Q: Over Thanksgiving my family and I went to Disney World. I developed a rash on my legs, and the clinic I went to in Orlando said it was “Disney Rash” from walking so much in the heat. Is this a real thing?

A: Yes! I have heard of this being called Disney rash, EPCOT rash, hiker’s rash and golfer’s rash, among other names. The first article I found on this was from 2005 where it was proposed to call this golfer’s rash (vasculitis) to make it more known to the public, so that is what I will refer to it as in today’s column.

Golfer’s rash is a red/purple blotchy/spotty skin lesion, typically above the ankles (usually it involves just the lower leg’s calves and shins, but it can go all the way to the thighs) and typically affects both legs. It is not usually itchy or painful and does not usually blister, but can cause some swelling, most often noticed around the ankles. So basically, it looks worse than it feels. It is thought to be a vasculitis (‘inflammation’ of the blood vessels) caused by an irritation of the blood vessels from exercise, heat and/or humidity (things that cause ‘overheating’ of the legs).

Golfer’s rash can affect anyone, but it most commonly affects otherwise healthy women (it is more common in women than men) over age 50. The typical history is that it occurs in someone who is on vacation or doing some activity (golf, hiking, etc.) and ends up walking more than they normally would on a hot, humid day and then notices a rash on their legs. The rash is visually obvious, but there is a lack of other symptoms as noted above. The rash will typically last days to weeks, so often ‘doesn’t get better’ until after they are home.

I could not find data on how common this condition is, likely because it is under-reported as most people just wait for it to resolve, which is does, on its own. Despite this lack of data, golfer’s rash is thought to be a pretty common condition.

There are many possible conditions that can cause a rash on the lower legs, and when people get golfer’s rash they are often suspicious that it is an allergic reaction (even though it does not typically itch) or some other condition. Before golfer’s rash was known to ‘be a thing’, some people underwent allergy testing and other tests to diagnose this condition. However, if the history and symptoms are consistent with golfer’s rash, it is likely best to simply observe the rash for any changes and to allow it to resolve over time (typically days to a couple of weeks).

Having had golfer’s rash is a risk factor for getting it again. Once again, I could not find any hard medical evidence to support suggestions to avoid developing this condition, but as it is thought to occur because of increased activity in hot, humid environment, preventing sweating and ‘overheating’ is thought to minimize developing this rash. Hence recommendations include wearing breathable, comfortable shoes, considering wearing breathable, comfortable gentle compression socks, using aloe or other lotions (or applying a damp, cool cloth during the day), or other techniques to keep the legs cool.

One the rash develops, the most effective treatment is time (that is, wait for it to resolve on its own), as well as elevating and resting your legs in a cool environment (that is remove the suspected causes of the condition to allow it to heal on its own). If there are other symptoms, or any complications develop, it is a good idea to see your healthcare provider to be sure the rash is not due to some other condition.

Jeff Hersh, Ph.D., M.D., can be reached at DrHersh@juno.com