When most people think about sports, they think about competition, teamwork, dedication and team spirit. Rarely do athletes consider that they could be exposed to infections ranging from athletes foot to serious skin conditions that could bench them, disrupt team dynamics and jeopardize their health. With proper diagnosis and treatment, skin infections do not have to sideline athletes or hinder their performance.
Speaking at the 64th annual meeting of the AmericanAcademy of Dermatology, dermatologist Brian B. Adams, MD, MPH, associate professor in the department of dermatology at the University of Cincinnati in Ohio, discussed the importance of early recognition, diagnosis and treatment of skin infections to minimize downtime and prevent team epidemics.
Athletes are particularly susceptible to skin infections because of several factors including skin-to-skin contact with other athletes and athletic equipment, increased sweating which can impair the main barrier of the skin and susceptibility of skin trauma, said Adams. It is important to recognize the signs of infection or other skin problems so they can be treated quickly and efficiently to minimize loss of training time for athletes and sometimes, entire teams.
Skin problems can differ from sport to sport and athletes at all levels, from Olympians to weekend warriors, can experience skin infections related to their sport. One of the most common infections found in many sports is impetigo. A superficial infection of the skin, impetigo particularly affects athletes with skin-to-skin contact like wrestlers, and rugby and football players. Impetigo, which is characterized by yellow, crusted, well-defined lesions, responds well to topical or oral antibiotics. Infected areas and lesions should be bandaged or infected athletes should not practice or compete until treatment has been determined effective.
Impetigo is highly contagious and can spread rapidly through teams or competitors, said Adams. In many states, a physicians note is required before wrestlers diagnosed with impetigo will be allowed to compete again.
Another common skin infection is herpes simplex, which also is transmitted by skin-to-skin contact. Studies show that wrestling and rugby athletes are particularly susceptible, having a 33 percent chance of transmission. Herpes simplex causes blisters and sores anywhere on the skin. The highly contagious infection needs to be quickly detected and treated to prevent transmission to other team members or competitors. Treatment consists of warm compresses and antiviral agents.
A major challenge with herpes simplex is that many athletes are infected with the virus before skin lesions are visible. Athletes can take oral antiviral agents daily during the season to prevent contracting herpes simplex. Adams warns that if the virus is left untreated, there can be unnecessary complications.
Athletes who have contracted the virus should refrain from skin-to-skin activity for approximately four to seven days following the beginning of treatment, said Adams.
Another contagious infection is furunculosis, an infection characterized by the presence of furuncles or deep sores of the skin, which are also called boils. Furunculosis has caused epidemics among high school, college and even professional teams. It is commonly seen in football players at the site of turf burns and is more common in certain positions, for example a lineman is 10 times more likely to be affected than a quarterback because they tend to have more contact with the turf. Treatment is typically a warm, moist compress applied three to four times daily for 10 minutes at a time and oral or topical antibiotics, though a physician may need to drain larger boils. Without treatment, the boil will likely heal in 10 to 20 days.
A fourth infection, tinea corporis gladiatorum, also known as ringworm, is one of the most common infections in wrestling and has caused epidemics, infecting between 24 to 77 percent of a team. This infection appears on the head, neck and extremities as a well-defined, red, scaly patch. Treatment options include the use of both topical and oral antifungal agents and athletes can take an oral antifungal agent weekly to prevent contracting the infection during their sports season.
Athletes, wrestlers in particular, are advised to refrain from their sport for five days after beginning treatment to ensure the infection is not transmitted to other athletes, said Adams.
Athletes depend on their feet for most of their movement and need to pay special attention to keeping their feet healthy. One type of infection of the foot is pitted keratolysis, also known as sweaty sock syndrome. This infection can be caused by wearing tight or restricting footwear and excessive sweating during exercise. The infection is characterized by craterlike pits on the surface of the feet and toes, particularly weight-bearing areas. Treatment consists of the application of topical antibiotics.
The best prevention is to wear breathable shoes and socks, and to remove sweaty footwear immediately after exercise, recommended Adams.
Another foot infection is plantar verruca, or foot warts, which occurs most often in swimmers, rowers and cross-country runners. This infection can be transmitted via the shower or locker room floor and can sometimes take months to grow large enough to be noticed. Plantar verruca is treated surgically, though other topical agents may be a preferred method of treatment in order to minimize the loss of training time for the athlete. Adams emphasized that the best prevention is for athletes to wear sandals in locker rooms and showers, and to keep their feet dry.
One of the most common infections in both serious and recreational athletes is tinea pedis, commonly known as athletes foot. It is often seen in soccer and basketball players, swimmers and runners, and can be contracted through contact with pool, locker or shower room floors or as a result of wearing tight or restricting footwear and excessive sweating. The contagious infection is characterized by scaly patches on the skin between the toes or with redness, scaling or dryness on the foot. In some cases, it can be characterized by pimples or itchy blisters on the feet.
Anti-fungal creams are an effective treatment and can often relieve symptoms fairly quickly, stated Adams. For more severe cases, doctors may need to prescribe antifungal pills. Adams recommends wearing sandals on wet floors in pool and shower rooms and wearing breathable socks. Drying agents such as foot sprays or powders also can be applied to feet before exercise to help prevent excess moisture.
Sports-related infections can cause serious complications and even epidemics which sideline entire teams. To reduce risk of infection, athletes should practice basic hygiene, know the infection risks inherent to their sport, recognize signs of infections quickly and seek proper treatment, said Adams. Sports are meant to be enjoyed and treating infections quickly can keep athletes and teams playing at their best.
Source: American Academy of Dermatology