Minor Athlete Infections and Other Annoyances: How to Prevent and Treat Them

From herpes to jock itch to jogger’s nipples, a tour of an athlete’s chamber of little horrors

From the WebMD Archives

As a child, I never would have guessed I'd one day be paid to type the phrase "jock itch."

Actually, I'm sort of surprised now as an adult to find that jock itch, and its southerly cousin athlete's foot, still exist. There's something sort of quaint about these and other minor locker room infections - they seem to belong in the moldering realm of short shorts and tube socks that marked our fathers' Saturday mornings at the Y. Surely today's athletes, with their x-treme cross trainers and x-treme energy bars, needn't worry about such musty old athlete infections. Anyway, that's what I thought.

I was wrong. For athletes who manage not to concuss themselves on the goalpost or collapse in a heap on the football field, a host of thoroughly non-fatal minor infections wait in the wings. Some can be a genuine pain in the, well, jock. Others are better filed under irritation. But all bring little leaguers and professionals alike to the doctor each season.

As Joanna Badger, MD, assistant clinical professor of dermatology at Stanford, tells it, the world's wrestlers are first in line.

Herpes gladiatorum: Wrestlers, that would be you

Herpes gladiatorum, as the name suggests, is "not at all uncommon with wrestlers," Badger says. "There are sometimes epidemic outbreaks throughout a whole team. My friend's a wrestler, and I'm always giving him something for herpes."

The infection is spread through close skin-to-skin contact, and results in a herpes simplex rash generally found on the shoulders, arms, neck, and face. (It happens enough that the National Collegiate Athletic Association has looked into ways of addressing its impact on wrestling.) Antiviral medications can speed up its subsidence, but generally, there aren't many preventive options besides watching for rashes and scrubbing those mats.

Impetigo: You again, wrestlers

Having dodged herpes, the wrestler often must contend with impetigo. More common in children, this skin infection is also spread via the close contact that wrestling rather depends on. Keeping the mats clean is, again, the best prevention. Failing that, the red sores that appear eventually start to ooze and will generally disappear on their own in a couple of weeks. They can also be treated with antibiotics.

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Ringworm, athlete’s foot, and jock itch: Equal opportunity infections

The now somewhat sickly sounding wrestling community will be relieved to hear that yet another common minor infection, tinea, dabbles freely in many sports. (Between October 2004 and April 2005, a French judo team saw 49 of its 131 members infected.) The tinea infection - also known as ringworm - is fungal, not viral or bacterial, and includes athlete's foot and jock itch. Damp, warm, and dark areas of skin are most receptive to tinea, as are teens and adult men. The infection announces itself with an itchy and sometimes scaly rash. Keeping clean and dry is the best prevention; clothing made from natural fibers also can help. Antifungal creams and lotions are the typical treatment.

What is it about sports that invites all this dermatological distress? Of course benchwarmers possess no special immunity - but athletes are made particularly susceptible to minor infections like these by a perfect storm of sweat, friction, skin contact, and heat. These factors contribute to non-infection problems, too.

Folliculitis, friction blisters, and jogger’s nipples

Watch what you wear, Badger says. For starters, folliculitis, an inflammation around the hair follicle, can "come from the continued wearing of wet clothing after exercise. The follicle provides an entry route for bacteria into the skin." Workout garb can also contribute to friction blisters, Badger says, another typical complaint. The feet get it worst, and a properly fitted, activity-appropriate shoe will minimize the irritation. Taking the prize for most memorably named, "jogger's nipples" is a common reaction to chafing - putting on an adhesive bandage will often help.

Onychodystrophy, or toenail abnormality

When they're not worrying about their nipples, runners have their toes to guard.

"Toenail abnormality, or onychodystrophy, can be brought on by the trauma of running," Badger says. "The toe is forced into the toe of the shoe, separating the nail plate from the nail bed. It's often confused with toe fungus."

Because onychodystrophy is the result of repeated minor trauma to the nail, sports doctors recommend trimming toenails regularly and not lacing shoes too tight. In extreme cases, surgery is the only treatment.

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Swimmer’s hair and sunburn

Even your hair isn't safe in the sporting life. "Swimmer’s hair," that Kermit-esque tint often seen in blond swimmers, is generally attributed to chlorine. In fact, look no further than the Statue of Liberty to get a sense of what's happening to their locks - the small amount of copper in the pool causes the green. Wetting one's hair before diving in can minimize the amount of pool water that gets absorbed. If the greenery is already in place, however, a hydrogen peroxide rinse is the easiest way to get it out.

Of course, that other hue frequently found on athletes - bronze - is far less trivial. Regular exposure to the sun is perhaps the least addressed and most serious of these sports-related health issues. Even on cloudy days - and this, like airplane seatbelt instructions, must be repeated long after we know it by heart - sun block is essential to prevent sunburn and sun damage to the skin.

"I guess frostbite is another exposure risk for athletes, but I don't think all that many are out practicing in the freezing cold," Badger says.

Lest the world of sports start to sound positively terrifying, a little practical advice is in order. "Sports injuries are underneath the radar screen of 99.9% of the general public," says David H. Janda, MD, director of the Institute for Preventive Sports Medicine. Janda can rattle off a frightening list of possible sports related traumas, but his most important take-home message is a simple one: Stay alert, because even minor afflictions like the ones described here deserve attention.

WebMD Feature Reviewed by Jonathan L Gelfand, MD on June 01, 2007

Sources

SOURCES: Joanna Badger, MD, assistant clinical professor of dermatology, Stanford University. National Collegiate Athletic Association Sports Sciences Safety Subcommittee of the Committee on Competitive Safeguards and Medical Aspects Of Sports. Sports Medicine Advisor, University of Michigan Health System. Mayo Foundation for Medical Education and Research. Eurosurveillance. The Cleveland Clinic, Department of Patient Education and Health Information. National Library of Medicine: “Skin Diseases of Football and Wrestling Participants.” American Medical Society for Sports Medicine. Tanzi, E. and Scher, R. The Physician and Sports Medicine, September 1999; vol 27(9). David H. Janda, MD, director, Institute for Preventive Sports Medicine.

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