What Is Golfer's Vasculitis?

Exercise-Induced Vasculitis
Wendy Bumgardner
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Whether you golf, run, walk, or hike, you may end up with a red heat rash on your ankles and calves. Golfer's vasculitis is a common rash that happens to otherwise healthy people and usually goes away on its own. Researchers call it exercise-induced vasculitis. You may also hear it called golfer's rash or even Disney rash.

Symptoms of Golfer's Vasculitis

The rash seen with exercise-induced vasculitis starts above the sock line and progresses up the calf. It can appear as red blotches, purple (purpuric) patches, or small dots.

The rash usually doesn't itch (although it might). It's believed to be heat-related, as often people who get it in warm weather don't get it in cooler weather. The rash is more common in people over 50. Most people can't pinpoint any new products they have used that might cause a reaction.

Diagnosis

Doctors rarely see this condition, since it is mild and usually clears up on its own. If you do see your doctor for golfer's vasculitis, they make a diagnosis based on the appearance of the rash. Your doctor might also do further tests to make sure the rash isn't a symptom of something of concern and to check on your health in general.

Allergy testing of people with the rash turned up no culprits. Skin biopsies show that what was going on under the skin was leukocytoclastic vasculitis, which means there is debris of white blood cells in the walls of the small blood vessels.

This can be seen in a variety of conditions as well as occurring for no known reason. Blood tests of people with golfer's vasculitis didn't show anything remarkable in the way of infection or systemic conditions.

Causes

Researchers conclude that this vasculitis is simply an irritation of the blood vessels following prolonged exercise in the heat, such as walking for extended periods in a theme park or playing 18 holes of golf.

Aging blood vessels are likely a factor, as golfer's rash happens more often in people over the age of 50. As you age, your calf muscle isn't as effective at assisting your veins in returning blood to your heart against gravity.

In warm weather, more blood is sent into the small capillaries under the skin to help keep you from overheating. When this blood isn't easily returned, you have venous stasis. As a result, a prolonged or unusual exercise in hot weather irritates the blood vessels just under the skin of your legs. This results in a red or purple rash.

Prevention and Treatment

There are no established treatment or prevention recommendations for golfer's vasculitis. The leg rash will generally go away by itself in three to 10 days. Using a topical over-the-counter hydrocortisone cream might reduce the symptoms. After a long walk, taking a cool bath, sitting with your feet up, or applying cool wet towels to the rash may help relieve discomfort.

For prevention, one review of studies could only suggest wearing light clothes when you're going to be standing or exercising in the heat.

Golfer's vasculitis seems to occur in healthy, active people. Researchers suggest it should not be a health concern and they say allergy testing is not needed.

Other Heat Rashes

Your rash may not be the common exercise-induced vasculitis. Here are other rashes seen by people who walk, golf, or exercise outdoors:

  • Cholinergic urticaria: With this condition, you break out in tiny itchy hives with an increase in body temperature, whether due to exercise or a hot shower.
  • Heat rash and prickly heat: Unlike golfer's vasculitis, prickly heat is itchy. It is triggered by blocked sweat glands and causes raised itchy red dots or bumps. It is best treated by getting out of the heat for a few days and not scratching the area.
  • Itchy legs syndrome: If your legs are itchy during or after exercise, with no relation to heat, you may have exercise urticaria.
  • Poison ivy and oak rash: Poison ivy rash is seen one to three days after contact with poison ivy, poison oak, or poison sumac. It is a very itchy, red, bumpy rash seen right at the point of contact, often forming a line where the plant rubbed. It may grow into fluid-filled blisters and last from one to three weeks.

A Word From Verywell

Getting an unsightly leg heat rash may be alarming. If it's your only symptom, you are probably safe to continue enjoying your warm-weather activities. But if you have any other symptoms, see a doctor to have them checked. Exercise in hot weather can result in dehydration and heat-related illness. Be sure that you take precautions.

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