Blisters start as a “hot spot”-an area that becomes irritated and that literally feels hot. If at all possible, you should intervene at this point. A hot spot WILL become a blister if you just keep doing what you’ve been doing.
After the hot spot stage, the outer layer of skin separates from the underlying layers. At this point it’s an early-stage blister and has become a proper injury that needs remedial treatment.
Beyond this stage, the blister will fill with pus, taking on 3 dimensions and becoming more painful and even more susceptible to rubbing. Without intervention, the blister will rupture and become vulnerable to infection.
Please, intervene well before it comes to this. But how?
- Finding a pair of shoes that fits better.
These remedies might help with abrasion blisters as well.
Ok, so you didn’t stop when you felt that hot spot-you decided to tough it out, and now you have a blister. What to do?
Many of the treatments are similar to the treatments for a hot spot, but there’s the added problem of this 3-dimensional bubble of painful, rupture-prone skin. If you’re in the middle of a run, you may have little recourse besides loosening your shoe and limping home. But if you have any first aid supplies, or your blister is from yesterday and you’d like to run today, we have some advice.
1. Decide if a rupture is unpreventable. Ideally, you should keep a blister intact, because nothing is better at keeping germs out and moisture in than your own skin. But if the blister is in a place where the pressure is high and you know it’s going to blow, then it’s better to do it deliberately under sanitary conditions than to let happen randomly in a sweaty sock. Clean the area with alcohol, and then, using a sterile needle or knife point, puncture the blister. Drain the pus. Treat with antiseptic or antibiotic, and put a thin bandage over the area.
As an alternative to a regular bandage, there are gel-filled products that help keep blistered skin moist and cool.
2. Protect the area from pressure with a “donut.” This is especially important if you’ve chosen to leave the blister intact. Cut a circle of moleskin (an adhesive-backed, felt-like material made by many manufacturers) that’s big enough to extend a half inch beyond the blister on all sides. Cut a hole in the middle that can accommodate the blister. Stick the donut to the skin surrounding the blister.
3. If the area will receive a great deal of rubbing, or if you need the repair to last for a very long run, there are some ways to reinforce it. First, apply compound tincture of benzoin to the area where you need adhesives to stick. This makes the skin tackier, and helps tapes and bandages stick more reliably. It may also toughen the skin slightly. Second, try covering the entire dressing with protective tape. Choose a tape that’s durable and non-irritating, like waterproof kinesiology tapes.
Of course, in a perfect world, you’ll want to avoid hot spots in the first place. To learn how to do this, we visited the very imperfect world of ultra-runners.
When you spend time with ultra-runners, on- or offline, you may notice that the conversation always turns to feet: how to prep, clean, nurture, swaddle, dry, lubricate, disinfect, bandage, and outfit them for battle. Feet develop myriad problems when pounded against the ground hundreds of thousands of times a day, with blisters high on the list. Which naturally makes the ultra-running community is fount of knowledge on the topic.
A key discovery made by ultra-runners (and the medics who keep them upright) is that skin is most vulnerable when damp. Dry skin is nice and slippery. So is wet skin. But in that damp middle ground, skin is both weak and very tacky.
This is why most ultra-runners, after finding a great fitting pair of shoes, turn their attention to keeping their feet dry. Here are some of their techniques:
- Well-ventilated shoes. This means lots of mesh. When worse comes to worse, some runners grab scissors and turn their shoes into sandals.
- Excellent socks, made from breathable synthetic yarns that efficiently wick moisture off the skin.
- Antiperspirants. Typically in stick form, slathered all over the feet and allowed to dry.
- Powders, like corn starch. These are controversial. Some runners swear by them. Some research shows that they can make matters worse.
- Changes of socks to bring on the road.
A small number of runners sweat so much that these techniques are powerless to keep their feet dry. This problem will of course be exacerbated by hot, humid conditions. These runners often take the opposite approach; instead of keeping their feet dry, they try to keep them soaking wet. To this end they use various concoctions of lotions, gels, and specialized lubricants.
The various methods of keeping your feet wet and lubricated are beyond the scope of this article. Just know that it’s a possibility, if you’ve been blessed with especially generous sweat glands.
Good luck! We wish you many miles of happy, blister-free running. And in the event that a hot spot starts complaining from under your socks, we hope you’ll take care of it right away-and that you’ll find these tips helpful.