Podcast Episode September 15, 2019

Episode 16 | Maceration and Immersion Foot Diseases




As backpackers, we spend a lot of time thinking about and managing our feet. One problem that crops up a lot (especially for those of us who choose to utilize ultralight footwear, hike in damp or snowy environments, or both) is wet feet. Feet that get wet and stay wet can cause all kinds of nasty issues – starting with maceration (wrinkly, pale, soft skin) and progressing through to immersion foot diseases like trench foot, tropical immersion foot, and warm water immersion foot.

In this SKILLS SHORT, Ryan and Andrew break down the causes, symptoms, and results of immersion foot diseases. After a fairly exhaustive and somewhat nasty primer (you’ll hear the phrase “sloughing skin” more than once) the guys discuss strategies to prevent and manage immersion foot diseases and their symptoms. The pod wraps up with a discussion on when you should get off the trail (blackened skin = big trouble), and Ryan shares some of his favorite resources and further reading on foot care.


  • Definition of immersion foot diseases
    • What is maceration?
    • Trench foot
    • Tropical immersion foot
    • Warm water immersion foot
    • What symptoms do the three diseases share in common?
      • Extreme maceration
      • Dermal layer separation
      • Redness
      • Tenderness
      • Swelling
      • Blisters
      • Sloughing skin
      • Open sores
  • What is the difference between the three?
    • Pathology
      • TF – cold induced vasoconstriction
      • TIF / WWIF maceration-induced separation of dermal layers
    • Variations in speed of disease progress?
  • How can these diseases be prevented?
    • Maceration vs immersion foot disease – a warning sign that needs to be addressed.
    • How much water can the skin absorb?
    • Preventing and managing maceration should be the PRIMARY FOCUS. If you handle that, you won’t get immersion foot.
      • Management and Prevention Strategies
        • Hydrophobic balm – one of Ryan’s recommendations is Body Glide Foot Glide
        • During hike AND BEFORE HIKE
        • Merino vs synthetic socks
        • Change blisters dressings and tapes frequently
        • Wear shoes that drain
        • Drain your footwear after a river crossing
        • Take off your shoes and socks at rest breaks
        • Change into dry socks during the day
        • Slow down your pace
        • Stop and camp

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Recommended anti-maceration and anti-blister balm: Body Glide Foot Glide

  • When do I need to get off the trail?
    • Redness
    • Tenderness
    • Swelling
    • Open sores / sloughing skin
  • When should I see a doctor?
    • Discoloration and dying skin – or, just for safety sake, if you have any of the symptoms listed in “when do I need to get off the trail.”
  • References and Resources

Feedback, Questions, Tips?


  • Backpacking Light – Executive Producer
  • Ryan Jordan – Director and Host
  • Andrew Marshall – Producer, Host, and Editor
  • Look for Me in the Mountains – Music

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Home Forums Episode 16 | Maceration and Immersion Foot Diseases

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  • Author
  • #3610278
    Backpacking Light


    Locale: Rocky Mountains

    Companion forum thread to: Episode 16 | Maceration and Immersion Foot Diseases

    In this SKILLS SHORT, Ryan and Andrew break down the causes, symptoms, and results of immersion foot diseases.

    Eric Blumensaadt
    BPL Member


    Locale: Mojave Desert

    So far I’ve never had this problem, even while using my 3mm thick divers socks for a VBL in cold weather.

    I’m very careful to dry those VBL socks every night and to change into a clean, dry pair of thin poly liner socks for the next day. But using the proper preventative creams/salves is another way to keep your feet healthy.

    When backpacking Coyote Gulch in Utah’s Grand Escalante I spent about 2/3 of my time wading in the creek wearing Merrill MOAB mesh shoes and wool/acrylic blend socks that dried rapidly. No problems that week.

    Eric B.


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