Volume , Issue

"The skin is, after all, not only the largest organ of the human body, but more importantly, it is the interface between climber and climb." 

With Adam Ondra’s recent third ascent of El Capitan’s Dawn Wall (VI 5.14d), I was reminded once again of the importance of skin care and the measures that climbers take to continue to pursue their passion. Beyond being the hardest big-wall rock climb in the world, all three climbers who have completed the 31 pitches of 5.10 to 5.14d climbing have mentioned the toll the razor-sharp edges took on their fingers and the care which they doled out on a daily, if not pitch by pitch, basis.

Tommy Caldwell, one of the first ascentionists, when asked about how
quickly Ondra completed the climb by National Geographic said, "One
thing that's pretty shocking to me is that he fell a lot throughout the route.
He had to re-climb pitches over and over and over again, and his [finger]
skin somehow held up to that. He fell way more than I did, and I took three
times as long, and my skin barely held up. And Kevin's didn't."

The skin is, after all, not only the largest organ of the human body, but more importantly, it is the interface between climber and climb. The friction created by hands and feet on the rock, snow, or ice is the foundational element of the sport and critical to success or failure. The goal of skin care for a climber is to have dry, sweat-free hands with hardened calluses that are well tapered to the surrounding skin.

While the most common skin injuries for other outdoor pursuits include blisters from ill-fitting boots and abrasions from trips and falls, the most common skin injuries for climbers occur on the hands and fingers. Basic skin care begins with nutrition and hydration, includes proper hygiene, and concludes with daily care. New climbers often overlook the importance of skin care and believe that the use of chalk is all that is needed. Education comes at a price and often in the form of gobies, flappers, splits, and worn tips (discussed later).

Beyond proper nutrition and hydration, climbers have developed numerous techniques to keep their mitts in perfect condition. Often overlooked but of extreme importance is keeping the hands and fingers clean. As we all know from our lives in hospitals, clinics, and in the field, good hand hygiene prevents infection and contamination. The same goes for climbers. Many climbers wash their hands multiple times a day. Any substances on the pads of the fingers can detract from climbing friction. This includes material picked up on the way to the crag, like oil residue from the gasoline pump, or from our breakfast or lunch (e.g., bacon grease). Additionally, hygiene should continue throughout the day to wash off the accumulated dust and grit, not to mention the aluminum that often adheres to the skin while belaying if no gloves are worn. Dirty, greasy hands detract from friction and make sending the long worked project even more difficult.

CHALK AND CREAMS

The use of chalk, made up of magnesium carbonate (MgCO3), is foundational, as keeping hands dry is one of the most important aspects of climbing. Every climber’s skin is distinct to them and the use of chalk varies by individual. From amount, to type, to quantity, everyone is different. Chalk comes in a variety of types (loose, liquid/paste, blocks, and balls) and concentrations. There are several quality brands, including Metolius Super Chalk and Friction Labs. The key for climbers is to experiment, find, and use what works best for them to keep the skin dry and reduce sweat. 

It might seem counterintuitive to mention hand lotions and creams after discussing how to dry the hands as much as possible, but the use of hand creams and salves is of vital importance to keep hands and fingers in shape for climbing. These products are used in the evenings after climbing and during “rest days” to help the hands heal, and to prevent the occurrence of cracks or splits. There are multiple climber-focused brands that include Joshua Tree Skin Care and Climb On, as well as brands marketed to the large public, including O’Keeffe’s Working Hands and Burt’s Bees Wax. As with chalk, finding the product that works best will take some trial and error, but the right recovery cream will keep you on the rock longer.

RESOURCES

Black Diamond "White Gold"   

Friction Labs                                   

Metolius "Super Chalk"                 

CHALK

Burt’s Bees Wax                              

Climb On                                          

Joshua Tree Skin Care                    

O'Keeffe's Working Hands

SALVES

SKIN CARE KIT FOR CLIMBERS

The first items of importance, as mentioned above, are to find the best chalk and salve for your skin. By identifying these two items and using them regularly, a climber can prevent many of the injuries mentioned later. In addition to chalk and salve, a well-built skin care kit can help ward off potential problems.

Skin Care Kit For Climbers

Nail and cuticle clippers assist in keeping finger and toenails in shape prior to and during a climbing session. Clippers can also be used to trim away torn skin and flappers during the day. Filing calluses to ensure smooth edge transitions to less thick skin is important to prevent flappers. Sanding blocks, found in any hardware store, are a good choice as they generally have several levels of grit and are easy to manipulate around the finger pads. Other options, all of which offer a more compact alternative for the weight and size conscious climber, include emery boards, nail files, or individual sheets of sandpaper.

Many climbers also include skin glue within their kits to seal split tips, flappers, and other skin injuries. Many climbers use the hardware store skin super glue, which is not recommended. For more information, check out Davis and Derlet’s article, “Cyanoacrylate Glues for Wilderness and Remote Travel Medical Care,” in Wilderness and Environmental Medicine (2013). With medical grade adhesives being relatively cheap, there is no real reason not to use these glues when available.

In addition to the preventative items above, climbers should include an assortment of adhesive bandages that can be used with tape, along with antibiotic ointment such as bacitracin or bacitracin/polymyxin B. These items take up little room and should always accompany a climber to the crag. Most climbers carry at least one roll of tape (often two inches in width) to create gloves for crack climbing, cover split tips, or to use in conjunction with bandages to cover injuries. Often, climbers will carry a larger roll of tape (useful for a number of non-climbing related emergencies) along with a smaller ½ inch roll specifically used for splinting injured fingers. There are several other items that are useful for skin care and are often included in a standard first aid kit, including safety pins (for relief of subungual hematomas and removal of splinters) and tincture of benzoin.

COMMON SKIN INJURIES FOR CLIMBERS

The following are injuries that are more common to climbers than the general population of outdoor enthusiasts. These injuries are relatively minor, but as was mentioned in the Tommy Caldwell quote, can stop a climber in their tracks (or stance)!

Flappers – These small avulsions of the outer layers of skin on fingers and hands are a common problem caused by the catching of a rough edge of skin, usually near a callus. If a callus does not taper to the surrounding skin, a rough plateau is created that is easily caught on a sharp rock edge and can tear away the skin. Care depends upon the severity and location (see photos). A small flapper (without or with only minor bleeding) may be trimmed, irrigated, cleaned, and dressed with little interference to climbing. If the skin tear is larger, complete the same wound care, but additional dressing with antibiotic ointment may be in order. As with all the following wounds, location plays an enormous part in a climber being able to continue to climb or bailing for the day.

Split/Cracked Tips – Split tips usually develop on dry fingers, are difficult to heal, and often occur on or near calluses. Splits can occur anywhere but are more common at climbing destinations that are in a dryer climate (e.g., Indian Creek, UT). Splits can be prevented by using salves or creams in the evening without detriment to the development of the calluses so important to climbers. All splits should be cared for utilizing basic wound care as discussed above. Once a split occurs, keep it moist and be patient. If obvious dead skin is observed, it can be trimmed back using clippers.

Worn Tips – Though commonly associated with climbers at sandstone crags, worn tips can occur on any type of rock and usually after long sessions. They can feel like fire during a pitch or when placed under even lukewarm water. Generally occurring on the fingertips due to the wearing away of the outer keratin layers, this injury is cured through a little rest as the outer layers of skin are replaced naturally.

Gobies – Gobies, also known as abrasions, are badges of honor for crack climbers. Though they can occur anywhere, for traditional climbers who are not wearing tape gloves they usually appear on the softer backside of the hand and are due to the “jamming” actions used in crack climbs. Standard wound care is all that is needed and perhaps, some good tape gloves for the next send.

Gobies

Skin care is essential for climbers to perform their best while at the crag. Though very few of climbers have the skills to ascend the Dawn Wall on El Capitan, we all have the same common issues with skin care and maintenance. As with most things, prevention is much easier than treatment, and with some attention to the common skin issues associated with climbing, most of these injuries can be avoided.

ADDITIONAL RESOURCES

Davis KP, Derlet RW. Cyanoacrylate glues for wilderness and remote travel medical care. Wilderness Environ Med. 2013; 24:67-74.

Hawkins SC, Simon RB, Beissinger JP, Simon DA. Vertical Aid: Essential Wilderness Medicine for Climbers, Trekkers, and Mountaineers. New York, NY: Countryman Press; 2017.

Jamshidi R. Wound Management. In: Auerbach PS, editor. Wilderness Medicine. 7th ed. Philadelphia, PA: Mosby Elsevier; 2017.

You Might Also Be Interested in


Climbing Anchors

Elaine Yu, DO, MS, FAWM9/9/2022

The Good, the Bad, and the Ugly


Cold Montane Environments

Derek DeBruin, WFR1/7/2022

Tips to Stay Warm and Dry (and Injury-Free)


Rock Climbing Accidents

Elaine Yu, DO, FAWM11/1/2021

2021 Year in Review


Accidents in North American Climbing (ANAC)

Corey Winstead, PA-S2, W/AEMT, FAWM, SPI5/10/2021

Accidents in North American Climbing