The Prevention & Treatment of Friction Blisters

​​Friction and pressure combine to create shear forces that stretch and irritate connective tissue within the epidermis initially creating a “hot spot.” Later, as the epidermis tears and plasma leaks into the torn tissue, a blister will form. As long as shear forces are present, the skin continues to delaminate and the blister grows until it breaks. More pressure—due to a heavy pack or persistent hiking downhill—will cause deeper damage and a more painful blister. Both the prevention & treatment of friction blisters require adding an external “sliding layer” to prevent shear forces from building within the skin.

​Friction Blister Prevention

• Wash skin, socks, etc. on a regular basis. Wear gaiters over boot tops and laces to keep dust & dirt out. Keep skin, socks, gloves, etc. dry. Change socks regularly. Sleep in clean, dry socks. An antiperspirant may help keep feet dry.
• Increase pack weight and distance slowly to allow the skin to adapt to new forces. Avoid continuous downhill hiking until skin has had time to strengthen.
• Make sure footwear, gloves, and clothing fit well.
• Anticipate blisters; treat hot spots immediately BEFORE they become blisters by adding an external sliding layer to reduce shear forces within the skin. Use tincture of benzoin and flexible medical tape to create a sliding layer between the skin and the inner sock. Add a friction patch (ENGO®) to footwear to create a sliding layer between the outer sock and footwear. [The use of Duct Tape® or Gorilla Tape® is not recommended to prevent or treat hot spots: the glue is very strong and often increases friction within the skin layers rather than reducing it.]

Friction Blister Treatment

• Using surgical scissors, remove skin lid over blister to prevent it from enlarging due to continued pressure from footwear. [Moleskin® or Molefoam® is not recommended to treat blisters; at best, their use may delay blister growth but will not prevent it.]
• Cover the exposed blister with a hydrogel or foam dressing to promote healing and decrease pain.
• Secure in place with flexible medical tape. Paint tincture of benzoin on the skin around the wound to increase adhesion and protect the skin. Benzoin is alcohol-based; avoid getting on the exposed blister.
• Add an ENGO® blister patch to footwear or socks to reduce friction and its accompanying shear forces. ​

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