No matter what sport you participate in, your skills will be impaired if you suffer a skin injury. Seemingly minor skin irritations can greatly affect performance.
Among the more common nagging problems are blisters, athlete’s foot, rashes, acne mechanica, warts and sunburn.
“It has been observed at the U.S. Open that more participants go to the first-aid tent for skin problems than for all other problems combined,” said Dr. Rodney Basler, a dermatologist and assistant professor of internal medicine at the University of Nebraska Medical Center, Omaha. Basler is a former chair of the task force on sports medicine for the American Academy of Dermatology.
The first step in treating athletes’ skin problems is to prevent them in the first place, said Dr. Richard Ray, head athletic trainer and associate professor of kinesiology at Hope College in Holland, Mich., and the author of three books on athletic training.
“Prevention for most skin problems involves good hygiene. That means frequent washing and complete drying,” Ray said. “Skin bacteria, viruses and fungi are the three primary sources of infection for skin problems. All of them like to grow in moist, dark, warm places.”
Therefore, the more athletes can keep their skin dry, cool and exposed, the less chance they have of developing skin problems on the feet or in the folds of the body, particularly at the armpits and groin.
Basler said he is amazed at the number of women who go to their workout class in exercise leotards, then go shopping without changing. “It’s best to get out of your exercise clothes as quickly as you can,” he said.
Skin problems also can be prevented by easing into an activity so the body has time to adapt, said Tory Aggeler, head athletic trainer at Northwestern University in Evanston, who coordinates medical care for the school’s athletes. “And if you buy a new pair of shoes, ease into them as well by wearing them around first to let the body form calluses.”
Following are some common skin conditions and how best to prevent and treat them:
Blisters
“Blisters are the skin’s way of protecting itself when under conditions of high heat or pressure,” Ray said. They are perhaps the most common and problematic skin problem on the feet.
Aggeler, who sees a lot of blisters among Northwestern athletes, said it’s important that they not go untreated because they tend to be a skin disorder that’s easily infected.
“We’ve had student athletes end up in the hospital for intravenous antibiotics due to a staph infection,” he said.
Some people are more prone to blisters than others because of their foot type, Aggeler said. “People who have high toes or high arches are more prone to problems because their body weight and the friction aren’t spread out over as great an area. It tends to be more on the ball of the feet or on the heel.”
If someone already knows he is at risk, it’s better to prepare by putting special non-abrasive, self-stick foot pads on the feet, he said. “If you put a pad such as Compeed or Dr. Scholl’s on the hot spot, it will absorb the abrasive action of the shoe or sock rather than your skin absorbing it.”
To prevent blisters, it is also important to take particular care of your shoes and socks and to keep your feet as dry as possible.
“Anything that causes the feet to be wet [particularly sweating] makes them worse,” Basler said.
Have more than one pair of shoes that you can rotate, allowing time for the damp ones to dry. Ray emphasized that the shoes should be well broken in and fit well. If not, they’ll put direct pressure on the foot, allowing it to slide and creating friction or heat, which produces blisters.
Socks are equally important, said Basler, who works with the tennis team at the University of Nebraska and sees a lot of blisters. He says a sock such as the Thorlo brand is good because it’s highly absorbent and adheres well to the foot. “It also has a cushioning, non-slip design,” he said. He advises tennis players to put on fresh socks between sets.
Athletes can help to keep their feet dry by spraying them with an antiperspirant or using a foot powder before play, according to the experts. “And if there’s a spot you know is susceptible to blisters, you can use some Vasoline or a skin lubricant [to ease the friction],” Ray said.
If you feel a blister coming on but it hasn’t developed, Ray suggests putting ice on the irritated area or dipping it in ice water to cool the skin. “It’s actually the heat that causes a blister,” he explained.
Once the blister is there, you have to take action. A study of blisters at the University of California, Los Angeles, found that draining a blister three times in 24 hours will help it to heal faster. Do this by nicking it with a sterilized needle, but leave the “roof” of the blister intact, Basler said.
Ray believes it’s best to pad the blister to prevent it from becoming an open wound and susceptible to infection (signified by redness, puss, pain and warmth).
“But sometimes you have to lance it because you can’t walk on it–it hurts so bad,” he said. In that case, he advises that you cleanse it with antibiotic ointment.
If the top of the blister comes off, Basler said, cover it with a membrane-like dressing called Spenco 2nd Skin Blister Pads. Cover that with a sticky blister bandage by Nexcare called Coban, he added. (These products are available at pharmacies and medical-supply companies.)
Rashes
Miliaria, an itchy, red, bumpy outbreak on the skin, is a common rash that occurs in the sweat glands of athletes, Basler said. Temperature changes bring it out.
“Athletes will come in from a cold environment, then work out and heat up the skin, then cool off again and then go into the sauna,” he said. “The best prevention is to keep the skin cool; don’t let it get hot again.”
If you do get a miliaria outbreak, treat it with a soothing cream and sleep in a cool environment at night without a lot of covers.
Athlete’s foot
Sweat is the culprit here, too, as a result of athletes not changing their socks frequently. Basler said true athlete’s foot is a contagious fungal organism that penetrates when sweat breaks down the natural barrier of the skin. It almost always occurs in the toe web. If you can’t prevent it by keeping your feet dry, treat it with a spray such as Lamisil.
Another skin condition often mistaken for athlete’s foot is called pitted keratolysis, according to Basler. The skin looks like a punched-out sponge. “This is a bacterial rather than fungal infection and causes a particularly pungent odor.”
Because this organism is closely related to the organism that causes acne, it can be treated with over-the-counter medications such as Oxy 10, he said.
Warts
Warts are seen with some regularity among wrestlers and swimmers and are spread by person-to-person contact and from within the dampness of locker rooms. The contagion lives on the locker room floors, Basler said.
“Warts are caused by viruses most of us already have, and it’s just a matter of if they’re expressed or not,” Ray said. “They typically occur on areas of high pressure on the feet.”
The best way to prevent them is to regularly use foot powders or drying sprays such as antiperspirants. It is also important to wear sandals in the locker room or other public, high-traffic areas.
Warts are most commonly treated chemically by over-the-counter wart products but also can be removed by laser or cryosurgery. Ray warns, however, that they often recur.
Acne mechanica
Common among football players, acne mechanica comes from a combination of pressure, friction, heat and occlusion. It’s a problem in football because the shoulder pads, helmet and chin strap cover the parts of the body with the highest concentration of oil glands, Basler said. Women who wear exercise clothes around all day after working out also get this type of acne on their backs.
The best prevention is to use peeling agents such as Oxy 10 or Retin A to keep the pores unclogged, he said.
Sunburn
We all know what causes it but don’t do enough to prevent it, Basler said.
Especially delusional are golfers, who believe they can protect themselves with a hat. “Because of the reflection from down below, a hat gives you an SPF protection of 2, except for the part that’s specifically covered,” he said. “I’ve told my friends on the golf course that you get more protection under a 4 iron than you do with a golf visor.”
Preparing to play sports outdoors should be no different from getting ready for the beach. Apply sunscreen with an SPF of at least 15 one-half hour before play. Then reapply it every two hours if you’re sweating or otherwise every four hours. In addition, a full hat offers better protection than a cap.
“It all comes back to hygiene and preparation,” said Aggeler, who sees a big problem with sunburn at summer camps. “It’s always more difficult to battle these things after you let them get out of control than to do it in a preventive fashion.”
