Consequences of Maceration

July 7, 2016 by
Filed under: blister care, Foot Care, Foot Care Products, Footcare, Health, Sports 
Macerated feet at the finish line of Western States

Macerated feet at the finish line of Western States

At Western States we saw a lot of negative results from wet feet. Even though we tried to spread the word, many runners did not protect their feet. Runners had poured water over their heads, which went into their shoes, and they sat in streams. Runners were complaining of blisters on the feet, mainly the balls of the feet but it was maceration. In reality, almost everyone had one or more skin folds common to their feet being wet for long periods of time. These might be in the center of the mid-foot or at the ball of the foot near the toes. Some did fine by warming their feet, applying powder, changing socks and shoe when possible, and maybe sitting a bit – and continued on and ran well. Others did not stop at aid stations or get crew help, and ran on with wet feet. Then they reach a pain point at which they cannot continue, or they reach the finish line – and they want help with their feet.

There is no quick fix to maceration. The more severe it is, the longer it takes to return to normal. Maceration can be painful – and yes, feel like one’s feet are burning. The skin is so soft and tender that every step is painful. Many times the skin has folded over on itself or has lifted to form deep creases, which can split open. I have seen maceration go through several stages:

  1. First, the skin begins to soften and becomes tender.
  2. Second, the pruning starts as the exposure continues. The skin wrinkles and softens even more.
  3. The third stage is when the skin can form creases and folds over onto itself. The creases may be shallow or deep, but are painful.
  4. The fourth stage is the most severe. The folds split open and/or the skin may tear.

If there are blisters, they must be drained and covered with a waterproof dressing to help keep tissue swelling under control. Tissue swelling leads to cold and damp skin, swollen and difficult to patch.

There are ways to deal with maceration, but it’s even more important to take steps upfront to prevent it. For instance, change into dry shoes and socks whenever possible, change socks as often as possible. When getting crew aid or at aid stations, remove your shoes and socks to allow your feet to dry, sprinkle with powder and rub it in, warm your feet with light massage, let them see some sunshine, and use one of the moisture control agents.

For moisture control, RunGoo from Foot Kinetics is one of the best. Its thick white paste works wonders on the skin and helps keep moisture at bay and it last a long time. has created a great product that works. Other excellent products include Trail Toes, ChafeX. SportsSlick, and Desitin Maximum Strength Original Paste. One thing to look for in these products is how long they last and do they come small packages or could they be packaged small enough to be carried in a hydration pack. My preference for applying any of these is to use them liberally. Then bunch your socks and roll them over your feet. Avoid just pulling your socks on, which can thin the product around your toes and forefoot.

Applying a coating of Hipoglos

Applying a coating of Hipoglos

Having severely macerated feet is not a badge of courage. It’s a sign that you could have made better earlier choices in foot care. Some of the worst feet I have seen have been because of severe maceration.

For 20% off your purchase of RunGoo from Foot Kinetics, use the coupon code “tfk20john.” I’m even using it as a chamois cream when road bike riding. It does last.

In a future post, I’ll talk about treating feet and maceration at a race finish line.

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9 Comments on Consequences of Maceration

  1. Jakob Herrmann on Thu, 7th Jul 2016 11:40 pm
  2. I’ve been using RunGoo for a while now and I love that stuff. It really helps me to keep my feet in good shape while running ultra marathons. I think every runner out there should get one and see if it works for him/her. (NFI in RunGoo)

  3. Farber@FootPainRelief on Fri, 8th Jul 2016 1:06 pm
  4. It’s not only the athletes and the runners who I know experience maceration. The military people who never took off their boots if they are assigned in remote areas too are experiencing this. And it is not because they do not care for their foot but because their resources are limited. Thank you for your post! More power!

  5. Concequences of maceration – AR Gaiters on Wed, 13th Jul 2016 3:43 am
  6. […] John’s full post ‘Consequences of Maceration‘ on his ‘Fixing Your Feet’ […]

  7. Bruce on Tue, 26th Jul 2016 3:59 am
  8. Two years in a row, around the 50 mile point, my brother in law has faced the feet going south exactly like this. In both cases, the foot station has cut off the macerated blisters, powdered, and covered with moleskin patches to send him back out… NOT a helpful fix!
    He’s always used rungoo liberally, rolled the socks, changed the socks, reapplied… Same results…

  9. Sandy Coutu on Mon, 6th Mar 2017 9:51 am
  10. Hi John. I have tried hipoglos on maceration but could not see much result. Are there any other products you could recommend? BTW as I have been seating in my office chair brwosing through a number of posts on mcaration yours is definitely the most detailed.

  11. John on Fri, 10th Mar 2017 10:34 pm
  12. There are several products. RunGoo is good (also called FootGoo. Maximun Strength Desitin Ointment is excellent and cheaper than most products. There’s a large section in the 6th edition on maceration if you haven’t seen it.

  13. John on Fri, 10th Mar 2017 10:43 pm
  14. For Bruce – He could try Maximum Strength Desitin Ointment. Another option I’d suggest is checking out ArmaSkin socks. These are from Australia and have helped many people over long runs and events. You can order them through the company’s website and even Amazon. Form fitting over your feet, and cover with a good sock.

  15. Hank Ketsbaia on Wed, 15th Mar 2017 1:40 pm
  16. Hi John. I tried FootGoo and it has helped a lot. I know this may not be up in your alley but wonder if you have any tips on fixing posture with braces. Do they work?

  17. Nick on Fri, 19th May 2017 9:29 am
  18. Thats hell of a consequences

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