[pct-l] Blistered hands on the trail-LONG POST

[john@frozenpoodle.com (John Brennan)]

I'm cross-posting this on my two resource lists. Excuse me if you get it
twice.

I wanted to see if anyone had experience with blistered hands on the trail.
This is a long post.

I started at Kennedy Meadows (south of Whitney) on June 15, 2001, and
continued to Yosemite Valley.  About a week into the trip, I started getting
really bad, large blisters on my hands.  They were worse on my right hand,
and I am right-handed.  The blisters were at high abrasion points,
particularly the first joint on the fingers and thumbs, and on top of the
knob where the fingers join the hands.  (Skip to the next paragraph here if
you don't need the gory details...) The blister would get incredibly tall
(and as a result, taut) before they would burst or be broken, the latter
being more common.  Inside, they were raw, and seemed to get more raw after
they were open.  At the worst point, an opening was like special effects
from a horror film.  The largest one (on my right index finger) was
eventually more than an inch long, along the length the finger.  They were
full of clear liquid, although very small amounts of pus formed during the
healing process.  The open places never actually bled.

I ignored the blisters at first, helped along by the anti-inflammatory I was
taking.  The anti-inflammatory medicine was part of the physical therapy for
my forearms and wrists distressed from keyboard and mouse use.  At some
point, another hiker, Sybex, suggested I should dress and cover them.  [Why
hadn't I thought of that?? Thanks Sybex.] Covering them seemed to have made
a difference although it would be another 3-4 weeks until they were fully
healed.
I noticed during the period of blistering, that the tops of my hands were
generally swollen, but not too much.  Also, my hands started getting
incredibly cold and would stay cold a long time.  In addition, at the worst
point, my hands were very pressure sensitive.  I couldn't sleep with the
sleeping back touching my hands because of the discomfort.  At times it felt
like my hands, not just the blistered areas, were on fire, like someone was
holding a blowtorch to them.  I would have this sensation even when my hands
were warm.  I had no other unexplained blistering on my body.
In the weeks following my trip, white arcs appeared on the nails of the
fingers that had the worst blistering (both thumbs and index fingers).

Here are some of the factors that may have contributed:
-I was stung on the middle finger of my right hand by a scorpion the morning
of my departure.
-This trip was the first time using hiking poles for more than 3 days (poles
put hands in sun much more, but I was judicious with sun block.) [This is
what I think caused the swelling, and is probably unrelated to the
blistering.]
-I was using Heet for fuel and could have gotten it on my hands early on.
-I was stuffing a WM Ultralight and a down sweater into a #2 OR stuff sack
every morning.  The set was borrowed, and the owner suggested that I do it
that way.  It was a *very* tight fit.  It hurt my cold hands each time I had
to do it.
-I was using Deet on hands and face (no blistering on face though) [DEET is
my leading suspect.]

My preventative actions were:
-Bandage hands
-Take care with fuel (Heet)
-Keep poles on pack, not in hands
-Not get hands wet before 8AM or after 6PM (to help with the cold)
-Switch sun blocks
-Switch anti-inflammatory back to ibuprofen

Anybody have any thoughts?  My doctor's diagnosis was a vague 'contact
dermatitis'.  The blisters were so fierce and big, that I think something,
aside from stuffing and packing was causing it.  I'd like to figure out what
it was so that it does not happen again.

Thanks for sharing any experience you might have.

John B.
Santa Cruz