Dealing with hikers rash (exercise-induced vasculitis) on the trail

[Eitan Paster]

On backpacking trips, I often get a rash on my lower legs, sometimes even extending to my thighs, especially in hot conditions. I’ve identified this rash as hiker’s rash and am looking for some ways to deal with this this.

What are some good ways to be able to avoid this and treat it? Advil relives the itching, but it doesn’t make it go away. Benadryl didn’t do anything at all. I’ve heard about compression sleeves, do those work?

Here is a picture of the rash I got

[Martin Van Laarhoven]

Start by wearing moisture-wicking clothing and using compression sleeves to minimize friction and improve circulation. Take regular breaks to cool down and apply barrier creams or talcum powder to reduce irritation. Hydrate well and consider non-drowsy antihistamines if allergies are a concern.

This should do the trick

[Brad W]

What pants are you wearing?

[Eitan Paster]

Outdoor Research Ferrosi pants. I also had the same rash on a recent day hike in hot conditions in shorts, however less so in my calves.

[Brad W]

I have had a similar rash under my Darn Tough Socks during very hot hikes-90F+ but it goes away after a few days. I did not get the rash on my legs wearing the same Ferrosi pants.

[Mark Verber]

I struggle with this as well.  For lower legs I have found ventilation, fast drying, and not too tight took care of the issue.  I will second Ferrosi pants.  I still struggle with my upper thighs.  The best thing has ben compression shorts.  My best experience has been Xoskin Compression Shorts

[peter v]

not sure if same thing, but i get redness on my back .. and lower. and i slather Lomotrin on it for quick be-gone-ness.

a fast trick might be to put anti-fungus cream on one leg, and not the other, and compare.

just a thought.

[MJ H]

I’m not a doctor, but if I get a rash and I don’t know why, I usually put hydrocortisone cream (OTC) on it. It works well about half the time and usually works at least a bit otherwise. But what I get is usually eczema, triggered by various things. I’ve never had to put an antifungal on my legs except near the groin, but humidity and heat are an awful combination.

[AK Granola]

I get this rash too whenever I hike in heat, but it’s not fungal, nor is it a reaction to plants, clothing friction, etc. It’s purely a circulation issue; the blood isn’t going back up quickly enough. Eventually my legs or feet will start to bleed if it gets really bad and I don’t rest it. After the initial rash, it will usually ease up and won’t return, once my body is used to the heat. I’ve tried a lot of the things others have suggested above. Treatments that are effective for me are putting my legs up above my heart- up a tree or a rock or a wall. Soaking in cold water (streams, lakes) helps somewhat also, as does ice. I have not tried compression sleeves; they sound awful but I may try them anyway to see if they work for this. The one thing that makes me think they just might work is that when I wear snugger socks I don’t get the rash under the socks, only above the cuff on my bare legs. We’ll see!

[Steve Thompson]

I don’t get a rash, but have circulatory issues with my right lower leg which swells when I work it hard.  Wearing a compression sleeve is a “hike-saver”.

Where I do get a rash is under my hipbelt.  Ditching synthetics (now wear merino wool shirt and underwear) and applying ~50/50 Lomotrin and Hydrocortisone creme prior to the hike start, and again after any swim keeps it contained.

[M. C]

Hi Eitan, Just wanted to second some of the excellent advice you received. I also get exercise induced vasculitis (have for years) and find compression sleeves to be invaluable. My understanding is the venous valves are not working optimally and blood is pooling in your legs, causing the rash. With the compression sleeves on my lower legs, I am usually spared the worst of it. At the end of the day, I prop my legs up (against a tree or rock) to allow the fluid to drain back to the heart. HTH!

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