Preventing blisters is all about building a blister plan and putting it into action.
In its most successful form, you'll avoid any hint of a blister.
However, if you're a bit lax on blister prevention, or if something unexpected happens, there's one last chance you have to prevent a blister from developing. It's called a hot-spot!
What is a hot-spot?
A hot-spot is a pre-blister state. It’s a warning that your skin is stretching too much and it’s starting to fatigue.
IT’S SUBTLE. It feels warm, like something’s rubbing, and it looks a bit red.
AND IT’S BRIEF. How long does it last? Well might not last 5 minutes. It might not even last 1 minute.
If you feel a sting, you’re too late – that’s the tear under the skin surface that kick-starts blister formation. Within two hours of that stinging sensation, you’ll have a blister.
Your tiny window of opportunity
The hot-spot stage is a brief window of opportunity for blister prevention.
Take it. Don't ignore it.
Be thankful you've received it.
A hot-spot is a pre-blister state
A hot-spot is a brief sensory warning that a blister is on its way. This is what Joseph Knapik and his colleagues (1995) have to say about how blisters develop and the entity of the hot-spot.
"Studies using (rubbing) techniques have demonstrated a predictable series of events that lead to blister formation. First there is a slight exfoliation of the stratum corneum and a reddened region (erythroderma) forms in and around the zone of the rubbing. The area encompassed by the erytheroderma is referred to as a 'hot-spot', presumably because the study participant experiences an increased sensation of heat. With continued rubbing of the area, the participant may suddenly experience a stinging or burning sensation with a pale, narrow area forming around the reddened region. This pale area enlarges inward to occupy the entire zone where the rubbing is applied. The area becomes elevated over the underlying skin as it fills with fluid."
There are two things you need to do to stop a hot-spot from becoming a blister:
You won't want to stop - I get that. But you need to, unless you want this blister to happen.
What are you going to do?
Firstly, do some general stuff. Have a look. What’s going on in there? Can you see where it’s red?
Are your socks bunched up? Is your insole not sitting right? Is there sand in your shoe? Sort this out.
Then do something more specific for that location. What do you have planned for this blister location? Whatever you have planned, implement that plan. Is it a silicone gel toe sleeve? Is it tape? You’ve got this stuff on you right? You’ve got your “on-the-move” blister kit right there, yes? No good it being in the car, back at camp or at home!
Here's an example of the importance of hot-spot treatment:
"When I've been able to work intimately with a group of trekkers or runners (ie: having opportunities for one-on-one time and supervising hotspot detection, blister prevention and treatment) I notice a very high success rate of blister avoidance with hot-spot taping with Fixomull. Up to four or five layers sometimes. I've had trekkers on Kilimanjaro, trekkers in the bush and the Simpson and other places and pretty much zero blisters due primarily to immediate hotspot taping."
Stop. And do something!
Do something and you might just remain blister-free. Do nothing and you will get a blister. Get a blister and you'll be mucking around with antiseptics, dressings, donut pads, changing all these things a few times a day and monitoring for infection.
Oh, and you'll be treating this blister for about a week until it heals.
If only you'd stopped and treated the hot-spot!
Written by Rebecca Rushton
Rebecca is an Australian podiatrist with over 20 years experience. She has spent a lifetime dealing with her own blister prone feet in her sporting and everyday life. Rebecca specialises in helping athletes and sports medicine professionals figure out how to manage foot blisters with ease. And for kicks, she enjoys providing blister care at multiday ultramarathon events.
Rebecca is the founder of Blister Prevention and author of "The Blister Prone Athlete's Guide To Preventing Foot Blisters".