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Hikers Rash and other lessons learned

Michael Walker

New Member
Time of past OR future Camino
2014
Three of us walked Leon to Santiago in April May last year. While walking fast one day on alot of pavement I developed Hikers Rash. This looks like a splotchy sunburn on the lower legs and feet. It sometimes itched but was not painful. A google search by my wife identified this condition as Hikers Rash, a form of vascularitus. The cure is 3 days of rest. If you keep hiking with this condition you can land in the hospital. I didn't have 3 days to rest so I chose to walk "gently" the rest of the trip and the condition went away. Watch for this and don't ignore it.

Boots: my wife tried out about 5 pairs of boots (walking in them for a week each) before she found a pair that worked with out blistering feet. We both wore goretex equipped boots and took them off several times per day. Then it was trying out socks. Research on socks told me that ones containing coolmax fibers wick moisture away from feet the best. We used these and they do work. Blisters: If you apply duct tape (grey tape) to hot spots on your feet you won't blister in those spots. just leave the tape on till it falls off then replace. It sounds funny but it works.
Clothing: Buy smartwool, (or icebreaker) marino wool everything. My wife and I wore smartwool undies and shirts and were amazed at how well they worked. They wick really well and dry fast. They won't pick up odors like polypro garments will. Smartwool is expensive and worth what it costs.
Trekking Poles: We took poles but only ended up using them on steep downhills and in rock strewn gullies. If you are prone to knee swelling the poles will help.

Buen Camino
 
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Hi and welcome to the forum! Thanks for sharing what you have learned, I hope you will continue to do so.
Out of interest, where did you find the info on vasculitis being so harmful that you can end up in hospital? I had this in 2012 and saw a doc in Leon about it - he gave me a cream to apply and told me to keep it out of the sun if possible, but didn't say a word about stopping walking - and I asked, as I didn't want to stop. I know a lot of people get this rash due to walking and also the hot weather, but have never heard about it being this serious before. Could you please provide that info so people don't get scared unduly? You carried on and nothing untoward happened, so what exactly are you warning others about?
 
I get this rash every year when I walk the Camino and I see it constantly on the pilgrims I pass.
I've never heard it could put you in the hospital.
I'd also be interested in knowing where you got this information as everything I've read says it is harmless and goes away on its own.
 
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There was some good advice about shoes and clothing, but I'm alarmed by the rather alarmist statement about hikers rash. (Illustrates the limitations of Dr. Google, who is also my personal physician!)

Skin can react to virtually everything (internal and external) and each person is different. I get hiker's rash quite regularly in a mild way. I know people who get rosacea on the face, which is an extremely common but poorly understood condition that is generally considered to be a cosmetic nuisance more than anything serious. Of course, all kinds of weird skin conditions can turn out to have unexpected and serious causes. After his own amateur but extensive research, the author on http://insuremekevin.com/hikers-rash-red-rash-between-knee-and-ankle-after-hiking-for-several-hours/ concluded that "age, stress, poor diet, long hot hikes, weeds...it all culminated in a leg rash." I would add that any combination of one or more of those factors could cause a similar rash by itself, for some people.

It is always wise, if you have a recurring condition that you can't explain, to consult a doctor to make sure you don't have some serious underlying condition. Listen to your body - if you have a nasty rash, ease off for a few days.
 
The account of someone landing in the hospital was a third hand account from someone we met on the way. Probably an autoimmune disorder.
Info on Hiker's Rash
http://insuremekevin.com/hikers-rash-red-rash-between-knee-and-ankle-after-hiking-for-several-hours/
This kind of article does tend to spread alarm, as it's written by someone trying to work out what was causing his rash, and includes some pretty extreme possibilities.

There was an earlier thread about this condition here: https://www.caminodesantiago.me/community/threads/leg-heat-rash-golfers-vasculitis-and-socks.24031/

Hiker's rash seems to be very common, as many have pointed out on the earlier thread, and there are lengthy discussions about it on numerous hiking sites and forums. Also known as "golfer's vasculitis", as in this article from the Medical Journal of Australia: https://www.mja.com.au/journal/2005/183/1/golfer-s-vasculitis and this Pubmed abstract from the Australian Journal of Dermatology: http://www.ncbi.nlm.nih.gov/pubmed/15670170

It appears not usually too serious, but as with any medical issue - if concerned, do see a doctor rather than relying on Dr Google.
 
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My wife gets a rash on her ankles and feet, this rash gets so bad that it looks like blood red under her skin. She has suffered with this for years and pretty much resolved that it is actually a heat type rash and can be controlled by keeping her feet cool by stopping on a regular basis and applying cool water or even ice in a scarf. She has helped many walkers on the camino and helped them resolve this same issue.
 
Welcome Michael and thanks for the information.
 
Better than rolling your ankle ;)

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Vascularitus? No thank you! A quick Google and one can see how dangerous this may be but worse the medical profession doesn't seem to know what causes the affliction. May be genetic, not necessarily connected with stress or hot sweaty feet, definitely not something you want to meet! I was worried since my walks on the Vezelay and Le Puy Caminos I have become a re-born gaiters person. No stones, gravel, mud, dust, thorns, or water for me and now evidently no vascularitus either.
 
It sure looks painful. I hope I am wrong though.
 
Skin can react to virtually everything (internal and external) and each person is different. I get hiker's rash quite regularly in a mild way. I know people who get rosacea on the face, which is an extremely common but poorly understood condition that is generally considered to be a cosmetic nuisance more than anything serious. Of course, all kinds of weird skin conditions can turn out to have unexpected and serious causes. After his own amateur but extensive research, the author on http://insuremekevin.com/hikers-rash-red-rash-between-knee-and-ankle-after-hiking-for-several-hours/ concluded that "age, stress, poor diet, long hot hikes, weeds...it all culminated in a leg rash." I would add that any combination of one or more of those factors could cause a similar rash by itself, for some people.

It is always wise, if you have a recurring condition that you can't explain, to consult a doctor to make sure you don't have some serious underlying condition. Listen to your body - if you have a nasty rash, ease off for a few days.

Lucky me, I hit the jackpot - rosacea and "hiker's rash"! In my case, the rash is urticaria and it is brought on by physical exertion of long duration or in hot weather. On any long distance walk, it surfaces on about day 3-4 and is very uncomfortable for a day or two and then my body kicks in and starts working the way it should i.e. I start to sweat properly.

Sydney summers can be quite humid and the rash will also appear after a day walk of much shorter distance than I would normally do on the Camino.

As both rosacea and urticaria are not allergies, it is very difficult to work out exactly what the triggers are. Heat certainly but rosacea is also a problem in winter as my skin takes some time to adjust when I move from a cold environment into a heated one.

Worth trying for those who are looking for answers is a daily antihistamine (I normally use Zyrtec) when walking and I've also given up drinking tea in the morning of and during a walk as tea seems to exacerbate the urticaria. Though I still have the problem when I use these measures, the severity and the duration of the rash is less than it is without them. I won't go into the rest of the long list of things that I've given up in the hope that it would solve my skin issues.

I've been walking on the Camino or other long distance routes for the past 10 years now. Urticaria is just part of the deal when I walk. It is frustrating but is a far lesser burden than that carried by many others and how grateful I am to have the strength and energy to continue doing what I love.
 
The one from Galicia (the round) and the one from Castilla & Leon. Individually numbered and made by the same people that make the ones you see on your walk.
The first edition came out in 2003 and has become the go-to-guide for many pilgrims over the years. It is shipping with a Pilgrim Passport (Credential) from the cathedral in Santiago de Compostela.
As someone who gets a rash on my legs and ankles and found that doctors may not know what the cause is, I did my own research. There appears be two causes - 'Heat rash' is due to (excessive) sweat while 'Exercise induced vasculitis' aka 'Golfers' rash' is a circulation issue where the small blood vessels get inflamed. In my case, the second condition was mostly solved by wearing calf compression sleeves that may also have helped with heat dissipation because they wick very well. There are a few good research papers on Vasculitis but none have specific solutions. In my case, creams, corticosteroids and antihistamines made little difference. A common factor is age ('over 50’) but it has also been recorded in a younger swimmer. If you google the condition and view images, there is a clue on some of the pictures - vasculitis tends not to appear under the elastic of sock-tops. That can be a way to indicate if it is sweat or circulation issue and was what led me to use compression sleeves.
 

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