Preventative Skin Care Tips for Athletes
Infections of the Skin In Wrestling:
A. Herpes Gladiatorum or Mat Herpes: This infection is transmitted to a wrestler when there is contact of the skin of a non-infected person that comes in contact with an active cold sore on an infected person. This form of herpes is usually caused by the herpes simplex 1 virus (HSV1). Approximately 75% of the general population has, or carries HSV1. HSV1 is a permanent infection that, when not visible or active on your skin (usually around the mouth or on the face), it is living dormant in the dorsal root ganglia of your nervous system. The dorsal root ganglia are the parts of nerves right where the nerves come out of the spinal column itself. The HSV1 virus lives here dormant until some stressor, trauma, burn, sunburn, or damage to that particular nerve ending takes place. At that point, the virus itself replicates along the nerve and goes to the end of the nerve and causes what is commonly referred to as a cold sore. Cold sores usually look like little blisters on a slightly pink base. They usually last about 10 days untreated and less if treated at the first sign of infection. Treatment needs to be initiated within the first 72 hours of onset of a new cold sore in order to decrease the duration of that particular cold sore.
The reason HSV1 is an important and dangerous communicable disease in wrestlers are several fold: 1. Once you are infected, you are infected for life. There is no known way to completely clear this infection from your body. 2. The virus will repeatedly make sores on your skin (usually in the same nerve distribution as the original infection) for the rest of your life–usually in the same place. 3. Once you are infected, you are then infectious any time you have an active cold sore. 4. If a wrestler were to get this infection in the eye, it can sometimes lead to permanent blindness and is an emergency. 5. There are disease associations with HSV1 that are just beginning to be discovered that have long-term implications.
How can I prevent getting infected with HSV1 as a wrestler: Hopefully all individuals who have an active herpes infection will be discovered at weigh-in, but if you see crusting or blistering around the lips or mouth or nose of a fellow wrestler, bring this to the attention of your coach. Also, never kiss anyone—even the cutest girl ever— when you or she has an active cold sore; or the rest will be history.
B. Staph or Methicillin Sensitive Staph. Aureus (MSSA) and Methicillin Resistant Staph. Aureus (MRSA): Staphyloccocus Aureus, or Staph. Aureus is an increasingly common and very contagious bacterial infection. MRSA is a now common strain of Staph. Aureus that is resistant to many antibiotics and can be quite invasive at times. Small children who live with people who are infected with MRSA are susceptible to getting a particular form of pneumonia that can prove fatal if not treated early and adequately.
Approximately 25% of people are “carriers” of one form or another of staph. aureus in their nostrils. These people do not usually show any signs of infection, but are carriers of the bacteria and can actively spread it to others. In my clinical experience I have found a very high rate of people who carry staph. aureus in those who experience a crack or cut inside of their nose—on the septum—that never seems to heal. The person will usually think that the inside of their nose is just too dry and attributes this cut to that. In actuality, this is often a sign of staph. carriage in the nose. Of those people who carry staph. in their noses, sometimes they will show signs of infection and sometimes they will not. Lets discuss the signs of infection other than this crack or cut in the nose.
1. Folliculitis: this is an infection that looks a lot like acne, but is usually in locations that acne wouldn’t necessarily be; i.e. the buttocks, thighs, and trunk AS WELL AS the places where acne is commonly found; the face, chest and upper back. One clue to a folliculitis infection caused by staph. aureus is that it will usually be a little 1-2mm bump filled with pus at the tip (a pustule) and a small rim of pink around the pustule. Sometimes this rim of pink can spread and spread leading to deeper, more dangerous infections like cellulitis (infection of the fat) and erysipelas(infection of the soft tissue). Folliculitis can be caused by other organisms like strep, pityrosporum (a yeast), demodex (a mite) and other bacteria, but Staph. aureus is by far the most common organism that causes folliculits.
2. An abscess, carbuncle or furuncle: These are localized, deeper skin infections that are filled with fluid, pus and dead tissue. An abscess is a single, larger infected lesion and furuncles and carbuncles are usually more numerous and smaller than an abscess. The lesions themselves can be quite painful, can drain, and can be locally destructive and can spread to elsewhere in your body. The treatment of choice of an abscess (usually a single lesion) is to incise and drain the lesion and to wait for it to heal. It is a good idea to do other “decontamination” as I will discuss later. Furuncles and carbuncles usually require systemic treatment with antibiotics.
3. Exacerbation of eczema: there are many forms of eczema, but two forms in particular (nummular dermatitis and atopic dermatitis) are exacerbated when there is too much staph. aureus on the skin. Both of these forms of eczema usually require some treatment of the staph. to get the eczema to clear. If there is any crusting, scabbing, oozing are brighter pink to the eczema, this is often a sign that it is “superinfected” with Staph. and needs to be addressed.
Read More: Staph. Infection Prevention Tips
C. Impetigo: This is a superficial skin infection of Strep. or Staph. Aureus. It can be easily confused with a herpes infection as they can look very similar. Impetigo is most commonly seen around the mouth and on the face. It looks like a little crusty sore; we often describe it as a honey-colored crust. Sometimes it can blister just like herpes making it something that should be evaluated by a dermatologist. It is extremely contagious and can be associated w. systemic problems if not treated.
Prevention: Same as that for staph. aureus above…and do not ever touch it. If you happen to touch it, wash your hands!
D. Fungal Infections: Fungal infections include the following: athlete’s foot–also called tinea pedis, ring worm (a localized infection of the skin anywhere on the body)—also called tinea corporis, jock itch (or tinea cruris), tinea captitis (infection in the scalp, Majocchi’s granuloma (a deeper skin infection caused by a fungus) and onychomycosis (infection of the finger or toe nails). All of the mentioned infections are contagious and are treatable. These infections in general are less dangerous if they are contracted than those listed above. Of note, the diagnosis of “ring worm” is often made with the problem is really eczema or any number of other skin diseases and it is best to have a well-trained dermatologist determine what the problem really is. Some of these infections can be treated with over the counter anti-fungal products (not Majocchi’s granuloma or onychomycosis or tinea capitis).
Prevention: If you have a fungal infection in your toe nails or have athlete’s foot, do not use your towel to dry off your feet and then to dry off your body…or you will spread it to other parts of your body. Interestingly, some people are just not prone to fungal infections and this is most likely due to the genetics of their immune systems.
E. Warts: Warts are caused by the human papilloma virus and they too are quite contagious. Most warts that are found on the body are caused by common strains of the virus. Some strains of the virus can cause genital herpes and are also known to cause many types of cancer. Warts are usually quite responsive to treatment. Please see our site on the many treatment modalities that are available.
Prevention of Wart infection and prevention of spreading of warts: Don’t touch anyone else’s warts and don’t pick at or bite your own warts. The act of biting your warts can introduce the virus into your mouth and throat. Recently, over 50% of throat cancers have been found to have wart viruses IN the tumors…this should be a great motivation not to bite your nails! If you are a nail biter and have warts on your fingers, the warts usually get worse and more embedded around the nails from this and become extremely difficult to treat.
F. Molluscum Contagiousum: Molluscum Contagiousum (MC) is caused by the Pox Virus. The Pox Virus is in the same family as the Smallpox virus, but instead of causing Smallpox, it causes molluscum….a pox infection that can scar. Children are most commonly infected with MC, but adults can have it sometimes as well. It is caused by skin to skin contact between a molluscum on an infected person and the skin of a non-infected person. It can also be transmitted via a fomite (any object that was touched by skin that had the virus on it). When left untreated, molluscum can sometimes take up to years to clear on its own. At Alpine Dermatology, we are able to treat you in the office usually in one or two visits and you will be free of molluscum in a matter of days rather than months or years.
Prevention of Molluscum: Avoid touching people or things that have touched the skin of infected people. It is very common to see molluscum after going to the public swimming pool and sitting on a bench there. Sit on your own clean clothing when in public places. Don’t make contact with the skin of someone who has molluscum.