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Golfer’s Vasculitis: Oops, I did it again!

July 22, 2016
Crowds in Florence near the Duomo on a hot, humid day

Five things you should know about “Golfers Vasculitis (aka Disney Rash)…”

We had a great day planned with friends: a morning tour at the Uffizi Gallery; followed by lunch at one of our favorite restaurants in Florence, Trattoria Cammillo; and an on-our-own walking tour of the city in the afternoon.

View of the Ponte Vecchio from the Uffizi Gallery

View of the Ponte Vecchio from the Uffizi Gallery

Birth of Venus in the Uffizi Gallery

The Birth of Venus by Botticelli in the Uffizi Gallery

Although it was only May, the changeable weather had turned oppressively hot and humid. After retrieving our rental van from one of the city’s public parking lots at the end of the day, I noticed that both my legs had a now-recognizable red rash just above the ankles: telltale sign of Golfer’s Vasculitis.

Golfer's Vasculitis in Florence

Golfer’s Vasculitis in Florence

Golfer's Vasculitis in Florence (closeup of right leg)

Golfer’s Vasculitis in Florence (closeup of right leg)

Oops, I did it again

Last year, I encountered this same, often misdiagnosed, malady for the first time. After a long, hot, but enjoyable day exploring the historic center of Orvieto, I was proud of the miles I had logged onto my Fitbit. But I freaked out when I glanced down at my legs.

Had I been bitten by an insect or spider? Even worse, bedbugs? Was I allergic to new laundry detergent or the bedding in the room? Was it cellulitis? The mind does tend to wander.

It turned out to be none of the above. Like any good researcher, I self-diagnosed my case of Golfer’s Vasculitis after finding pictures of equally ugly legs (and some worse ones) on Google. My physician confirmed the diagnosis after I sent him an email with a series of “wish-you-were-here” photos.

Golfer's Vasculitis in Orvieto (closeup of right leg)

Golfer’s Vasculitis in Orvieto (closeup of right leg)

Should it happen to you, here are five things need to know about Golfer’s Vasculitis:

1) Golfer’s Vasculitis is usually harmless, resolves on its own, and affects people who are relatively healthy. 

It is a form of vasculitis (an inflammation of blood vessels) that appears as a rash, usually above one’s ankles (above the sock line, if you are wearing them). It can extend as high as one’s thighs and affects both legs rather than one.

The red spots are hot and feel like sunburn. The rash usually doesn’t itch or blister but can cause swelling, especially around the ankles. It looks worse than it feels.

2) To promote awareness, medical researchers have suggested calling the condition Golfer’s Vasculitis.

In one of the few published studies, an Australian medical researcher suggested using one standard term to promote awareness of the disorder. In both the medical and lay literature, Golfer’s Vasculitis is variously referred to as:

  • Disney Rash
  • Epcot Rash
  • Dollywood Rash
  • Hiker’s Rash, and
  • Exercise-Induced Vasculitiis (EIV)

3) Some individual factors place certain individuals at greater risk than others for experiencing this condition:

  • Being over the age of 50
  • Being female
  • Having blood relatives who have had it
  • Having had it before (oops…)

4) Situational/environmental factors also come into play. 

The condition tends to occur among at-risk individuals (already predisposed to getting it) who spend extended periods of time on their feet in hot, humid climates.

For example, the rash is often reported after:

  • Taking long hikes, city walks, or walking tours
  • Visiting amusement parks (like Disney)
  • Taking cruise excursions
  • Participating in charity walks
  • Playing golf

5) Unfortunately, there’s little you (or I) can do to prevent Golfer’s vasculitis. 

Aside from staying hydrated and stopping to elevate your feet whenever you have the opportunity, there aren’t many practical prevention strategies.

Experts recommend wearing open shoes that are more breathable. Although flip-flops or sandals might reduce the odds of the rash appearing, they predispose travelers to other dangers, especially when walking on uneven streets or in crowded places.

Others suggest wearing compression hosiery, although it can be quite uncomfortable when visiting hot, humid places for extended periods of time.


Read more about Golfer’s Vasculitis:

  • Reply
    Debbra Dunning Brouillette
    July 22, 2016 at 12:13 pm

    Hi Irene! I get this, too, and have for years, off and on, when I’ve done a lot more walking than usual. I had never heard it termed Golfer’s Vasculitis or the others you mentioned, however! I looked it up on dermatology sites and cannot find what term I found years ago, but now I know it’s temporary and not a serious condition. I have had swelling along with it a couple of times, though, and wear compression knee-high stockings on flights.

    • Irene S. Levine
      Reply
      Irene S. Levine
      July 22, 2016 at 5:51 pm

      I don’t think this is what you get on flights…but I’m so sorry to hear that you share my misery, Debbra!
      Best, Irene

      • Reply
        Debbra Dunning Brouillette
        July 22, 2016 at 5:55 pm

        No, it’s not happened from flying, rather from lots of strenuous walking, but I wear the compression stockings to prevent swelling and potential blood clots. 🙂

  • Reply
    Laura
    July 22, 2016 at 6:05 pm

    Alyssa and I swear by these sandals. Their bottoms are like athletic shoes.

    http://m.zappos.com/cobb-hill-fiona-taupe

    • Irene S. Levine
      Reply
      Irene S. Levine
      July 22, 2016 at 7:40 pm

      The only danger of shoes like this as walking shoes (like other sandals) is that they leave your toes exposed to dangers…Better than flip-flops for sure!

  • Reply
    Jo ~ Lifestyle Fifty
    July 25, 2016 at 4:18 pm

    My hubby has had this quite a few times after long hikes or long (6 hour) walks in crowded cities pounding pavements and we’ve wondered what it might be! Now we know! Thanks Irene!

    • Irene S. Levine
      Reply
      Irene S. Levine
      July 25, 2016 at 4:48 pm

      Although I now feel a kinship with your hubby :-), I’m sorry that there are so few ways to prevent it!
      Knowing what it is does allay anxiety.

  • Reply
    Janice Chung
    July 25, 2016 at 4:52 pm

    OMG I’ve never heard of this and when I looked at your list of who is at greater risk, I was so ticked off! Women, over 50….same demographic for those most likely to get frozen shoulder (Yup, got it in both shoulders).
    Glad to hear it isn’t too painful, although it certainly looks like it is. Thanks for sharing….I think!

    • Irene S. Levine
      Reply
      Irene S. Levine
      July 26, 2016 at 7:20 am

      Now, I’ve gotten to google “frozen shoulder.” Hope it’s not too painful either.

  • Reply
    Suzanne Stavert
    July 26, 2016 at 1:20 pm

    I didn’t know this had a name! Thank you Dr. Levine!

  • Reply
    Donna Janke
    July 27, 2016 at 9:13 am

    Good to know about this. I’ve never had Golfer’s Vasculitis. I would have imagined all kinds of things about it – like you my mind would wander. I hope I don’t ever get it, but if I do I’ll now know what it is and not imagine the worst!

  • Reply
    Charles McCool
    July 27, 2016 at 12:23 pm

    Disney rash is a great one. I have not heard of this malady so this was quite informative.

  • Reply
    Sue Reddel
    July 27, 2016 at 3:04 pm

    I’ve never heard of Golfers Vasculitis – and I’m a golfer! Oh the joys of being over 50. I’ll be on the look out for it now. Thanks for the great information.

    • Irene S. Levine
      Reply
      Irene S. Levine
      July 28, 2016 at 9:11 am

      Consider yourself lucky! But now you’ll be able to spot in the course:-) Look just above the sock lines of your golf buddies!

  • Reply
    Kristin Henning
    July 29, 2016 at 9:21 pm

    Well, I learn something new every day. Now I will quickly try to forget this:) Here\’s to you never having to deal with it again.

    • Irene S. Levine
      Reply
      Irene S. Levine
      July 30, 2016 at 8:19 am

      All things considered…it was a minor ailment, once I knew what it was!

  • Reply
    Suzanne Fluhr
    July 31, 2016 at 6:29 pm

    Oh dear. Another age related malady to worry about. OTOH, I’ve never had it and I’ve done lots of walking in hot places. However, now that I think about it, I really wilt in hot humid weather, so maybe I collapse before I walk enough to give myself golfers’ vasculitis.

  • Reply
    Laura
    April 28, 2018 at 9:21 pm

    Use voltaren emulgel (https://amzn.to/2vUcm6b) if you can get it. Its an anti-inflammatory you apply to the skin for muscle inflammation but works wonders on inflamed capillaries just under the skin (they radiate heat so there’s inflammation going on). Apply several times per 24 hours til gone. Should be gone in 2 days. Only thing that has ever sped up healing for me. Antihistamines and even strong steroid creams did little to help.

    I get no new rash when going out again with the emulgel on. So maybe a preventative too? Worth a shot!

    • Irene S. Levine
      Reply
      Irene S. Levine
      April 30, 2018 at 8:27 am

      Thanks for this suggestion. I hope to give it a try.

  • Reply
    Merrilyn McHarg
    June 2, 2018 at 2:42 am

    I do lots of bushwalking and often have the hikers rash after many hours walking in the heat. The more severe the rash the longer it takes to disappear. Recently a hiking friend told me about a cooling towel from China. He took many orders and I purchased it for 8 dollars. It comes with a bottle to keep wet and cool. I need time to see if it works. Wring out wet towel, flap about and wrap around legs when stopping for morn. tea or lunch. I used to splash cold water from creeks on my legs while bushwalking and it did help. Thought I should share this with you.

    • Irene S. Levine
      Reply
      Irene S. Levine
      June 3, 2018 at 8:02 pm

      Sounds like something worthwhile to try! Let us know how the towel solution works out.

  • Reply
    Lisa
    February 22, 2019 at 4:38 am

    I get it also!! I’m on my feet at work for 10 he shifts and have been getting this for years!! I never knew what it was! Thank you!!

    • Irene S. Levine
      Reply
      Irene S. Levine
      February 23, 2019 at 2:29 am

      Of course, you should check with a doctor but if the shoe fits…:-)

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