Most people get them. Some don’t. It’s not a function of who you are or what socks you wear (if only it’d be, that’d be so much easier) but a combination of many stresses and effects on the most used tool on the Camino: your feet.
It gets a “little” anatomy-histology-science-y now, don’t be scared. It’s easy.
Blisters are, what happens when your epidermis detaches from your dermis. That’s the first two layers of skin that protect your body. The epidermis has no blood vessels and is essentially the wrapper around you. Underneath this lies the dermis, a few layers of skin that do all the work: grow hairs, produce sweat, host most nerve endings (some extend into the epidermis), and more. Here you’ll also find blood vessels.
If you put enough pressure onto the epidermis and exact a “shear” force on it, it may dislodge from the dermis. A cavity builds, that is (to protect) flooded with fluids. A blister happens.
There is a second kind of injury, often lumped in with blisters, and that’s friction against the skin that rubs off the epidermis. If it bleeds, the dermis is also impacted.
Remember the “hypodermic needle” – it’s called that, because it usually ends in the “hypodermis,” which is not truly part of the skin but below it. It anchors our skin to the muscles and organs underneat it.
So, how do blisters happen?
The first, and most obvious, cause of blisters is pressure against your skin. Ill-fitting shoes are one cause, but also the simple act of walking a whole day and your sock continuously rubbing somewhere might cause one. Most of those injuries are friction injuries, though, in which no real “blister” builds, but the epidermis is rubbed away.
Other, less obvious, reasons are softened feet. This could be caused by moisture, but could also happen if your diet changes considerably. Your skin’s ability to anchor to itself is based on collagen. Collagen is to your body what wheat is to good bread: it’s the main ingredient. Everything inside you needs it. Collagen is built by your body from three main amino acids: lysine, proline, and glycine. These ingredients must be ingested. Your body also needs Vitamin C to convert them, as well as zinc and copper. You can get those by eating citrus fruits, fish, nuts, seeds, beans, and whole grains. The strain of the Camino is definitely upping your intake requirements here.
As you get older, you produce less and less collagen. This is, what makes skin wrinkly and thin. If you’re past 40, you should definitely watch and add more of the above foods to your diet on the Camino.
Avoid moisture damage, by switching out socks when your feet are very wet. Also shower in the evenings (seriously, do this anyway, it’s annoying as all hell if you stink up the dorm rooms).
What can I do, to prevent them?
Start listening to your feet. No, not in the esoteric-spiritual way but by not ignoring pains. If your shoes are tight, change them or try to remove the offending part with a fine file and clippers. Also make sure you only put the recommended weight on them: your weight + 10% of your body weight in backpacks. Do not forget, as well, that a pound on your feet equals five on your back, so get light shoes.
As mentioned before, shower in the evenings.
Wear double layer socks like Wrightsocks. The two layers will rub against each other instead of one layer rubbing against you.
And if I got them?
This is where it gets iffy. The Camino is full of home remedy recommendations and gut feeling treatments. Many will just make it worse. And please remember: the plural of anecdote is not data – just because it worked for Jane from Spain doesn’t mean it works for Marc from Morocco.
One of the most gruesome suggestions I’ve heard was to “leave the thread in” (pull a thread through the blister and leave it in “to prevent infections”), which is not just useless, it also pulls a rather contaminated and dirty item, the thread, into an open wound. Another one is to soak it in water and “let it pop by itself.”
The best solution for blisters (we get to open wounds in a second) is to simply use a needle (see my First Aid Kit), sterilize it over a flame, wipe it down with an alcoholic wipe or spray it with disinfectant, do the same to the blister and surrounding area (disinfectant, not flame), then poke it once at the base of the blister closest to the heel.
Leave it to drain by itself, then just walk. In some, rare, cases the blister will dislodge instead of simply allowing new keratinized skin to be produced underneath it, then see “open wound” below.
If you have an open wound, from a ripped off blister or from friction, do not do much else. Disinfect with spray and, in the evenings and overnight, cover it with a band aid. During the day’s walk, you have to make a decision. If the wound was caused by tight friction adding a band aid would be not so cool: it adds even more pressure. So take away the friction or put a very , very, thin cover over the wound. This is, by the way, why I do not recommend blister patches: they’re thick. Whatever caused the blister or wound by being too close, now comes even closer.
You can use a wound ointment like Bepanthen salve (Dexpanthenol) and always use a mild wound disinfectant.
The beat way to treat blisters is to avoid them. Wear light, pre-worn, shoes. Don’t shower before walking. Avoid wet feet (that also means sweat). Wear double layer socks. Eat well.
If you get them, don’t overdo it. Drain the liquid with one(!) poke, don’t peel off the “flap”, and do it after walking (and showering) so it has a chance to heal. A band aid is all you need, blister patches have a nasty habit of adding girth you don’t want and to soften the skin underneath them even more, making you dependent upon them.
Have an amazing Camino, blister free I hope!