Health

Skin Condition for Athletes

Brian Adams, MD, Assistant Professor, Department of Dermatology, University of Cincinnati School of Medicine, and Chief of Dermatology, VA Medical Center, Cincinnati, Ohio, discussed the prevalence and treatment of skin conditions that can result from engaging in athletic activities, such as infections, blisters, abrasions, rashes, acne, and sunburns.

Perhaps the most serious conditions that can afflict athletes are the various infections caused by bacteria and viruses transmitted by skin-to-skin contact with other athletes or athletic equipment.

"Athletes are particularly susceptible to infections for a variety of reasons," said Dr. Adams. "Sweating softens and impairs the skin’s main barrier of the body, the stratum corneum. Athletic equipment obstructs the skin, thereby creating a warm and moist environment for microorganism growth. In addition, athletes often suffer from skin trauma such as cuts or scrapes, which facilitates the entry of microorganisms."

Types of bacteria, known as gram positive bacteria, can infect athletes and cause impetigo and folliculitis. Impetigo is a contagious skin condition characterized by yellow, crusted, well-defined lesions. Wrestlers, rugby players and football players are more at risk for developing impetigo because of the close skin-to-skin contact inherent to these sports.

"Infected athletes should be isolated if the lesion cannot be bandaged," said Dr. Adams. "In many states, wrestlers will not be able to compete unless a physician has made a specific note that the particular lesion is not contagious."

Clean gear and equipment is important, not only to get rid of the stink or make the gear last longer, but more importantly to keep you healthy. Dirty gear and equipment is a breeding ground for fungus, mold, and bacteria. Methicillin-resistant staphylococcus aureus (MRSA) is appearing more and more and can be attributed to unhealthy gear.

What is MRSA?

MRSA is a type of Staphylococcus aureus (S. aureus). Staphylococcus aureus, often referred to simply as "staph," are bacteria commonly carried on the skin or in the nose of healthy people. Some S. aureus are resistant to the class of antibiotics that are frequently used to treat staph such as methicillin-and thus are called methicillin-resistant S. aureus(MRSA).

Who gets MRSA?

S. aureus (staph) including MRSA can be spread among people having close contact with infected people. MRSA is almost always spread by direct physical contact and not through the air. Spread may also occur through indirect contact by touching objects (e.g., towels, sheets, wound dressings, clothes, workout areas, or sports equipment) contaminated by the infected skin of a person with staph bacteria or MRSA.

Just as S. aureus can be carried on the skin or in the nose without causing any disease, MRSA can be carried in this way also. This is known as colonization. MRSA infections are usually mild, superficial infections of the skin that can be treated successfully with proper skin care and antibiotics. MRSA, however, can be difficult to treat and can progress to life-threatening blood or bone infections because there are fewer effective antibiotics available for treatment.

MRSA infections occur commonly among persons in hospitals and healthcare facilities. However, MRSA can cause illness in persons outside of hospitals and healthcare facilities as well. Cases of MRSA infection in the community have been associated with recent antibiotic use, sharing contaminated items, having recurrent skin diseases, and living in crowded settings. Clusters of skin infections caused by MRSA have been described among injecting drug-users (1,2); aboriginals in Canada (3), New Zealand (4) and Australia (5,6); Native Americans in the United States (7); incarcerated persons (8); players of close-contact sports (9,10); men who have sex with men (MSM); and other populations (11-17). Most of the transmission in these settings appeared to be from people with active MRSA skin infections.

How do I know if I got MRSA from the community or from a healthcare setting?

Persons with MRSA infections that meet all of the following criteria likely have community-associated MRSA (CA-MRSA) infections:Diagnosis of MRSA was made in the outpatient setting or by a culture positive for MRSA within 48 hours after admission to the hospital. The patient has no medical history of MRSA infection or colonization The patient has no medical history in the past year of: Hospitalization Admission to a nursing home, skilled nursing facility, or hospice Dialysis Surgery The patient has no permanent indwelling catheters or medical devices that pass through the skin into the body.