Athlete Rashes: Fungal, Bacterial, and Viral, Oh my!

I always thought the “job hazards” of sports participation were orthopedic injuries and concussions. Did you know that athletes have a whole set of common skin infections? I didn’t until I started working at KidMed. Disclaimer: I am not an athlete. The big three athlete rashes fall into the big three skin infection categories: fungal, bacterial, and viral.

 

Fungal: Ringworm

 

Don’t let the name fool you. Ringworm is not actually a worm. It’s a fungus that lives on the surface of the body, and “eats” the keratin cells in skin, hair, and nails. It’s diagnosed clinically, which means we don’t really need to do a test to decide if a rash is ringworm. Most people will recognize it. The technical name is tinea corporis, and it can infect the feet, groin, face, or hands.

 

It’s spread by direct contact, which is why wrestlers are particularly prone to this infection. Ringworm causes a round or oval, scaly, itchy patch. It spreads centrifugally, and as it grows out the center clears. I sometimes have a hard time telling the difference between ringworm and eczema. But in an athlete, with a new itchy, round patch, it’s almost always fungal.

 

Topical antifungal creams, once or twice a day, for one to three weeks will knock a simple ringworm infection out. You know to stop the cream once the rash clears up. If the infection is super widespread, or on the scalp, an oral antifungal is more effective, but these drugs have more side effects.

 

Bacterial: Staph (or strep) infection

 

Once again, these athlete rashes are spread by direct contact. Seeing a trend here?? The bacteria gets into breaks in the skin, and then goes crazy. Under the skin is warm, moist, and dark, which is the perfect breeding ground for bacteria. The immune system also has a difficult time reaching this space, so it’s the perfect storm for an athlete rash. I typically see bacterial skin infections as cellulitis, an abscess, or impetigo. I’ve written about impetigo before, so I’m just going to focus on cellulitis and abscess.

 

Cellulitis is a more generalized infection, while an abscess is localized. Cellulitis is warm, red, and swollen skin with pretty easy-to-see borders. An abscess is a painful pus pocket, and may or may not be surrounded by cellulitis. If the infection has pus, it’s almost always going to be staph, but if there isn’t pus it’s typically strep.

 

Just opening and draining it can treat a single, small abscess. Outside of this, though, cellulitis and multiple abscesses require antibiotics.

 

Viral: Herpes gladiatorum

 

This one always freaks the teenagers out. HSV-1, or herpes simplex virus type 1, is the “cold sores” herpes. It can get under the skin and cause a rash. In athletes, particularly wrestlers and rugby players, the rash typically shows up on the face, neck, and arms. It is a vesicle on a swollen red base. Basically, it’s a fluid-filled bump, like a small blister, with a red halo. Athletes with herpes gladiatorum should not participate in their sport until the entire rash has crusted over. Antiviral medications can speed healing of the initial outbreak, as well as recurrent outbreaks.

 

All of these infections can lead to lost playing time, scarring, and rashes that keep coming back. Treatment works, but it’s really much better to prevent athlete rashes in the first place, don’t you think?

 

  1. Wash those hands – this should go without saying, but please, wash your hands with soap and water and/or an alcohol hand sanitizer.
  2. Wash your body – take a shower as soon as possible after your sport. Use soap and water, and don’t share towels.
  3. Wash your clothes – wash your clothes, equipment, and towels after every use with detergent and hot water. Don’t let these bugs hang out on your stuff.
  4. Keep it covered – if you have a cut, scrape, scratch or other break in your skin, keep it covered. Remember, all of these athlete rashes take up residence under your skin, so cover the weak points!

 

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