Gò0dNews for Women’s Health
Disney Rash ne of my patients recently sent a photograph of her lower extremities. She was on fall break in Florida and developed a rash of the inner calf regions. I reviewed the photographs and immediately asked if she was on vacation at Disney World. She confirmed that she was on vacation and had been to the Magic Kingdom the day prior and at Epcot that very day. One of the most common rashes reported from Disney guests is Exercise-Induced Vasculitis (EIV) and is what most people experience when they talk about the Disney rash or the Epcot rash. EIV is also commonly called Golfer’s Vasculitis because the doctor who published an early study on the condition started investigating it as a result of patients who complained of developing a rash on their lower legs and ankles while playing golf.
Most people are not accustomed to walking 5-10 miles in a single day. The venous return system is overwhelmed and not able to transport the venous blood back to the heart. This back up of venous blood causes venous stasis. The rash appears over the inner aspect of the lower extremities from the calf to the ankle and is related to extended periods of long distance walking or standing. People with varicose veins are more prone to developing the rash. Prolonged standing causes vein blood flow stasis. Blood flow backs up and pools in the lower extremities. The legs and ankles begin to swell. Fluid leaks from the veins and capillaries into the soft tissues. The swelling inflames the small blood vessels in the cells and causes red bumps to appear on the surface of the skin directly related to the areas of maximum swelling. This particular rash can be itchy. The reason that the rash doesn’t occur below the sock line is that socks and shoes provide compression that reduces edema and prevents damage to small blood vessels. In fact, compression stocking therapy is a mainstay in the prevention of Disney Rash. This type of rash is not contagious and typically goes away in about a week.
38 // November 2018
How to Avoid Exercise-Induced Vasculitis (EIV):
• Get walking! One of best things you can do is to begin regularly walking in the months prior to your trip to Disney; this will increase your stamina and you’ll enjoy the whole vacation more. • Drink Plenty of Water - It may seem counter-intuitive but drinking water will help reduce swelling. People sometimes decrease their water consumption in the parks because of the cost of bottled water and because Florida tap water has a strong taste. You can get a free cup of filtered ice water at any Disney quick-service restaurant. • Elevate your feet – Once swelling begins, you may be able to decrease it by raising your feet above your heart. • Take Aleve or Ibuprofen (Advil, Motrin) at the beginning of the day. In this case, you’re taking ibuprofen, which has anti-inflammatory properties, to reduce swelling, so take it in the morning, before you start walking in the parks. Consider repeating the dose throughout the day, per package instructions. • Wear Socks – Wearing taller socks or even compression socks will cover the skin and restrict swelling. • Cool the affected area – Cover affected areas with wet towels, get in the swimming pool, or even rub an ice cube over the area, if you’re still in the parks. • Alternate your activities – Look for things like shows, longer rides, and 3D movies that get you off of your feet and out of the sun in the theme parks.
What to Do If You Already Have the Rash
• Use a topical anti-itch ointment. They can give you an ointment at the first aid stands in the park or you can purchase an over-the-counter variety in a pharmacy. Some people swear by those blue, aloe “after burn” gels available in drug stores; others recommend calamine lotion. • Consult a doctor if you get worse or if the rash doesn’t begin clearing on its own in about a week, sooner if your symptoms progress or do not respond to conservative measures. • Consider formal ultrasound review to determine if you have significant venous reflux and varicose veins.
About The Author
O
by Dr. James White
Dr. James E. White is a board-certified General Surgeon by the American Board of Surgery and is a Fellow of the prestigious American College of Surgeons. His office, Advanced Surgical Concepts (ASC) is located at 2290 Ogletree Ave, Suite 112 in the Hamilton Office Park across from the Hamilton YMCA. ASC offers a variety of cosmetic procedures including varicose vein procedures, laser skin resurfacing, facial fillers, minimal invasive surgery and liposculpture. 423-6484011 or visit www.advsurgical.com for a complimentary consultation.