Tim Cain is a leadership and management expert, and teaches First Aid courses to those who work in, or visit the hills and mountains. We asked Tim, of Tim Cain Leadership, a question that proved popular among our readers with regards to first aid when out and about.
Blisters are common in adventure activities, despite being relatively minor they can be really painful, preventing you from achieving your aims or just making the otherwise enjoyable experience miserable. It is possible to take preventative action to reduce the impact and likelihood of blisters forming, but in reality, you should be prepared to deal with them effectively.
Commonly blisters form where friction against the skin causes ‘hot spots’, either from poorly fitting footwear, or problems with your socks. The skin’s natural defences send serum to act as padding under the skin at the hot spot, thus forming a blister. The padding protects the tissue beneath from further damage. Sadly, however, additional padding at a point that is already under pressure tends to make the process pretty painful.
General advice is not to burst blisters, due to the risk of infection, but on the hill, the ability to continue often means that you have to take action to reduce the pressure in order to continue on to safety. Therefore, to treat a blister you can break the skin on the edge of the blister, usually in two places, ideally with a sterilised needle (hold the needle in a flame). This allows the serum to escape. Take care to protect the skin over the hot spot, as this in turn protects the tissue beneath. Cover the blister with a single layer of zinc oxide tape so that the whole area is protected and smooth. Ensure that your feet are dry and well powdered. Replace socks by swapping them over so that the worn area that was over the hot spot is now on the other foot, or put on a spare pair.
If the skin is worn away, you should consider the use of a hydrocolloid plaster. These plasters are designed to react with the serum to form an artificial blister (padding). The down side is that they tend to swell up and like the blister they replace, they may cause pressure and pain. An alternative is a standard plaster, covered again by zinc oxide tape. Where you do have broken skin it is helpful to wash the open wound with saline from your first aid kit before drying it with a clean swab and applying a dressing. In all cases, keep checking the wound for signs of infection and if you observe inflammation or yellow or green pus seek professional help immediately.
It is always good practice to prevent blisters by making sure your footwear fits, and your socks are in good repair, keeping seams away from pressure points. Keep your feet clean, dry and powdered while you are out, carrying spare socks in case your feet get wet (I carry waterproof socks just in case my boots get saturated). If necessary, put a single layer of zinc oxide tape on hotspots as they develop, before they become blisters or even before you start, if you know that you are prone to hotspots in certain parts of your feet.