Common Skin Problems from Sports

Participating in sports is part of a healthy lifestyle, but there are a number of skin conditions that can result from these activities and hamper performance and enjoyment. Exercisers are prone to skin problems caused by increased moisture or friction or damaging elements like cold, sunlight, and infection. Common weather-related problems include frostbite, dry skin, sunburn, and fever blisters. Many of these can be prevented by keeping the skin dry, clean, and protected.

Foot odor, for example, is largely due to bacteria that thrive in a moist environment. Jock itch (tinea cruris) and athlete's foot (tinea pedis) occur more often in moist conditions. Wear socks that are made of absorbent synthetic material to keep your feet drier, change your socks frequently. After exercising, wash and dry your feet, and air out your feet and your shoes between activities. To help avoid jock itch, keep the skin in the groin area as dry as possible. Work out in loose underwear and pants. Bathe and change into clean clothes as soon as possible.

A boil is a skin infection, usually of a hair follicle, caused by common bacteria. Wrestlers are particularly susceptible to boils because as they sweat, their skin comes in contact with athletic mats -- which may harbor bacteria when they are not properly cleaned after use -- or other wrestlers who can transmit the infection. Boils should not be squeezed, as this will spread the infection. While warm compresses can relieve the pain, athletes should see a dermatologist if the boil does not drain by itself.

Those prone to fever blisters should apply a sunscreen-containing lip balm before going outdoors and then reapply it frequently. Very susceptible people may wish to consult their doctor about preventive drugs like acyclovir.

Acne Mechanica
Acne mechanica is a form of acne seen in athletes that is a result of heat, pressure, occlusion, and friction. It usually occurs in areas such as the shoulders, back and head that are covered by protective gear. Tight synthetic clothing or equipment such as helmets and shoulder pads are primary culprits of acne mechanica in football and hockey players. Prevention and treatment of acne mechanica include obvious measures such as wearing a clean T-shirt made of cotton or a material that whisks away moisture against the skin or underneath a uniform, washing the affected areas immediately following athletic activity, and applying a keratolytic solution -- such as one containing salicylic acid and resorcinol -- directly to the rash.

Blisters
Most athletic activities include movements that may cause the skin to develop heat and friction against athletic equipment: tennis rackets, shoes, oars or paddles, etc. Compounded by perspiration, this friction commonly results in blisters that can be quite painful and diminish the athlete's ability to compete.

To prevent blisters, athletes should keep the skin well lubricated to help reduce friction. Tennis players often use petroleum jelly on their feet, and a study in the August 1998 issue of the Journal of the American Academy of Dermatology found that applying antiperspirant on the bottom of feet prior to athletic activity may actually prevent blisters. Foot powders and spray antiperspirants that contain aluminum chlorhydrate or aluminum chloride are inexpensive ways to decrease moisture. Nightly application of prescription-strength 20% aluminum chloride hexahydrate (Drysol) provides more effective drying.

Another preventative step to avoid blisters include wearing acrylic socks rather than cotton socks because they actually eliminate friction and whisk perspiration away from the skin, keeping it as dry as possible. Padded insoles can help decrease friction in a specific area. Layering of socks or special double-layered socks can minimize shearing forces. You can also carry extra pairs of socks to change into if your socks become too damp.

Buy shoes specific for a sport. When trying on shoes, be sure to wear the same socks, insoles, or orthotic inserts that you wear when playing or working out. Try on shoes in the afternoon or evening, because feet tend to swell during the day. Walk or jog around the store before buying them and then wear the shoes around the house for 1 to 2 hours to identify any areas of discomfort. It often helps to break in shoes by wearing them for 1 to 2 hours on the first day and gradually increasing use each day. Shoes should fit comfortably, with about a thumb's width between your longest toe and the end of the shoe. Narrow shoes can cause blisters on the big toe and little toe. A shallow toe box can lead to blisters on the tops of the toes, while loose shoes can create blisters on the tips of the toes.

The same principles of reducing friction apply to hands. Wear gloves if practical, tape areas that are prone to blisters, apply powder or antiperspirants to help keep hands dry, and increase physical activity gradually to help keep blisters away.

Blister Care
You can treat the vast majority of blisters yourself and need to call a doctor only if blisters become infected, recur frequently, form in unusual locations, or are very severe. Signs of infection include pus draining from the blister, very red or warm skin around the blister, and red streaks leading away from the blister.

Small, intact blisters that don't cause discomfort usually need no treatment. Nature's best protection against infection is a blister's own skin, or roof. To protect the roof, this type of blister can be covered with a small adhesive bandage if practical. Larger or painful blisters that are intact should be drained without removing the roof. First clean the blister with rubbing alcohol or antibiotic soap and water. Then heat a straight pin or safety pin over a flame until the pin glows red, and allow it to cool before puncturing a small hole at the edge of the blister.

Drain the fluid with gentle pressure, then apply an antibiotic ointment such as bacitracin with polymyxin B (double antibiotic ointment) or bacitracin alone. Avoid ointments that contain neomycin because they are more likely to cause an allergic reaction. Finally, cover the blister with a bandage. Change the dressing daily -- more frequently if it becomes wet, soiled, or loose.

Blisters with small tears are treated the same as those that you have punctured. Blisters with larger tears should be "unroofed" carefully with fine scissors, and the base should be cleansed thoroughly with soap and water or an antibacterial cleanser. Apply antibiotic ointment and bandages as described above.

When you have a blister you may need to additional padding to protect it, especially when you get back into the game. Ring-shaped pads made of felt will protect small blisters. Larger blisters may require dressings. Some of the many available dressing materials are DuoDerm, Spenco 2nd Skin, Vigilon, and Opsite.

Sunburn . Perhaps one of the most damaging effects of participating in outdoor sports is the threat of overexposure to ultraviolet (UV) light, which can lead to skin cancer and premature aging. Baseball, golf and tennis players often play during the midday sun, when the sun's damaging rays are the strongest. Several bad sunburns during childhood may predispose a person to skin cancer. Skiers and hikers also need to be aware that the higher the altitude, the faster they will develop a sunburn. 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 midday sun from 10 a.m. to 4 p.m. whenever possible.

Treatment of green hair includes applying a 2-3% hydrogen peroxide solution and leaving it in the hair for 30 minutes to remove the color. Also effective is the use of commercial chelating agents applied after swimming, which will solve the problem without bleaching the hair.

  Sources:
1. Common Skin Problems From Sports Can Sideline Athletes if Left Untreated. October, 2000 The American Academy of Dermatology.
2. Ramsey, M.L. 1997 Skin Care for Active People. The Physician and Sportsmedicine Vol. 25 No. 3.
3. Ramsey, M.L. 1997 Avoiding and Treating Blisters. The Physician and Sportsmedicine Vol. 25 No. 12.

Each year, Medical College of Wisconsin physicians care for more than 180,000 patients, representing nearly 500,000 patient visits. Medical College physicians practice at Children's Hospital of Wisconsin, Froedtert Memorial Lutheran Hospital, the Milwaukee VA Medical Center, and many other hospitals and clinics in Milwaukee and southeastern Wisconsin.