Heat. Moisture. Friction.
Sounds like an accurate description inside your boots after a few miles on the trail, right?
It also describes the triad of conditions leading to a blister.
To understand the impact of this triad on your skin, visualize one of those thin plastic bags, hanging on a roll in the produce section of your favorite grocery store.
What do you usually have to do to get one open? Vigorously rub one layer against the other (friction and heat), and lick your finger (moisture) to separate the layers.
Congratulations! You’ve demonstrated the triad.
Now transfer that knowledge to your hot, swollen, sweaty feet encased in soggy, dirt encrusted socks, entombed within your snug boots.
- Warm, damp socks rub the top layers of cells on your feet, while grimy boot linings drag against the socks. (Extra heat and friction due to trail detritus like stones and pine needles, optional.)
- Over time, the blister triad succeeds in separating the top layers of your skin (epidermis) from the underlying dermis. A new space is formed.
- Clear fluid from epidermal cells, and/or dark red fluid from blood vessels in the dermis (“blood blister”), begins to leak into the space.
- The epidermis is forced into a dome shape to accommodate the fluid.
- Jangled nerve endings in the dermis fire off messages to the brain.
And that’s when you have to decide which camp you’re in.
The “Pop A Blister” Camp
You’re a popper if you’re thinking:
1. “This hurts!” You can relieve some of the pressure, and thus pain, by allowing the fluid to drain out.
2. “It’s big.” You don’t have enough moleskin (which relieves friction and pressure if properly applied) to bail you out of this one.
3. “I need to keep going.” If none of the variables in the triad are changed, the blister will enlarge. If you don’t have extra socks, a layover day, or a change of footwear, pop it and keep it covered so you can reach your objective.
4. “I’m in charge!” When you decide to pop a blister under controlled conditions, you can keep it clean and save the top flap of epidermal skin to use as a protective “lid” over the tender dermis.
5. “It’s leaking.” Once a blister starts to leak fluid, little nasties like bacteria and dirt can enter your bloodstream. Time to drain it completely and clean it.
The “Don’t Pop” Camp
You fall into the non-popper camp with these statements:
1. “I don’t want to make it worse.” You can try to keep the blistered skin intact to protect the dermis until you can stop hiking (see #4 & #5 above).
2. “It’s tender but not excruciating (yet).” Popping a blister does not always relieve pain. In fact, open raw skin is exquisitely sensitive to pressure inside your boot.
3. “I don’t have the right stuff.” No soap, alcohol wipes, sharp pointy objects, bandages, antibiotic ointment, or tape in your pack? No blister popping for you!
4. “I’m diabetic or take immune suppression medication.” Leave it alone and check it often. If the blister pops, treat it aggressively to head off the risk of infection. There’s no such thing as a trivial blister for a diabetic.
5. “Yuck!” Maybe you’re hiking solo AND you’re squeamish about stabbing yourself in a painful spot with a sharp object. Or could it be that you aren’t enthused about handing over a sharp object to your trail buddy?
Ignoring Blisters: Not An Option
If the pain of a blister doesn’t get your attention, the risk of infection and the oozy, bloody socks might force you into one camp or the other.
Before a sharp pointy object is deployed:
- Size up the depth of the blister(s).
- Factor in your pain threshold and risk tolerance.
- Decide whether or not your hiking plans can be modified to allow a speedy epidermis/dermis reunion.
- Calculate your patience for hobbling.
Then pop. Or not.