First, let me state what you should already know.   I AM NOT A DOCTOR and ANYTHING that I recommend here is only based on my personal experience and you should consult your physician for anything medically concerning….not this blog.

 

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Photo: Pam Wright

The being said, let’s talk about Hikers Rash aka Disney Rash, Golfers Vasculitis and Exercise Induced Vasculitis.   Google any of those terms and you’ll be sent down an internet worm hole full of people wondering what the heck is going on with their legs.   I haven’t mentioned it on here until last week because I like to keep things positive. But yesterday, to be totally honest, it stole all of the joy out of my otherwise glorious 16.5 mile training hike.

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Photo: Pam Wright

The day started at 6am, with a 23 lb pack and a group of awesome ladies training for their trips to Grand Canyon, Ice Age Trail and John Muir Trails.   I had so much energy, and felt like I could have done 20 miles even with all of Afton’s hills.   Bike commuting, occasional strength training and Saturday hikes have made me stronger and have made all the difference in my endurance (and confidence!).

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But somewhere around mile 10, I felt it.    The familiar burning, tightness and prickly feeling just above my ankles.    CRAP.

 

The discouragement set in about mile 14, as I popped one more electrolyte pill, hoping that would help.   Nope.   I drove the hour back home from the trail discouraged, tired of googling cures, treatments, scary internet diagnoses and having the fun sucked out of yet another summer hike that was over 80 degrees and 8-10 miles.

Here’s where I’m going to conclude my complaining part of the post, because so far, complaining about it just makes me feel worse.   On the flip side,  the only way to beat the darkness is to bring it into the light.   So, my goal of this post is to share what I have tried and am trying next and hopefully help someone else.  I should also note that I have been seen by two dermatologists and my primary care doctor to rule out anything more serious.

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Day 1: Hives (this was a particularly bad one 2 years ago)

WHAT IS IT?

From what I can piece together Exercise Induced Vasculitis is basically an irritation of the blood vessels during exertion as the body tries to cool itself.   It starts as blotchy hives and eventually blooms into a bright red flat discoloration of the lower legs that can result in swelling and feel hot to the touch.   It is not always painful, but I have found that it has gotten a little angrier over the years and can feel like a sunburn.

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Day 2: Flat, bright red spots

As I mentioned above, it has a few other cute nicknames due to where people are most likely to encounter it.    It appears to be most common in women over 50, but affects younger people and men as well.  I have personally noticed that my fair skinned friends seem to be more susceptible.

Reading this New Zealand Dermatology article today was helpful in confirming some of the strategies I have discovered in the 5 years since it first showed up and prompted me to write about my experience.

Here’s a list of considerations I include on hikes that are over 80 degrees and 8-10 miles:

  1. Antihistamines
  2. Hydration
  3. Electrolytes
  4. Compression

 

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Photo of all sorts of beautiful sneezy things

 

1.  ANTIHISTAMINES

It is thought that histamines play a role in this condition and they get especially active in the heat.    As you get older, your histamine levels can increase too.   So I always make sure to take my Claritin and Flonase the day before and day of a hike (which I take for seasonal allergies)

Here’s an article I read last year that I almost forgot about.   It talks about Xyzal being a more affective OTC antihistamine for skin reactions and I’ll probably go buy some this week to try.    The ‘wheal and flare’ term used in the article sounds like something from my 4th grade square dancing class, making me laugh a little and is a perfect description for Hiker’s rash.

Xyzal may be slightly more effective for seasonal and year round allergy symptoms and is certainly more effective for histamine induced ‘wheal and flare’ skin reactions.

Reference:  https://www.pharmacistanswers.com/questions/xyzal-vs-claritin-what-is-the-difference

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I’ve moved to a Smart water bottle vs. nalgene to save weight, but also avoid hydration bladders so I can “see” how much I am drinking during activities

2.  HYDRATION

Staying hydrated is important no matter what, but water is especially critical for maintaining your internal cooling system.   I try to drink 2-3 liters on long hot hikes.

3.  ELECTROLYTES

Typically, I try to have an electrolyte drink at least one day before and a couple on the day of a big hot hike.   Yesterday I tried a new electrolyte supplement that was recommended, but I didn’t feel a noticable a difference.   I’ll try it again, but taking a pill every hour or two was kind of hard to remember to do vs just drinking a flavored natural supplement like this one. 

IMG_05414.  COMPRESSION

I noticed a couple of years ago that wearing compression socks as a recovery seemed to help my rash dissipate quicker.    I shifted to wearing compression socks while hiking and I believe they have lessened the severity (except for yesterday – what the heck?!) and also help with leg fatigue.   I might play around with getting compression sleeves and lighter ankle socks instead of a full compression sock to get some air in the area and make it easier to access my feet if I need to address a blister (compression socks are kind of hard to get on and off quickly).   I love these!

FINAL THOUGHTS

Unfortunately, none of the strategies I have listed above have resulted in a total cure, but they seem to help a little.

One other observation about yesterday’s hike is that I wore my Innov8 wool gaitors that I got at a gear swap.   They are great for keeping the bugs, sand and rocks out and help keep your shoes tied.   Since they are heavy wool, I think they held in the heat around my ankles and may have contributed to the cooling problem that my vascular system was already overloaded with.   I have an idea for some DIY lighter weight gaitors that I’ll work on this week.

Last week I was all about the Benedryl Gel, since it took down the wheals quickly after applying it.   But after further research, I see that it’s not recommended for use in larger areas on the body and  doing so can actually make it worse, causing contact dermatitis.  (Great)  I seem to have more burning and heat (feels like a sunburn), this time around and wonder if Benedryl may have aggravated it.   So, I’m sticking to Aloe, elevation, cooling the area and rest as post-rash treatments.

If you are reading this, have hikers rash and have done a multi day trip with it, I’d like to hear from you!   I’m betting on cooler weather for our thru hike, but would like to hear some personal experience on multi day hikes with this condition.    I’m still accepting prayer, good vibes and any prevention tactics as well.  Last week, a random person in the elevator suggested acupuncture as a way to treat too much internal body heat.   I’m intrigued!

Thanks for reading and shoot me a note in the comments whether you’ve already found relief strategies or just need a place to feel supported.

UPDATE

Read Part 2 of this post for more information on treatment and what I’ve learned since this article was posted.

Happy Trails!

~WP

4 thoughts on “Wheal n’ Flare!  My Dance with Hiker’s Rash.

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