them for two years without blisters or any other ailments. I seem to have been getting blisters only this summer which has been very hot. My feet sweat a lot. Will be trying the double socks technique next...

Hi!
I love my Lowa boots, too. Are you slathering your feet with Glide, wearing wool liners (they don't make your feet hotter, btw, but wick sweat) under a wool or wool with some synthetic socks? Are your boots large enough? You might consider replacing the insert if they are too worn in. I like Lowa because of the larger toe box, but still bought a 1/2 size larger than normal. It may also be you need to make sure they are laced correctly for the type of walking you're doing. Good luck and ¡Buen Camino!!!

 

[Chacharm]

I didn't have any blisters until I hit the Meseta - the heat made my feet sweat and swell and the blisters came out in force. I was seriously ready to quit over it. My boots were very expensive and I didn't want to quit them. I bought a giant roll of mole skin (not a compeed fan) and cut it into blister sized pieces and covered all my problem areas every single day. It simply didn't help once we hit the Meseta. If you actually have a blister - run a needle and thread through it and leave the thread in it, ends hanging out. This will allow it to drain slowly and not damage the skin.
I was going to wear the same boots on my second Camino but found them in poor shape just before I went. I bought some Scarpas and though I had no time to break them in I thought they were FANTASTIC! I only walked for ten days but most of them were HOT days and with a lot of time on blacktop I expected problems. Didn't have one. Turns out I have very narrow feet so they fit perfectly.

 

[AnnieS]

Helene:

I got blisters in between my small toes 3 times during training walks. I stoped my training for a few days to let them heal. I then used Vaseline inbetween my toes for a few days and nothing...no returning blisters. I found the Vaseline very messy but it worked. A fellow experienced Camino walker told me about Hikers Wool. She saw many New Zealanders using it during their Camino.

Currently I wrap Hikers Wool around each toe and I have not had 1 blister or hot spot appear. I also put it on once I feel a hot spot. It adheres to my merino woll socks which have also been GREAT for anti blister formation.

http://www.hikerswool.co.nz

Buen Camino

I second Hikers Wool - amazing stuff. There is one distributor for North America out of Colorado. I ordered a bag ($15.00 and free shipping to Canada) and realized it is carded wool (wool that is ready to be spun). Luckily my mother is a spinner and weaver and has 60 bags of carded wool!! More than a lifetime supply!

 

[Hélène Cholette-Lacasse]

I have walked four caminos in Lowa Boots. (I love these boots.) However, they do have gortex and I noticed during a very warm week on my camino last March that my feet got really sweaty. I think the heat is probably a contributing factor to your blister problem.
On my first camino I got blisters between my small toes just like you described. My small toes kind of overlap a bit and rub together - add sweat/friction and you get a blister. Here is the solution that has kept me blister free: 1) I use a product called "Glide". It is like a deodorant-type stick you rub all over your feet and between your toes (a lot less messy that Vaseline). It reduces friction. 2) I wear a liner sock. The one that has really worked in preventing the blisters between my toes are "Injinji" socks. They have five individual toes so they keep the toes from rubbing together. 3) I wear Smart Wool socks (light weight for summer). They absorb sweat. 4) If I feel a hot spot, I stop immediately to inspect my feet and put some mole skin on the affected area. This system has kept me blister free. I really recommend the five-toe Injinji socks for the problem you describe. A regular liner sock will not stop the rubbing between your toes. If you don't use the toe socks, then put mole skin or some other preventative barrier between your toes before you walk. You can find the products mentioned at both sporting goods or runners stores.

Thanks LauraK. I have Body Glide at home so I will start using it on my feet. Will also try the double socks technique. So far, I have worn only one pair of the Icebreaker Light hicking Merino socks.

 

[Hélène Cholette-Lacasse]

I didn't have any blisters until I hit the Meseta - the heat made my feet sweat and swell and the blisters came out in force. I was seriously ready to quit over it. My boots were very expensive and I didn't want to quit them. I bought a giant roll of mole skin (not a compeed fan) and cut it into blister sized pieces and covered all my problem areas every single day. It simply didn't help once we hit the Meseta. If you actually have a blister - run a needle and thread through it and leave the thread in it, ends hanging out. This will allow it to drain slowly and not damage the skin.
I was going to wear the same boots on my second Camino but found them in poor shape just before I went. I bought some Scarpas and though I had no time to break them in I thought they were FANTASTIC! I only walked for ten days but most of them were HOT days and with a lot of time on blacktop I expected problems. Didn't have one. Turns out I have very narrow feet so they fit perfectly.

I am not a Compeed fan either just because it hurts a lot when I put on a blister...

 

[domigee]

Merci. I am currently using NOK cream to thicken the skin. Will look into Vick's and Proshield plus. Have been using the Bandaid Advanced Healing Blister plasters for toes but still hurts and gets worse following hicking.

I was just about to advise using Nok cream, not sure it thickens the skin (?) but it's anti-chafing and works a treat.
Secondly, 2 pairs of socks work for me... (Thin liner sock plus smartwool sock)
Also at the first hint of soreness, BEFORE a blister appears, some lambs wool. I use the one I pick up from hedgerows but you can buy it as hikers' wool...

 

[ricitosdeplata]

Take a look at this website. It's a link on the one recommended by @Wokabaut_Meri and specifically for blisters between toes added to the already suggested application of moisturizers. See what is says about the importance of reapplying moisturizers or antifriction lotions .
http://www.blisterprevention.com.au/blister-blog/how-to-manage-interdigital-blisters

 

[Hélène Cholette-Lacasse]

Same thing really.

As soon as a hot spot develops, use the hikers wool. Then it won't turn into a blister.... Of course as long as you are following all the other guidelines as well re boots, socks etc! I think looking after your feet has to be 'all or nothing'. i.e. each part of the regime is important.

Helene:

I got blisters in between my small toes 3 times during training walks. I stoped my training for a few days to let them heal. I then used Vaseline inbetween my toes for a few days and nothing...no returning blisters. I found the Vaseline very messy but it worked. A fellow experienced Camino walker told me about Hikers Wool. She saw many New Zealanders using it during their Camino.

Currently I wrap Hikers Wool around each toe and I have not had 1 blister or hot spot appear. I also put it on once I feel a hot spot. It adheres to my merino woll socks which have also been GREAT for anti blister formation.

http://www.hikerswool.co.nz

Buen Camino

ok thanks!

Helene:

I got blisters in between my small toes 3 times during training walks. I stoped my training for a few days to let them heal. I then used Vaseline inbetween my toes for a few days and nothing...no returning blisters. I found the Vaseline very messy but it worked. A fellow experienced Camino walker told me about Hikers Wool. She saw many New Zealanders using it during their Camino.

Currently I wrap Hikers Wool around each toe and I have not had 1 blister or hot spot appear. I also put it on once I feel a hot spot. It adheres to my merino woll socks which have also been GREAT for anti blister formation.

http://www.hikerswool.co.nz

Buen Camino

Hey Dan, where did you buy the Hikers Wool?

 

[Hélène Cholette-Lacasse]

Take a look at this website. It's a link on the one recommended by @Wokabaut_Meri and specifically for blisters between toes added to the already suggested application of moisturizers. See what is says about the importance of reapplying moisturizers or antifriction lotions .
http://www.blisterprevention.com.au/blister-blog/how-to-manage-interdigital-blisters

OK thanks, wiil do...

 

[Hélène Cholette-Lacasse]

OK thanks, wiil do...

This is an excellent site!!

 

[Deleted member 3000]

For a local area such as between the toes, this stuff is great as a lubricant; light and easy to use:

http://www.2toms.com/products-page/sportshield/sportshield-roll-on/

I found it at a local running store.

 

[Lori D.]

I think I can offer advice, having had the most and largest blisters of all time from Pamplona to just past Leon.
1. do not hike 17 miles the first day in 90+ degree heat;
2. use vaseline
3. change socks often
4. when you first feel anything - stop and apply compeed or moleskin or something!
5. Maribell at Cizur Menor and all 3 of the doctors i visited (Santo Domingo, Burgos and Leon) drained the blisters, applied betadyne and covered with gauze;
6. Keep it clean!
7. Hike fewer kilometers until your blisters get better (you don't have to stop completely, just decrease distance for a while)

My problem was i did #1 and did not do ##2-3; as for #6, one got infected and i had to be on anitbiotics for 8 days, no walking for 3 days.

You can say all you want about breaking shoes in, etc., but my brother did nothing but #1 and had zero blisters! I had broken the shoes in, wore fancy socks and still got them.
In the end, it remains a mystery how to prevent the blisters - luckily, my Camino experience was awesome and i would do it again.

 

[Dan the Man]

I j

I think I can offer advice, having had the most and largest blisters of all time from Pamplona to just past Leon.
1. do not hike 17 miles the first day in 90+ degree heat;
2. use vaseline
3. change socks often
4. when you first feel anything - stop and apply compeed or moleskin or something!
5. Maribell at Cizur Menor and all 3 of the doctors i visited (Santo Domingo, Burgos and Leon) drained the blisters, applied betadyne and covered with gauze;
6. Keep it clean!
7. Hike fewer kilometers until your blisters get better (you don't have to stop completely, just decrease distance for a while)

My problem was i did #1 and did not do ##2-3; as for #6, one got infected and i had to be on anitbiotics for 8 days, no walking for 3 days.

You can say all you want about breaking shoes in, etc., but my brother did nothing but #1 and had zero blisters! I had broken the shoes in, wore fancy socks and still got them.
In the end, it remains a mystery how to prevent the blisters - luckily, my Camino experience was awesome and i would do it again.

I just finished SJPDP to Santiago with NOT ONE BLISTER. I went through 2 pairs of shoes and had no time to break them in.

Everyday I used Vaseline and Hikers Wool from New Zealand. I put a small bit between my toes ( where I tend to blister) and on any hot spots I felt.

I gave it those who were in need and met others who used the NO PROBLEMS!

 

[Lori D.]

Next time i will definitely try that. Thanks

 

[Carolethecatlover]

Foot Blister Prevention
VOLUME: 15 PUBLICATION DATE: Apr 01 2002
Issue Number: 4
Author(s): By Mark A. Caselli, DPM, and Jean Chen-Vitulli, DPM

Foot blisters are among the most common injuries for athletes. According to research from the Scholl, over 5.2 million people suffer blisters every year. In a study of lower extremity injuries that occurred at the New York City Marathon, the most common foot problems reported were acute shear and stress injuries resulting in blister formation. Aside from being painful, blisters can alter an athlete’s running form and lead to even more serious injuries of the leg and hip due to irregular gait biomechanics. Blisters result from frictional forces that mechanically separate epidermal cells at the level of the stratum spinosum. Hydrostatic pressure causes the area of the separation to fill with lymph-like fluid. The magnitude of the frictional forces and the number of times an object cycles across the skin determine the probability of blister development. The higher the frictional forces, the fewer cycles are necessary to produce a blister. Moist skin increases frictional forces, leading to blister formation, while very dry or very wet skin decreases frictional forces, preventing blisters.

Other risk factors for foot blister formation include ethnicity (African-Americans are at lower risk than others), flat feet and feet with structural prominences, such as bunions, hammertoes and Haglund’s deformity.

Tips About Shoes, Insoles And Socks You Can Pass On To Patients

In order to prevent blisters, we need to minimize friction. This begins with shoe selection. Emphasize to patients that their shoes should fit comfortably, with about a thumb’s width (3/8-inch to 1/2-inch) between the longest toe and the end of the shoe. Narrow shoes can cause blisters on the hallux and fifth toe. A shallow toe box can lead to blisters on the tops of the toes, while loose shoes often create blisters on the tips of the toes. Shoes should be sport specific. When trying on shoes, athletes should wear the same sock, insoles or orthotic inserts they wear when playing or working out. Encourage them to get shoes fitted in the afternoon or evening, since feet tend to swell during the day. Athletes should wear their shoes around the house for one to two hours to identify any areas of discomfort. It often helps to break in shoes by wearing them for one to two hours on the first day of sports activity and gradually increase use each day.

However, even if shoes fit well, the insoles (or sock liners) could cause problems if they have worn out or flattened down. Remind athletes to check the condition of the insoles periodically and replace them if necessary. A new OTC insole (such as those manufactured by Spenco Medical Corporation) can keep friction to a minimum. Also encourage runners to examine the inside of footwear for seams or rough areas that often correspond to the sites of blisters.

Emphasizing the proper socks also can decrease friction and prevent blister formation. Socks made from synthetic blends are best. Socks made from polypropylene or other new synthetic materials can wick moisture away from the skin more effectively than wool or cotton, further decreasing the likelihood of blisters. Layering socks or special double-layered socks can further minimize shearing forces. If your athletes wear socks with large toe seams, tell them that wearing the socks inside out can help prevent blisters on the tops of their toes. It is also a good idea for athletes to carry an extra pair of socks to change into if their socks become too damp.

A Review Of Helpful Lubricants And Drying Agents

When athletes have areas of the feet that are prone to blistering, applying lubricants (like petroleum jelly, bag balm or even dry soap flakes) before they put on socks helps reduce friction. Athletes should reapply large amounts of petroleum jelly every 10 miles during long walks or running events. Instead of petroleum jelly, some athletes prefer applying non-petroleum anti-chafing lubricants, such as BodyGlide (W. Sternoff, LLC) or Runner’s Lube (Mueller Sports Medicine, Inc.), prior to a long distance walk to prevent blisters. These products are waterproof, perspiration-proof, non-greasy, and wash off with soap and water. It’s better than petroleum jelly since it doesn’t create heat when friction occurs. It is also a good barrier for water in case it rains during the event. Minimizing moisture on the feet by using drying agents is another way to reduce blister formation. In a double-blind study conducted at the U.S. Military Academy, cadets who used the prescription antiperspirant Drysol (Person & Covey, Inc.) for at least three nights before a 21km hike had a 21 percent incidence of foot blisters, as compared to 48 percent for the placebo group.

Drying foot powders, such as Zeasorb (Stiefel Laboratories, Inc.), and antiperspirant sprays (that contain aluminum chlorhydrate or aluminum chloride) are inexpensive ways to decrease moisture. Other Preventive Approaches Toughening the skin is another method of avoiding blister formation. Conditioning the skin by gradually increasing activity tends to lead to the formation of protective calluses rather than blisters. Applying multiple coats of tincture of benzoin to sensitive areas or soaking feet in strongly brewed tea (tannic acid) are commonly used skin toughening procedures. Protecting or “shielding” areas of the foot with a high potential for blister formation is an excellent preventive approach. Some of these susceptible areas include bony prominences such as: The dorsum of hammertoes; medial prominence areas of bunions and tailor’s bunions; the posterior heel; and the middle of the arch, especially when the athlete is using orthoses.

Products such as Band-Aid Blister Block (Johnson & Johnson, Skillman, N.J.) and Dr. Scholl’s Cushion Blister Treatment (Schering-Plough Healthcare Products) are self-adhesive, silicone-like pads that act as an extra layer of skin to absorb friction. They are available in various sizes. If athletes apply them properly, these pads can stay on the skin for several days, even through showers. Cut slightly larger than areas of intense friction or sensitive skin, moleskin provides another inexpensive method of preventing blister formation. Liquid adhesives, such as Mastisol (Ferndale Laboratories, Inc.), promote adherence of moleskin to the foot. Alternatives to moleskin are the “liquid” bandages such as New Skin (Medtech Laboratories, Inc.), which dries to form a tough protective covering on the skin.

Athletes may also consider using lambswool, commonly used by dancers, between the toes in order to prevent and/or soothe blisters.

Pertinent Treatment Tips

Since it’s not always possible to prevent blisters, it is important to relieve pain, prevent enlargement or infection, and promote a speedy recovery when they do occur. Small, intact blisters that don’t cause discomfort usually don’t need treatment. The best protection against infection is a blister’s own skin or roof. To protect the roof, you can cover this type of blister with a small adhesive bandage or blister guard. However, you should drain larger or painful blisters that are intact without removing the roof. Proceed to apply an antibiotic ointment and cover it with a bandage. Remind runners to change their dressings daily. If you’re dealing with blisters that have large tears, you should “unroof” them and cleanse the base thoroughly with soap and water or an antibacterial cleanser. Then cover it with an antibiotic ointment and bandage. Additional padding may be necessary for continuing sports activity. Ring-shaped pads made of felt will protect small blisters. Larger blisters may require dressings such as DuoDerm (ConvaTec), Spenco 2nd Skin (Spenco Medical Corporation), Vigilon (CR Bard, Inc.), or Opsite (Smith & Nephew United). Doughnut-shaped paddings may be used in conjunction with these dressings.

Prevalence and risk factors associated with the formation of dermal lesions on the foot during hiking.
Chicharro-Luna E et al
J Tissue Viability. 2020 Apr 27

BACKGROUND:
The aim of this study is to assess the prevalence of blisters on the foot during hiking and the factors associated with this condition.

MATERIAL AND METHODS:
A cross-sectional observational comparative study was conducted of 315 patients treated at two hostels, located on the Way of Saint James, in northern Spain. The study participants were interviewed and clinically examined to obtain sociodemographic and clinical variables. The variables recorded concerned the type of terrain covered (asphalt or dirt trails), the weight carried (backpack), the footwear used (weight, type, impermeability), the type of socks worn and the hydration of the skin obtained. The inclusion criteria were at least 18 years and to walk at least 20 km in the last five days.

RESULTS:
74% (n = 233) of the hikers presented a bullous lesion on the foot after completing several stages of hiking. The most frequent locations were the first or second metatarsal head and the fifth toe. Logistic regression showed that risk factors for the appearance of blistering were the number of kilometres walked on asphalt (p = .001 [95% CI (1.019-1.064)]) and having wet socks at the end of the day (p = . 006 [95% CI (1.286-4.479)]). The protective factors identified were walking on a dirt, grass or gravel surface (p < .001 [95% CI (0.982- 0.995)]) and using customised plantar orthoses (p = .001 [95% CI (0.085) - 0.512)]).

CONCLUSIONS:
The type of terrain is a determining factor in the appearance of blisters. Walking on a dirt trail reduces the risk. Using custom made insoles and controlling humidity are other factors that should be considered as preventive measures.