A long day of walking leads to a case of Golfers Vasculitis
When we recently toured the hill town of Orvieto, Italy, the temperature was in the mid 90s as it had been for days. In addition to the oppressive heat, the humidity was uncomfortably high.
Glancing at my Fitbit later that day, I realized we had clocked nearly four miles of walking on cobblestone streets (apart from the time we had spent standing on our feet in museums and churches).
Because we were running from place to place, and appointment to appointment, trying to soak in all of the city’s sights, I made the mistake of not drinking enough water.
After returning to our hotel that evening, I glanced down and noticed a rash with unsightly dark red spots on both legs —just above the line of my athletic socks. Yikes, it looked dreadful!
Searching for a diagnosis
Because I always tend to think of the worst-case scenario, my first thought was that I had cellulitis. My husband hypothesized it might be an allergic reaction to a new detergent I had used in the self-service laundry on the cruise ship we had been on the week before.
But after “Googling” and reading hundreds of anecdotal reports on MedHelp.org and looking at some of the medical literature, I’m convinced that I had a case of “Golfers Vasculitis.” Some people also call it “Golfers Ankle.”
No, I’m not a golfer but playing 18 rounds of golf is the common precipitating event that has given this condition its name.
The ailment has also been documented in otherwise healthy people who discover the rash on their ankles after spending hours on their feet in hot, humid climates in a variety of circumstances besides playing golf, such as hiking, participating in charity walks, taking cruise excursions and visiting amusement parks, like Disney World and Dollywood.
The characteristic rash usually appears above the ankles, on both legs, sometimes extending up as high as the knees. Golfers vasculitis is more likely to occur in women than men, in older people rather than younger ones.
(See the photo of Golfers Vasculitis below).
Although it’s vascular, even doctors often mistake it for cellulitis or a skin condition. It has also been variously called “Exercise-Induced Vasculitis (EIV)” and “Disney Rash.”
Golfers Vasculitis: The course of the rash
Although this rash with red, hot spots can feel like sunburn, it doesn’t blister or cause much pain. It is self-limiting, usually resolving without any treatment within a week or so.
Mine almost disappeared after five days of unsightliness. Some people are left with a light brown pigmentation that doesn’t go away. Unfortunately, once you have had it, you are more prone to experience it again.
The good news is that there’s no established connection with venous disease but there also is no definitive approach to either prevention or treatment.
Some patients and doctors recommend the following:
- Staying hydrated when doing a lot of walking in a warm climate.
- Wearing compression hosiery (although I can’t imagine wearing those socks in the heat.)
- Wearing open shoes like flip-flops rather than closed athletic sneakers (although this could create other types of problems).
For more information on Golfers Vasculitis:
My article on Forbes: Are You At Risk For This Common Travel Malady?
SherylSeptember 3, 2015 at 7:26 pm
Never heard of this before- – it sounds almost like heat rash? Is that similar? Glad you’re okay and it was nothing more serious. That’s a LOT of walking in the heat!
Irene S. LevineSeptember 3, 2015 at 7:35 pm
We were out that day for over 10 hours….returned completely destroyed:-) The heat was incredible.
From what I read, I don’t think it is related to heat rash, which might have more to do with the skin.
LauraSeptember 5, 2015 at 2:22 am
So glad you’re okay and it’s not serious! I have some great walking sandals that you could wear all day. I sent you the pins.
Irene S. LevineSeptember 5, 2015 at 5:51 am
Thanks! In this case, I don’t think it was the shoes…although I’m always on the hunt for good walking shoes that come highly recommended!
kathryn kellySeptember 19, 2015 at 12:01 pm
I had a similar thing happen in Venice over cobblestone — I saw my FitBit said 12 miles and then looked at my ankle and it was swollen and turned black and blue over the next few days. Doctor told me that cobblestones can aggravate the tendons – and they can get strained and as a result you get bruising.. so glad to know I am not the only one who gets so excited about where I am traveling and what I am seeing that I forget to take care !
Irene S. LevineSeptember 19, 2015 at 1:30 pm
Another friend wrote me on Facebook that she also experienced this condition. I guess it may be more common than people realize. It’s easy to dismiss as a sunburn.
gwendolyn KeyMay 16, 2016 at 11:40 am
I was at Hollywood over the weekend, when I got back to my room, after 8 hrs of walking, pulled my socks off, and there’s this horrible looking red color, flat, smooth rash obove my sock line, I freaked out, and it was also on other leg, will this go away, and when, its hot weather, and I can’t even wear shorts. It doesn’t itch, it just looks so bad,
Irene S. LevineMay 17, 2016 at 8:06 am
I can’t diagnose it but if it is Golfer’s Vasculitis, it should start getting lighter very gradually. If you are concerned, you might want to check with your physician.
LynnMarch 22, 2022 at 1:12 am
I am a security guard and I get it frequently walking.. good grief I was in Hawaii and my ankles swelled up and I had that rash…. ugh
Irene S. LevineMarch 22, 2022 at 7:38 am