Arlington Foot & Ankle Center

Ben Pearl, D.P.M., F.A.C.F.A.S.

N.I.H. Consultant

Blister Prevention And Care for Runners and Hikers

Blisters caused by running and hiking are among the most common injuries at any finish line or trailhead.  The resulting cascade of problems can result not only from the blisters themselves but also from the changes in gait that may occur as a result of compensating to take pressure off the blisters.

The first factor in developing a blister is the failure to have proper protection from shearing forces in the shoe.  This can occur from not having enough room in the toe box.

It is important to have about a thumb’s width between the end of the shoe and the longest toe.  The shoes should be high enough so they do not rub on the tops of the toes and not too narrow so they do not put excess pressure on the first and fifth toes.  The wear on the shoe tread and insoles can contribute to blister formation when there is not enough shock absorption left.  There are various gel insoles that offer additional cushioning such as spenco insoles.  Dry-z insoles provide cushioning and help to wick away moisture from your feet. Shoes that are constructed of breathable fabrics like nylon or gortex tend to help with transfer of moisture away from the skin.

 Socks are another element that can contribute to blisters. I do not recommend cotton socks to my patients that tend to develop blisters. Cotton tends to retain water.  Polypropylene and gortex blends are more effective at wicking away moisture.  Another tip is to bring an extra pair of socks on a hike or long run to change into if it rains or if your socks become soaked with perspiration.

 Lubricant on your feet is another smart preventative measure.  There is the old standby petroleum jelly and the more expensive Bodyglide or Runner’s Lube for a less greasy feel Lanolin is another substance which may be rubbed into the fee several days before an event which does not create heat with friction like petroleum jelly.

 There are prescription products that help keep the foot more dry such as drysol or xerac-ac that can be helpful. Antiperspirants that contain aluminum chloride or aluminum chlorhydrate are other options. 

 Once a blister has formed it is best to lance it with a sterile needle only if it biomes painful or is fairly large.  The blister may need to be lanced more than once if there are several pockets of fluid.   The blister then can be treated with an antiseptic or antibiotic ointment and a bandage.  If you are headed back to the trail immediately Second Skin or a host of other blister pads may be used.  I am not a big fan of mole skin as it has a tendency to slide off but it is inexpensive and some people swear by it.  If you are a diabetic or immunocompromised I would not suggest the self-treatment modes.  If the blister becomes infected that is another instance to seek professional help.   

Copyright 2001, Dr. Pearl. All rights reserved.