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Expert Q&A: How Athletes Can Prevent Rashes

A dermatologist offers tips to help athletes avoid rashes and contagious skin infections.

Feb. 7, 2011 (New Orleans) -- Recent data show that contagious skin infections account for one in five injuries among college athletes and 8.5% of health problems among high school players.

Skin-to-skin contact and profuse sweating create an ideal environment for the spread of common skin conditions caused by bacteria, viruses, and fungi, says Brian B. Adams, MD, MPH, associate professor of dermatology at the University of Cincinnati School of Medicine.

At the annual meeting of the American Academy of Dermatology, Adams discussed some of the common skin conditions among athletes.

What are some of the common bacterial infections among team players?

The three most common bacterial infections are folliculitis, which appears as pus bumps; boils; and impetigo, characterized by honey-colored crusted, red areas which may be itchy. Occasionally, blisters may occur. 

The diagnoses are often missed as all three can masquerade as other common disorders: folliculitis as acne, boils as bed bug bites, and impetigo as lupus or eczema.

What's causing all these infections?

Many are caused by MRSA, a "super-staph" bacterium that causes infections that are resistant to common antibiotics such as methicillin, penicillin, amoxicillin, and oxacillin. In a recent survey of nine Ohio high school gyms, 20% of doorknobs and 90% of mats tested positive for MRSA.
Football players are at greatest risk for MRSA infections due to a variety of factors: shared towels and soaps, body shaving, turf burns, and even ingrown toenails.

What about viral infections?

One that is easily transmitted is the herpes simplex virus. It typically causes blisters and sores around the mouth, nose, genitals, and buttocks, but they can occur almost anywhere on the skin, especially in athletes.

Wrestlers who spar with an infected partner have a one in three chance of contracting herpes simplex, so it is crucial that the virus is treated and athletes avoid competition during the period of infection.

What about fungal infections?

Tinea corporis, better known as ringworm, is a fungal infection that develops on the top layer of the skin and is characterized by an itchy, red circular rash with clear skin in the middle. Early in the disease, the lesions do not acquire the classic ring shape and appear as relatively red, round lesions. Most commonly, the lesions appear on the head, neck, and upper extremities and develop after skin-to-skin contact with an affected person. Again, this infection is particularly common among wrestlers.

Topical and oral antifungal medications are effective in clearing ringworm, so athletes should have any unusual lesions on their skin checked out immediately.

Another common fungal infection among athletes is athlete’s foot. This particular fungus grows best in dark, moist, and warm environments, making sweaty feet enclosed in athletic shoes prime targets.

Some people may experience peeling, cracking, or scaling between the toes; others may have redness, scaling, or dryness on the soles and along the sides of the feet. Many individuals often mistake athlete’s foot for dry skin.

To reduce the spread of this fungus, wear moisture-wicking socks; cotton socks trap moisture and should not be worn by athletes. After working out or competing, athletes should shower immediately and make sure they wear flip-flops in the shower or locker room.

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