Train wrecks

PUBLISHED : Tuesday, 07 August, 2012, 12:00am
UPDATED : Wednesday, 15 August, 2012, 11:05pm


Olympic athletes are usually the picture of health and well-being. But as a recent research paper published in the journal Sports Medicine notes, extensive training and environmental conditions can result in significant skin problems.

'Olympic athletes are vulnerable to traumatic, environmental and infectious skin conditions ... Common skin conditions can be harmful and even prohibitive for competition,' writes the research team, which was led by Dr Jacqueline DeLuca, of the University of Hawaii's school of medicine in Honolulu. DeLuca was a member of the US women's water polo team that won the bronze medal at the 2004 Athens Olympics.

The researchers reviewed all available studies on sports-related skin diseases among Olympic athletes up to January last year. They found that common causes of skin problems related to sports include infections, abnormal growths, inflammatory conditions, trauma and those brought on by environmental factors.

Pre-existing skin problems can also be aggravated by practice sessions and competitions. The researchers say this is especially problematic because the prevalence of eczema and atopy (a genetic predisposition to develop allergic diseases) are higher in the elite athlete population.

Skin conditions were most prevalent among the medical (non-injury) complaints at the 2004 Olympics, comprising 16 per cent of consultations.

In the report, the problems are grouped by the categories of Olympic sport. Here's a list taken from their study of the most common problems that would apply to athletes, particularly marathon runners, triathletes and swimmers.

Friction blisters

This is the most frequent complaint of marathon runners, affecting up to 39 per cent of them. Blisters usually occur in areas where the outer layer of skin is the thickest, such as the palms of the hands and soles of the feet. The most commonly affected sites are on the tips of the toes, balls of the feet and back of the heel.

Treatment: within the first 24 hours, a sterile incision and drainage at the edge of the blister, while carefully maintaining the blister roof, should be done. The blister roof acts as a dressing for quicker healing and lower infection rates. Moleskin padding may be used to minimise trauma and relieve discomfort.

Prevention: wear proper-fitting shoes and low-friction socks. Socks made of acrylic or polyester material are great for wicking away sweat and reducing moisture. Antiperspirants can also help, but may cause skin irritation.

Jogger's nipple

Up to 16 per cent of marathon runners experience this problem, which is usually caused by a tight-fitting, coarse cotton shirt. Repetitive friction can lead to painful irritation, fissures and bleeding.

Treatment: application of petroleum jelly or a topical antibiotic called erythromycin.

Prevention: wear clothes that reduce irritation, such as supportive jogging bras for women, and lycra or silk shirts instead of cotton ones. Cotton absorbs water, keeping the area moist and creating more irritation. Lubrication and protecting the nipples with surgical tape, bandages or breast shields can also help.


The condition is especially common in athletes, particularly runners. The two most common types of hives are cholinergic (brought on by hypersensitive reaction to body heat) urticaria and exercise-induced anaphylaxis (EIA). Itchiness and spots of skin swelling are symptoms of both conditions, though EIA is potentially life-threatening.

Sometimes, EIA can be brought on by eating food within four hours before exercise; other causes may be atopy, aspirin or Nsaid use, exposure to pollen, insect stings, extreme weather, humidity and menses.

Treatment: initial treatment should consist of antihistamines. Other treatments include avoiding exercise and triggers. For serious cases, get medical attention immediately.

Prevention: identify and avoid any provoking factors to prevent recurrences.

Athlete's foot

Almost all athletes are at risk of this condition, but more so those involved in running, swimming, soccer, water polo and basketball. Occlusive footwear is a major culprit as fungi thrive with sweat and wet, soft skin. For swimmers, the floor of swimming pool decks and locker rooms may be sources of infection.

Treatment: most cases are mild and can be treated at home with anti-fungal medication. Serious cases may require stronger medication prescribed by a doctor.

Prevention: wear moisture-wicking synthetic socks and change them regularly, keep the feet dry, wear well-ventilated shoes, use anti-fungal powder, and always wear sandals in the locker room and on the pool deck.

Skin cancer

Long training hours in the sun expose athletes to high levels of ultraviolet (UV) radiation, which is believed to be the most significant environmental risk factor for the development of melanoma and non-melanoma skin cancer. During an Ironman race in Hawaii, three triathletes were found to have an average personal UV measurement that exceeded the international exposure limits by more than 30 times. Six cyclists during the Tour of Switzerland race had a comparable measurement.

Sweating and sea or pool water can make matters worse: skin hydration, in general, increases its photosensitivity. Water and sweat can also wash away sunscreen and increase the risk of UV radiation.

Treatment: immediately seek doctor's advice.

Prevention: wear water-resistant sunscreen and sun-protective clothing. Try to train when sun exposure is low. Visit a dermatologist regularly.

Green hair

This is a problem for water sport athletes. Those with blond, grey or white hair are prone to pigmentation by copper ions in pools, which originate from the water's source, the pipes or algaecides. Physical and chemical damage to the hair, including sunlight and chlorinated water, also cause hair to turn green.

Treatment: use a shampoo that contains penicillamine, or hydrogen peroxide (2-3 per cent), or chelating agents.

Prevention: wear a cap and use a chelating shampoo.