Blister Treatment or Prevention?

June 3, 2013 by
Filed under: blister care, Foot Care, Footwear, Health, Sports, toenails 

Which is more important, blister prevention or blister treatment?

For more than 17 years, I’ve taught foot care techniques to anyone who will listen. I have taught classes at running stores, REI stores, events, and more. In addition, I have worked medical at many races, helping provide foot care to participants. These races have been in Death Valley, Chile, Costa Rica, BC Canada, Colorado and Washington, and many in California. This year I will be at Western States 100, Badwater, the Gold Rush Adventure Race, the Jungle Marathon in the Amazon, and hopefully at races in Colorado and Namibia.

I have never counted the feet I have worked on but I would put the number well over 3000. I remember one race in Colorado in 2010 when I saw the same lady 10 times. It was a six-day stage race and she’d come in every evening and morning! I’d patch her feet in the evening and she’d take it off when she went to bed in her tent. She had foot wear issues that gave her blisters on top of blisters. She was never into prevention mode – only treatments.

In this picture, taken from the cover of the 5th edition of Fixing Your Feet, we see treatment taking place. I love the picture. I even know whose foot it is. What I can’t tell you is what he did for prevention. I wish I knew.

FYF Cover Image

FYF Cover Image

My question in this blog post is what should we spend more time on, blister prevention or blister treatment?

Prevention can take many forms: good choices in footwear, the right socks, lubricants and powders, toenail care, skin care, taping, Engo patches, correct lacing, the right insoles, and training and conditioning.

Treatments likewise offers many options: blister draining, many different types of patches, taping, ointments and salves, a multitude of tapes, wraps and straps, silicone pads, Engo patches, toe caps, and lubricants and powders.

So here are a few questions:

  • Does prevention last only until the race starts?
  • What are your best prevention options?
  • How much do you count on aid station personnel to manage treatments?
  • Do you know how to treat your feet?
  • Do you carry materials to treat your feet?
  • What are your best treatment options?
  • How well do you understand blister formation and prevention?

For 17 years, athletes have had Fixing Your Feet as a resource to learn important information about foot care. As I patch feet at races, I try to educate the athletes about what I am doing and why, and what could have helped in their feet. If crews come to me for advice, I try to help them too. I have watched athletes and crews work on feet with materials and using techniques I have long preached.

In general, foot care has advanced over the years. Shoes, socks and insoles have become light years better. Lubricants, powders, blister patches, and our tools are better. People interested in foot care are trying new blister patching techniques.

All this is good because every day there are new athletes coming into running, adventure racing, hiking and thru-hiking, walking, and other feet stressing sports. Let’s make sure they understand the importance of prevention before treatment.

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6 Comments on Blister Treatment or Prevention?

  1. Lisa de Speville on Mon, 3rd Jun 2013 2:59 pm
  2. Prevention, prevention, prevention. I hate getting blisters and I’ve been very fortunate over the past eight years or so to have had really good feet. Definitely part excellent foot care year round (file away hard skin, trim and file toenails, toughen skin if required etc) and good sock and shoe combo (that works for me) and also many, many hours spent on my feet over the years which have made them tough and strong.

    I don’t see the point of developing blisters and having sore feet for the rest of the race when you can put in the effort to not even get them in the first place – or to minimise the severity if they do arise.

  3. Daniel on Wed, 5th Jun 2013 8:57 am
  4. I believe prevention is more important. I am new longer endurance events, I just did my first marathon and Ultra (50K). I developed a painful blister on my left foot at about mile 20. It made the rest of the day miserabele.

  5. Daniel on Wed, 5th Jun 2013 8:58 am
  6. Lisa,
    How do you “file away hard skin” I cant not stand the sound or feeling of a nail on a file. Any reccomendations?

  7. johnvonhof on Wed, 5th Jun 2013 9:54 am
  8. Most drug stores sell callus files, but many shred the skin. I prefer a product I reviewed a while back – Silk Feet. Type “Silk Feet” into the search box at the top right of this blog and you’ll find the post. Here’s the link too:

  9. johnvonhof on Wed, 5th Jun 2013 9:59 am
  10. Here’s some comments received from Joe Lugiano:

    Does prevention last only until the race starts?

    Definitely not. You have to be aware of hot spots starting so that you can treat them as quickly as possible before they become more of a problem. And of course after the race you have to be sure to properly take care of any problems until healing is complete.

    What are your best prevention options?

    This obviously has all the answers you’ve talked about over and over. Here’s what I do:
    1. Be sure that my toenails are trimmed neatly about 2 to 3 days before a race or long run.
    2. I rub Body Glide all over the bottom, sides and tops of my feet.
    3. I use Wigwam Ironman Triathlon socks.
    4. I wear shoes that are generally a 1/2 size bigger or change to them part way through a 100 miler
    5. Unless I sense a problem with my feet, I generally do not change socks or shoes during a 100 miler / 24 hour run.

    What are your best treatment options?

    For a blister, I’ll generally pierce the blister to drain it and cover it with an antiseptic and pad.

    How well do you understand blister formation and prevention?

    Well enough to do everything I can to prevent them from happening. I’ve been running for 34 years and have covered over 90,000 miles. Have raced distances from 1/4 mile to 100 miles. I had more problems in my early years before the introduction of better socks, lubricants and shoe innersoles. Since, I’ve been able to run the long distances pretty blister free.

  11. John on Sun, 8th Feb 2015 3:22 pm
  12. If you are talking about callus, most drug stores or stores with foot care sections sell callus files. You can also use a pumice stone. offered many options too. As far as the sound or feeling, sorry, but you have to do what it takes to reduce the callus. The same thing applies to filing toe nails.

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