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Q&A

Preventing "heat rash" around ankles and shins?

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I'm currently hitchhiking in South East Asia where it's of course always hot. I'm getting a rash around my ankles that I've had in the past but never looked into.

Rash on my lower leg
(The same rash, but on a different trip, in Korea, about 5 years later.

In Australia I guess we would call something like this "heat rash", though I was never prone to such things when I was younger so I'm not that familiar with what such rashes look like. Doing some Googling it seems to be known as "golfer's vasculitis".

It doesn't hurt or itch or sting. I know it's not caused by poison ivy or allergies. It just looks ugly plus I wonder if it could be doing harm that I don't know about.

I thought it might be to do with type of socks or socks being too tight. But those are just guesses. Is there something that can be done to prevent getting this rash?

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This sounds to me what we would call in the UK prickly heat.

What causes prickly heat?

Prickly heat usually develops when a person sweats more than usual, such as during hot or humid weather. However, it is also possible to get prickly heat in the winter. The condition is caused when the body's sweat glands become blocked. Excessive sweating can result in sweat becoming trapped beneath your skin. The trapped sweat causes skin irritation and the characteristic heat rash. The symptoms of prickly heat are usually worse in areas that are covered by clothing. This is because clothing can make you sweat and sometimes causes friction (rubbing).

In your case I'd say the cause is likely sweat not being able to evaporate off your skin, thus blocking the pores.

Couple of hints I'd suggest:

  • Ensure your socks, shoes, etc. are as breathable as possible, give the sweat a chance to evaporate. If you're in a humid climate this might be easier said than done though.
  • Try to keep the irritated area dry and clean. Again easier said than done but try and take care of the skin. When you stop, wash and dry the area carefully.
  • Try and keep the area cool. Thin cooling socks and shoes where possible, don't use water unless you intend to dry the water off.
  • Hydrocortisone cream should help with any reactions. Try and use sparingly because of side effects (thinning of skin, etc.)
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This sounds like exercise induced Vasculitis. This is tiny blood vessels which break due to heat & restriction due to socks & friction. Also known as a golfers rash. It tends to happen more in people over 50. It has nothing to do with being overweight either as someone commented on the web. Mine was as a result of hiking a minimum of 25km per day in heat on a walking holiday. Creams do not help. Antihistamine tablets could help but also removing socks and shoes when resting and elevating your feet. I saw a consultant for this diagnosis. In my case I've been left with some scaring but other people on my walk recovered completely when they returned home. It is not well documented as a condition so I hope this helps.

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Heat rashes are caused by excessive heat trapped under the skin.

  • As you specifically referred to ankles and shins, I'd suggest you considering using shorts instead of full pants, only if those tiny red rash-bums have not burst. If those are already burst then you should be going to a doctor in order to avoid any infection.
  • Try to avoid clothing with synthetic fiber material as they are less breathable. Cotton should be an obvious choice. Wear something which is a light-weight, loose-fitting attire. Socks would be an exception to that.
  • Before the rash actually appear, you may have felt some sort of itchy feeling. That is a sign of possible heat rash development. In such a case, dry that part of skin thoroughly. Consider applying Calamine lotion or hydrocortisone cream to get rid of itchy feeling.
  • If it the weather is hot and humid than what you are habitual with, apply a paste of baking powder (Mix baking powder with a little bit of water). (If you have hypersensitive skin, then please consider taking a professional medical advice first before trying this.)
  • Consider taking a shower when you get a chance. A Detox bath shall be even better. Apply talcum powder or cornstarch.
  • Applying Lavender/coconut oil to the skin is one of the ways to prevent the Heat rashes and chafing.
  • Drink adequate water, Stay hydrated. Staying well hydrated will help prevent them by allowing you to perspire freely. The moment you stop perspiring, your sweat will form salt crystals on your body, closing the sweat glands and heat will trap beneath the skin causing a rash.
  • Not sure if its applicable to your situation, but if possible avoid getting out in the sun.
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I was told to keep dry, take as cool of showers as you can stand and use dial non scented soap. Also bring a change of socks. In the military I changed socks about 3 times a day.

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