Hikers are keenly aware of certain maladies that can seemingly strike up even the most prepared hikers. From blisters to poison ivy, sometimes your beautiful outdoor adventure can be tainted by a hiking injury or a nuisance that can quickly turn your fun time into an uncomfortable struggle.
Hiker’s rash or a sock rash from hiking is another common issue that plagues beginners and experienced hikers alike.
But what is hiker’s rash? What can you do to prevent hiker’s leg rash or sock rash? How do you treat hiker’s rash?
In this article, we will describe the symptoms of hiker’s rash, discuss the causes of hiker’s rash or sock rash, and suggest ways to prevent it.
We will cover:
- What is Hiker’s Rash?
- Signs and Symptoms of Hiker’s Rash
- What Causes Hiker’s Rash?
- How Do You Treat Hiker’s Rash?
- How Long Does Hiker’s Rash Last?
Let’s get started!
What is Hiker’s Rash?
Hiker’s rash is the common term used to describe the medical condition known as exercise-induced vasculitis. Although typically not serious, it can be quite uncomfortable. It is typically an itchy, red rash that is sometimes accompanied by burning, stinging, or pain.
Hiker rash may appear on one or both of your legs after hiking.
However, the same skin condition can also occur after other types of extended exercise, such as playing golf, in which cases it is sometimes called golfer’s vasculitis.
It may also be referred to as Disney rash because some people get this same exercise-induced vasculitis when they visit one of the Disney theme parks and walk for an extended period of time.
No matter what type of activity has induced the rash—hiking or otherwise—exercise-induced vasculitis is a type of cutaneous small vessel vasculitis.
Signs and Symptoms of Hiker’s Rash
Hiker’s rash is typically bright red, bumpy, and itchy, although it may also appear purplish and may burn or sting.
It is almost always on the lower legs, either on one or both legs. However, it can occur in other areas of your body.
It usually extends from your ankle up to your knee on the skin that is exposed outside of your socks, but it can also extend downward below your ankle under your sock line.
The texture of your skin can change in the days following the first appearance of hiker rash, but the bumpiness or scaliness that you feel should not be permanent.
Hiker’s rash is not contagious.
With hiker’s rash, no treatment is necessary for healing. However, some people find that applying ice or aloe vera gel can be soothing and may help take down inflammation that is contributing to the rash.
What Causes Hiker’s Rash?
Hiker’s rash typically is caused by hiking in warm and humid weather for an extended period of time, though it’s possible to get the rash with shorter hikes and mild climate hiking.
Because Disney World is located in Florida, which is relatively warm and humid for much of the year, this is another reason why it is sometimes called Disney rash and may appear on your legs after a long day walking through the Disney theme parks.
The rash is a result of inflammation in the small blood vessels just below the skin in your lower legs.
During prolonged and strenuous exercise, these blood vessels may become overworked.
When it is hot out, cutaneous blood flow, or blood flow to the surface of the skin, increases in order to help move blood away from the core of your body and cool your body down.
This is a thermoregulatory mechanism that, like sweating, helps your body handle exercising in the heat.
However, the little capillaries in your lower legs can become inflamed from long periods of hyperperfusion and being in the dependent position, which means that your legs are below your heart.
This means that your blood vessels have to work harder to return blood to your heart, and some amount of pooling can occur in your ankles and small blood vessels in your legs.
All of this amasses in inflammation in these small cutaneous blood vessels. This inflammation results in hiker’s rash.
Sun exposure on the legs can potentially increase risk, which is often why the rash begins at or above the sock line.
Although hiker’s rash is not a sunburn, sun exposure adds to the heat on the lower legs and can increase blood flow to the surface of the skin and inflammation. Therefore, keeping your skin covered may help prevent hiker’s rash.
Another potential prevention strategy is to wear compression socks during long hikes and walks. The compression may help prevent the pooling of blood in the legs.
Studies have found that compression stockings or socks can potentially reduce the risk of getting hiker’s rash in those who have previously dealt with the condition.
When possible, gradually build up your hiking duration to allow your vasculature time to adapt to longer hikes.
Lastly, minimizing salt intake can help prevent excess edema on the lower legs, which may help prevent the swelling and pressure in the cutaneous capillaries underlying this rash.
How Do You Treat Hiker’s Rash?
Although there are no medical treatments that are necessary for hiker’s rash, your skin could be quite itchy or painful, and the rash can be annoying.
Fortunately, there are a few things you can do to help manage the symptoms.
#1: Stay Cool
One of the primary factors that cause hiker’s rash is hiking in the heat.
Because cutaneous blood flow increases when your body is overheated in order to help cool down your core temperature, the small blood vessels near the surface of your skin can become inflamed and hyper-perfused with blood.
Therefore, once you already have hiker’s rash, you want to avoid exercising in the heat or getting too hot overall.
This will just continue to aggravate those small blood vessels that are already inflamed and irritated. In turn, your rash may flare up and will feel hot, itchy, and even bumpier.
#2: Rethink Your Exercise Routine
Exercise, in general, will potentially exacerbate your symptoms because it is again increasing your body temperature and thus increasing circulation to the inflamed blood vessels in your lower legs.
If you do want to exercise, consider swimming or doing deep water exercise. Not only will the water help keep your body temperature down, but the hydrostatic pressure of being in the water can help reduce inflammation and encourage venous return of excess fluid in your lower legs.
If water workouts are not possible, you might also consider something like using a recumbent bike or rowing machine.
These types of exercises put your body in a position where your feet are not as far below your heart.
By having your legs out in front of you, there will be less pooling of blood in your lower legs, which will potentially cause less inflammation and irritation to the little blood vessels that are damaged.
#3: Elevate Your Feet
Because blood pooling in the lower legs can contribute to developing hiker’s rash, elevating your legs, particularly after standing, walking, or doing any type of exercise, will help facilitate the venous return and cut down on swelling.
#4: Wear Compression Socks
Compression socks or compression sleeves around your lower leg can help encourage blood to return to the heart, and they reduce inflammation in the capillaries and small blood vessels in your lower legs that are inflamed with hiker’s rash.
#5: Use Ice
As mentioned, using ice on hiker’s rash can help reduce inflammation.
Make sure to use an interface between your skin and the ice and to ice for no more than 10 to 12 minutes at a time.
A good alternative is to use a cold compress made from cold, wet towels.
#6: Apply Topicals
If your hiker’s rash is burning, you can apply aloe vera gel to soothe your skin.
If it is itching, you might feel better adding hydrocortisone cream or a calamine lotion.
How Long Does Hiker’s Rash Last?
If you are in good health, hiker’s rash should resolve on its own within 3 to 10 days in most cases.
This means that the itching, burning, and pain will resolve rather quickly. However, the discoloration of your skin may last up to 3 to 4 weeks in some cases.
If symptoms are persisting or if the rash is getting worse, it is likely not hiker’s rash, and you should seek medical attention for further evaluation.
Blisters are another potential ailment of long hikes. To help treat and ultimately avoid blisters from the get-go, check out our guide to blisters here.