The Pros & Cons Of Lubricants For Blisters
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Table of contents
- A quote from Doug Richie
- Five reasons why lubricants might make things worse
- How to manage friction blisters
In this video, I’ll show you how a bunch of topical blister products look, feel, (smell) and how they work.
Lubricants reduce friction levels. They do this very well. Initially. But research shows lubricants can be counterproductive to blister prevention
A quote from Doug Richie
This quote is from a literature review by Doug Richie DPM (2010):
"Physicians coaches and athletic trainers continue to advocate the use of petrolatum jelly and skin powders to prevent blisters while the scientific literature suggests these measures may actually increase the chance of blistering on the feet." .
Five reasons why lubricants might make things worse
Problem 1: Lack of traction
Viscous lubricants reduce friction levels! You can see that in the 3rd graph below - the curve immediately drops below the baseline. This third graph pertains to viscous lubricants (they tested petrolatum (aka Vaseline), mineral oil and glycerine). The first and second graphs are for mildly greasy and moderately greasy moisturisers. These increased friction straight away. So that's one thing to make sure of - that your lubricant is viscous and greasy, not just like a moisturising cream.
Results from Nacht et al 1981 (reported in Wolfram, 1983):
- Graph a) Mildly greasy moisturisers and water
- Graph B) Moderately greasy moisturisers
- Graph c) Very greasy moisturiser
When you are dealing with friction levels, it's important to realise that friction is not bad. In fact it's necessary to provide traction. When you put lubricant all over your foot, your foot loses traction. Without traction your foot moves around too much in your shoes. Your toes can hit the end of your shoe causing bleeding or blistering under the nails. Over time, this trauma causes the nails to get thicker and thicker and possibly even lose the nail (it will grow back, but a little thicker each time). This lack of traction reduces your functional efficiency (acceleration / deceleration). And puts you at higher risk of musculoskeletal injury as your muscles have to work harder to compensate for the lack of traction.
For these reasons, lubricating large areas of the foot, particularly the plantar (sole) surface may not be a good idea. In preventing blisters, the aim is not to reduce friction all over. A targeted approach is necessary. If you're using a lubricant, apply it only where needed!
Problem 2: When friction levels actually increase
The results from Nacht et al (1981) in the graph above show that although friction reduces initially, it later rises above the baseline friction level. So you should stop every 90 minutes or so and reapply to ensure you are still benefiting from reduced friction. If not, not only has your blister protection gone, you're actually at more risk of blistering.
Problem 3: Lubricants weaken the skin
Lubricants are occlusive which means they form a barrier to transepidermal water loss, a normal function of the skin. If water can't be released from the skin, it stays trapped within the skin, hyperhydrating it. This causes it to become weaker and less able to resist trauma. A bit like how your skin goes when you’re in the bath for too long. Imagine then having to run, accelerate, decelerate, change direction etc on this weak wrinkly skin! In this way, lubricants probably work best in the short term.
Blister lubricants prevent transepidermal water loss, weakening the skin to Blister-causing shear forces
Problem 4: Lubricants attract grit
The common lubricant Vaseline (petrolatum jelly) can be counter-productive particularly on off-road surfaces due to a tendency to attract grit. This increases the likelihood of blisters or other skin trauma. In addition, Vaseline's carcinogenic properties have become a concern in recent times as it is a product of petroleum.
Problem 5: They retard adhesion of tapes
Lubricants reduce the ability of adhesive tapes and dressings to stick to the skin. You'll find it difficult to combine the two preventive strategies of taping and lubricants. You'll also find it difficult to combine lubricants with blister dressings. This can get very tricky when you use a lubricant, it doesn't work and you get a blister, and then you want to apply an island dressing or plaster. It won’t stick!
How to manage friction blisters
This begs the question, if skin lubrication isn't a great way to manage friction, how do we reduce friction levels to prevent friction blisters, without all these downsides?
There are many ways: certain socks, powders, shoe patches, antiperspirants and possibly even tapes. Some of these work better than others. I particularly like shoe patches called ENGO Blister Patches because:
- They provide an exceptionally low friction level
- This friction relief lasts day in, day out for 300 miles (~500kms)
- They allow your sock to protect your skin
- They take up no room in your shoe
- They can be used to maintain "good" friction
- They save you heaps of time!
Using lubricants like Vaseline as a means of blister prevention may not be the ideal option for the reasons above. If it's already working for you, wonderful. If not, you've probably just found out why, and an alternative in ENGO patches.