Playing With Skin Problems Isn't a Game
by American Academy of Dermatology
NEW ORLEANS – While we all know that Olympians spend years of training to compete in their sport, what we may not realize are the countless skin conditions they’ve battled over the years as a result. But these conditions do not affect only full-time athletes, but recreational athletes as well. What many athletes themselves may not realize is that although sports offer many positive health benefits, they can cause a number of common skin conditions that – if left untreated – can significantly impact an athlete’s performance.
Speaking at the American Academy of Dermatology’s 2002 Annual Meeting in New Orleans, dermatologist Brian Adams, MD, Assistant Professor, Department of Dermatology, University of Cincinnati School of Medicine, and Chief of Dermatology, VA Medical Center, Cincinnati, Ohio, discussed the prevalence and treatment of skin conditions that can result from engaging in athletic activities, such as infections, blisters, abrasions, rashes, acne, and sunburns.
Infections
Perhaps the most serious conditions that can afflict athletes are the various infections caused by bacteria and viruses transmitted by skin-to-skin contact with other athletes or athletic equipment.
"Athletes are particularly susceptible to infections for a variety of reasons," said Dr. Adams. "Sweating softens and impairs the skin’s main barrier of the body, the stratum corneum. Athletic equipment obstructs the skin, thereby creating a warm and moist environment for microorganism growth. In addition, athletes often suffer from skin trauma such as cuts or scrapes, which facilitates the entry of microorganisms."
Types of bacteria, known as gram positive bacteria, can infect athletes and cause impetigo and folliculitis. Impetigo is a contagious skin condition characterized by yellow, crusted, well-defined lesions. Wrestlers, rugby players and football players are more at risk for developing impetigo because of the close skin-to-skin contact inherent to these sports.
"Infected athletes should be isolated if the lesion cannot be bandaged," said Dr. Adams. "In many states, wrestlers will not be able to compete unless a physician has made a specific note that the particular lesion is not contagious."
Athletes who use hot tubs and whirlpools during rehabilitation can contract a condition known as hot tub folliculitis. Typically, this condition becomes apparent within two days after exposure to infected water and is marked by red or green pustules or papules that appear on any submerged skin surface. Risk factors for developing hot tub folliculitis, which usually resolves by itself in seven to 10 days, include inadequately chlorinated water, prolonged exposure in the spa, hot temperatures, and skin abrasions.
One of the most common types of infections that can occur in wrestlers is a fungal infection known as tinea corporis gladiatorum. Characterized by well-defined, red, scaling plaques located on the head, neck and upper extremities, tinea corporis gladiatorum epidemics have been reported in numerous wrestling teams ranging in prevalence from 24 percent to 77 percent. While both topical and oral antifungal agents have been used to treat this infection, athletes are advised to refrain from wrestling for 10 days after treatment to ensure the infection is not transmitted to other athletes from skin-to-skin contact.
Wrestlers and rugby players can also be infected with the herpes simplex virus from skin-to-skin contact and equipment that harbors the virus. The herpes simplex virus, which often causes blisters and sores, is quite contagious. This infection, called "herpes gladiatorum," must be quickly detected and treated to prevent its transmission to other team members.
"Once the virus is detected, athletes usually are advised to refrain from skin-to-skin activity until approximately four to seven days following the beginning of treatment – providing that the lesions are resolved by then," explained Dr. Adams. "If the virus is left untreated, complications can result and more athletes are put at risk unnecessarily."
Blisters, Abrasions and Rashes
Since playing sports involves a considerable amount of movement and athletic equipment that can cause friction to the skin, many athletes develop blisters. Heat, moisture, and poorly fitted shoes increase the risk for blister development.
"While blisters may not seem like a serious problem, they can have a considerable effect on agility," said Dr. Adams. "Oftentimes, basketball players are sidelined due to blisters on their feet that inhibit their ability to run up and down the court quickly."
To prevent blisters, athletes should keep their skin well lubricated to help reduce friction and decrease moisture. Good fitting shoes are critical in preventing blisters, as are acrylic or other synthetic socks that are designed to decrease friction and wick away moisture.
Another condition caused by friction that occurs in runners is known as "jogger’s nipples." Constant chafing between a runner’s nipples and his or her shirt, particularly during long runs, can lead to painful crusted lesions that often bleed and show through a runner’s shirt. To prevent jogger’s nipples, dermatologists recommend applying petroleum jelly, patches or adhesive tape over the nipples prior to long runs. Semi-synthetic or other soft-fiber bras and shirts may also help prevent jogger’s nipples.
Rashes can also form on parts of the body that rub against athletic equipment or come into direct contact with bacteria. For example, adhesive tape, rubber in athletic shoes, underwater masks, bathing caps, balls, equipment handles, and protective goggles can cause allergic contact dermatitis in athletes. Non-allergic equipment is available for athletes susceptible to rashes.
Acne Mechanica
Acne mechanica is a form of acne seen in athletes that is a result of heat, pressure, occlusion and friction. This type of acne usually occurs on areas of the body that are covered by protective gear, such as the shoulders, back and head. Tight clothing or equipment such as helmets and shoulder pads can result in acne mechanica in football and hockey players.
Although acne mechanica does not respond well to typical acne treatments, a keratolytic solution – such as one containing salicylic acid and resorcinol – applied directly to the rash can be effective.
"The best thing an athlete can do to help prevent acne mechanica is to shower immediately after practice or competition," explained Dr. Adams. "Wearing moisture-wicking clothing under a uniform or protective gear can also help."
Sunburns
Athletes who spend a considerable amount of time practicing and competing outdoors are at risk of overexposure to ultraviolet (UV) light, which can lead to skin cancer and premature aging. In addition to athletes who are outdoors during the intense midday sun, skiers and hikers need to be especially cautious – research finds that the higher the altitude, the faster a person will develop a sunburn.
To ward against skin cancer, the American Academy of Dermatology recommends that everyone wear a broad-spectrum sunscreen with an SPF of 15 or higher – even on cloudy days, wear protective clothing, and avoid the sun from 10 a.m. to 4 p.m. when the sun’s rays are the strongest.
"Athletes can reduce their risk of becoming affected by these common skin conditions by practicing basic hygiene and making sure their equipment and shoes fit properly," said Dr. Adams. "Sports are meant to be fun, but the risks they pose to the skin should be taken seriously."
Press release issued by
American Academy of Dermatology
www.aad.org
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Last modified: 07/28/03
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