Walking Well: Trail Medications

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Dermatological Treatments
For dermatological use I have found 1% hydrocortisone ointment (Cortaid, OTC) to be very useful for many skin conditions. (The 0.5% preparation is too weak and should be avoided.) Use it to treat irritation from chafing, rash, rectal irritation, non-blistered poison ivy, insect bites and stings, eczema, psoriasis, and other skin conditions. Cortaid is also useful as a lubricating ointment to prevent some skin conditions.

For athlete's foot, I believe that Tinactin ointment (OTC) works better than Desenex and that ointments are more effective than powders because they achieve more constant contact with the afflicted area. For scrapes and small cuts I find that New Skin is better than a Band-Aid. It is applied as a liquid and dries to form a film that covers and protects the wound, aiding healing. In areas of some friction and water exposure it should be applied as a double layer. In high-friction areas, a Band-Aid works better.

Anti-diarrheal Drugs
If backpacker's diarrhea strikes you while on the trail, you can take some Pepto-bismol, Imodium A-D (2-mg capsules, over-the-counter), or Lomotil (2.5-mg tablets, prescription required). A few pills of either of the latter two drugs will take care of the problem. When you get to town, see a doctor in case more treatment is necessary.

Vitamins
Vitamins may have a place on the trail. With the problems of food weight and selection, it is possible to develop a moderate dietary deficiency. Recent medical reports suggest that vitamin E and related antioxidants may protect against myocardial infarction. For either indication, it would not be irrational to take a multivitamin capsule daily, just in case.

Specific Treatments for Preexisting Conditions
Hikers with pre-existing conditions should discuss their hike and medications with their doctor. Hikers with cardiovascular conditions such as hypertension or cardiac arrhythmias obviously should carry their standard medication. Hikers should take their aspirin prescribed for prevention of myocardial infarction.

If a prospective hiker has a CNS disease that is well-controlled, they should carry the specific drugs, such as anti-epileptics, anti-anxiety agents, and sedatives.

Similarly, hikers with endocrine or metabolic diseases should carry an adequate supply of their specific medication (for example, hormones, oral anti-diabetic drugs).

Supplying Medications While on Route

1. Carry a supply of a drug. Do this if you have a known condition or a history of need. Or:
2. Carry prescriptions from your physician that can be filled and/or refilled. However, be aware that if the illness starts on the trail, with no town nearby, the delay in starting treatment may allow it to progress, making it harder to treat successfully.

I carry a substantial supply of ibuprofen (which is easy to replenish), plus four Tylenol+codeine tablets, four Benadryl capsules, 4 days' supply of Dicloxacillin, a tube of 1% hydrocortisone (like Cortaid) ointment, a small plastic bottle of New Skin, small and medium Band-Aids, four Imodium capsules, and multivitamins. I put additional supplies in my equipment box (mailed ahead to each weekly mail drop).

The diseases mentioned here are only a selection of those that most commonly occur among hikers, and the list is obviously not meant to be exhaustive. The drugs singled out here are among those most frequently available in their classification. In most cases there are acceptable substitutes.