Pilgrimage to Santiago de Compostela

[marniedent]

I have overcome a number of obsticals for my upcoming Camino in June, but have encountered a crazy one now and hope someone can help!!! I'd been walking 12 miles at a stretch with no problems, but when I increased to 18 miles I now have a horrible beet red splotchy rash on my lower legs and feet. It doesn't itch and Benedryl doesn't help it. Today after walking I found hives up to my knees. I assumed it is a sock allergy, but have changed liners 3 times and nothing seems to help. The outer socks are various kinds of wool, but I've never had a wool allergy. Could sweat be adding to the problem, and how in the world do you avoid that? Any suggestions will be appreciated.

[Arn]

Hi,

This is quite common with folks that walk long distances where their feet, socks and boots combine to create a "heat rash".

Go to any multi-day walking event in the summer and you will see it -- a red rash on the calves of many walkers. It often starts above the sock line and makes red patches and splotches up the calf. It usually doesn't itch and is believed to be heat-related, since these same walkers don't get it in cooler weather. What is it?

Common name: Golfer's Vasculitis

Ask most physicians about this common rash and they draw a blank. That is probably due to few people seeking medical help for it. The rash usually clears up in a couple of days, usually before they are able to get an doctor's appointment. At last, a paper in the Australasian Journal of Dermatology has described it and proposed naming it "golfer's vasculitis."

Causes of the Heat Leg Rash

Researchers interviewed several people with the rash and discovered that many underwent extensive allergy testing because they believed they must have been having a reaction to some chemical or plant. But it was simply an irritation of the blood vessels following prolonged exercise in the heat, such as walking for extended periods or playing 18 holes of golf.

The rash is more common in people over 50. Most walkers can't pinpoint anything new they have used that may be causing a reaction. And since so many walkers have it, they couldn't all have contacted the same irritant. The source is simply heat and age--your leg blood vessels getting irritated from the heat.

Prevention and Treatment

The research offered no treatment or prevention recommendations. It seems to occur in healthy, active people. The researchers suggest it should not be a health concern and recommend not getting allergy testing, etc.

In my non-medical experience 3-Day Walks and walking conventions, this rash appears on a vast range of walkers and commonly goes away by itself after a few days. Pampering yourself after a good long walk by taking a cool bath, sitting with your feet up, or applying cool wet towels to the rash may help relieve discomfort.

Buen Camino,

Arn

[MermaidLilli]

AH HA!! I was fooled!! I got that rash, very mild though, and I was told it was from eating grapes of the camino. " But", I said, "I only ate several that some guy gave me!!" Now I believe this was a trick to get me to confess to picking someone's grapes. Which I didn't. So I thought it was from some plant I may have rubbed against, since it was above the sock line. And now I also realize it was the camino's trick to giving away my age. I cannot hide it, folks, I am over 50. <shows calf>
Proudly,
Lillian

[Marilyn Canada]

Wow...obstacles to overcome I can relate to....but I really thought I was the only one with the weird, red, non-itchy rashes on my lower legs..usually all around the ankles and up my shins as far as the knees....I have had it show up when you rather it didn't for a few years now ...usually it is activated by warm weather/sweat and often starts around the cuffs of my pant legs and also if I'm wearing capris or shorts it will start just above the top of my socks...I've seen a few specialists who have offered no explantion to prevent or cure....which is quite frustrating...

Last year on our trip to Italy the lovely rash broke out and the nice hot sun caused it to flare up...it will give a burning feeling if the hot sun hits it directly...but a visit to a pharmacy and with my limited Italian...the pharmacist took a good look at it and sold me the only cream that has ever worked... called "Dermocortal"........but I call it the wonder cream.......it is a 500 mg idrocortisone cream.....it cost 5 euro and cleared up the mystery rash in two days!!

I had tried several expensive Dr prescribed creams and antibotics at home in the past and none had worked...so I brought 10 tubes of "Dermocortal" to bring home with me....and three of them are packed for my Camino...next month....gosh soon I can say this month....wow...it is getting closer....

Hope this helps and Buen Camino...

Marilyn...yes, Arn.....I'm over the 50 mark.....

[marniedent]

Thanks Arn, for the in depth reply to my query. Sounds like something to just ignore and not shell out a lot of money for medical advise on!!! I've read a number of your postings- where do you come up with all your medical knowledge??? And yes, I also fit into that over 50 category, so you're right again!!! April is fast approaching, so have a great Camino.

[KiwiNomad06]

I have had this problem occasionally lately, when I have walked on particularly hot days with socks on. First time it happened was two years ago in Ireland when I struck 32 degrees or so in Co Kilkenny. On that occasion, with no treatment at all, some parts of the rash turned into infected areas that took quite a few weeks to heal. I have since found that a steroid cream, applied very lightly, helps the rash disappear quickly without getting any worse.

However, having seen the photos of recent snow, I am not packing any cream for my imminent departure. When it warms up along the way, I will buy some then!!!
Margaret

[MermaidLilli]

Come to think of it, when I walked with sandals and no socks it did not happen.
Lillian

[Arn]

where do you come up with all your medical knowledge???

No I'm not a doctor, but I've played one in the Marines and the Boy Scouts. As a company commander In the Corps, you've got the best interests of your men in mind all the time and while they may not be over 50, some do exhibit similar rashes above the boot line. In the Scouts, it's somewhat the same, especially among the adult leaders that haven't gone on long hikes in sometime and want to try and keep up with a 12 year old.

Initially I was amazed at the accuracy of the information contained in the Forum, then I came to realize that the makeup of the Forum members is such that we are all in this together and we WANT our fellow peregrinos to succeed.

Buen "15 days and counting" Camino
Arn

[marniedent]

I finished the Bataan Death March on Sunday, a 26.2 mile walk/run with 1500 ft elevation gain. It took 9 1/2 hrs and was in the mid 80s. My rash really flared up, legs, arms, back with minimal blistering on the legs. My family insisted I see a doctor, so just came from the dermatologist who said "vasculitis", and advised against doing the Camino!!! Yeah, right!!!! I politely turned down the offer for biopsies, etc. and walked away with a lovely bill and Rx for prednisone for the Camilno!!! She was concerned about what was/is happening on the inside of the body that we don't see- I feel great, so... My questions now are 1) Has anyone experienced this rash on a daily basis on the Camino and how do you keep the skin from breaking down" 2) Traveler's medical insurance may not be a bad idea- is anyone able to suggest a reasonable company for it 3) Are steroids (prednisone) available OTC in Spain if I need a second dosing. Thanks for the help.

[MermaidLilli]

I got mine in the beginning part of the Camino..... after Cirauqui and was gone by Burgos. I never had it again. Not sure why. Same socks, only difference was no shoes, jsut the Tevas. I do not think that would be the reason. Maybe it was those darn grapes!!
Lillian

[suzannedarosa]

my accupuncturist, natural healer says to stop several times a day and lay on the ground with your behind up against a wall and your feet/legs up the wall -- stay that way for at least 20 mins if possible

This advice wasn't for the problem you are talking about but for good general health and circulation and says if done 2-3 times per day it will improve many leg problems greatly

I plan to do it on my upcoming walk in two weeks. (except maybe in taht snow in roncesvalles!)
will let you know how it goes

[Lillian Rodriguez]

Come to think of it, I've have had this rash which I attributed to wearing Woolmax socks in the hot and humid tropical island called home. It was not sock allergy but the combination of too-tight laces often used to prevent the forward foot movement inside the boot while descending hills the pressure irritated ankles and/or inner step. Does it look like this?

IMG_0371a.jpg (43.96 KB) Viewed 705 times

If so apply a rash cream. I still wear the same woolmax socks with liner, boots tied not so tight anymore following lacing instructions at http://www.montrail.com. While these instructions are no longer available online, I have them in a Word document which is available for anyone interested. Just pm me!

Buen camino to all departing soon!

[katy06]

I carried a mixture of citrus, lavender and tea tree oils with me and bathed my feet in cold water with twenty drops every time at the end of each walk, Also socks need to be cotton if allergic-- and 'other' sweat proof'- not always the best,,

Shoes I recommend Brasher boots as they were excellent- and I never suffered from any feel problems--

Hope all is going well BUEN CAMINO!

[viajero]

I walked from Roncesvalles without problem but a friend joined me in Ponferrada for the last week. ALthough in early April it was rather warm out. After a couple of days of walking, she developed this very red, blotchy rash on her feet and legs. She muddled through and in Santiago was planning to go to see a doctor. Michael, the hospitalero at the Acuario albergue in Santiago, thought it was heat rash. He suggested that she soak her feet in cold water. He was most helpful and gave her a small tub to soak her feet in and replenished it for her with cold water. She had some immediate relief. And from that point on the situation began to improve. Of course, there was no more walking after Santiago so that probably helped too. Try soaking your feet/legs in cold water. I hope it helps.

[ksam]

liner, boots tied not so tight anymore following lacing instructions at http://www.montrail.com. While these instructions are no longer available online, I have them in a Word document which is available for anyone interested. Just pm me!

Buen camino to all departing soon!

Ok Lilli...would love to have the lacing instructions...

Karin
http://ksam-caminoportuguese.blogspot.com

[Lillian Rodriguez]

Ok Lilli...would love to have the lacing instructions...

Will send as soon as you provide an email address!
No neet to, it uploaded properly!

Regards,

[notion900]

I personally think people set too much store by the 'magical' properties of wool socks. They make me itch and I hate them. Thorlos make some lovely hiking socks that are mainly cotton with no wool content, they are super comfy and last nearly forever. Prickly heat is also a possibility. Canesten cream helps, as does hydrocortisone (you can get a combo of these two as well).

[Rambler]

Just got back Sunday and I had this same rash. But my included significant swelling and a pain in my shin. It started on the climb to O Cebreiro and I thought it was just tendenitis. The pain got worse each day, as did the swelling and the rash. Every time I took my boot off (this was only mon my left leg) and put on crocs, I hobbled around like the leg was broken. Wearing a boot actually made it feel better.
By Sarria, I seriously was thinking I was goitn to have to quit. I went to the hospital there and the doctor said it was from the rubbing, but she said it was an infection. I got a shot of something (never did find out exactly what) and the pain began going away as did the rash. By Finisterre, I would only occasionally have a pain in my leg and the rash was totally gone.
I wish I had known about this before so I would not have been so concerned. Now I think I had two problems, golfers vasculitis and tendenitis.

As to travel insurance or packing lots of drugs, may I say my experience with the Spanish medical system made be realize these were not necessary. Medical care in Spain is free, though it may not be as convenient as in the States, they were very helpful, especially to pilgrims, and I got medicine and the shot for free, with no paper work. I would suspect that if you are in need of any steroids or other items such as this because of the onset of a know condition, you would easily be able to go to a hospital and get this taken care of.

[marthas]

Thank you, Arn and others, for sorting this out. I thought this was the oddest problem, but we are never alone, are we?

Perhaps it would help others to know that, after some experimentation and advice from a backpacking website, I've found that Bridgedale A.T. Boots Plus socks eliminate or greatly reduce the rash problem. They are made of merino wool wrapped with CoolMax and the cuff is much less snug -- the loose loops in the foot part continue up around the ankle. I have very small feet and the smallest size is borderline too big, but they are nice and cushy and I'm thrilled to avoid the ankle rash.

In the US, I found them at http://www.sockcompany.com at a pretty good price with quick delivery.

Martha