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Athletic Skin Infections
Avoiding and treating them

Even the strongest athlete can be affected by common skin problems. Some infections are just a nuisance and do not cause any serious harm. Others can be quite serious, even life threatening.

Fungal infections

Fungal (tinea) infections commonly affect skin, hair and nails. These infections can show up anywhere on the skin. They thrive in warm, moist areas, often developing between the toes (as ‘athlete’s foot’ or tinea pedis), the armpits or the groin (as ‘jock itch’ or tinea cruris).

Direct skin contact, as in wrestling, can spread tinea infections from person to person. Dogs, cats and farm animals also carry tinea. As well, fungi grow on damp surfaces like shower floors and locker rooms. Those with chronic diseases affecting the immune system, such as diabetes and HIV, are at greater risk of infection.

How would I know if I have a fungal infection?

Tinea infections of the body and toes usually spread out in an irregular circle-like pattern with a well-defined red, scaly border. The central area is clear and looks normal. As the infection has a worm-like appearance, it is often called ‘ring worm.’ However, it is not actually caused by a worm. The area is usually itchy. Tinea infections of the scalp (tinea capitis) cause red itchy patches and often leave bald spots.

Fungal infections of the nails (onychomycosis) can make finger or toenails thick, discoloured, and misshapen. The nail may be brittle, and many toes can be affected.

Since other skin infections can look like a fungal infection, your doctor should confirm diagnosis and start appropriate treatment. Sometimes, a scraping of the skin or nail may be needed to decide whether a fungus is causing the problem.

How are tinea infections treated?

Most skin and scalp tinea infections are easily treated with anti-fungal creams that can be put on the skin. Nail infections usually require two to three month courses of oral medication. Recently, a medication that can be brushed onto the nail was developed.

It is rare to become seriously ill, since the body can usually control a fungal infection. In fact, people often don’t even realize they have had one because the body heals itself. Tinea infections do not usually leave scars after the fungus is gone.

Can I prevent tinea infection?

You can reduce your risk of getting a fungal infection by using the following strategies.

• Dry your skin carefully after bathing, especially between toes and in the groin and armpit areas.
  
• Wear loose fitting clothing and underwear. Natural fibres like cotton or synthetic fibres that wick away moisture are best.
  
• Do not share towels, hairbrushes, combs, or sports equipment that is worn against the skin.
  
• If you have diabetes, keep good control of your blood glucose.
  
• Check your pets (or have your vet check) for areas of hair loss and possible tinea.
  
• To prevent athlete’s foot:
  • Change your socks daily.
  • Alternate shoes, allowing each pair to dry completely between wearing.
  • Avoid walking barefoot in shared shower areas and locker rooms. Wear sandals or water shoes.
    
  • Take your shoes off at home to allow your feet to dry.

CA-MRSA infections

Recently, outbreaks of methicillin-resistant staphylococcus aureus (MRSA) infections have affected athletes. It is important to understand why these infections happen and how to prevent them.

Many healthy people carry the common bacteria staphylococcus aureus, or ‘staph,’ on their skin or in the nose. Staph can cause minor skin infections that heal without antibiotic treatment. More serious staph infections of the skin, lung or blood usually clear up with standard antibiotic treatment. However, some staph infections, such as MRSA, do not respond to routine penicillin-like antibiotics.

MRSA infections usually affect people in hospital or who have poor immune system function. However, a number of recent MRSA outbreaks affected young, healthy individuals outside of health care facilities. These cases are called Community-Acquired MRSA, or CA-MRSA.

Such infections in athletes including football and rugby players, wrestlers and fencers are of particular concern. Athletes may be at higher risk of CA-MRSA infections because of small cuts or sores, frequent skin-to-skin contact, and contact with infected sports equipment and towels.

What are the symptoms of a CA-MRSA infection?

Staph skin infections, including CA-MRSA, typically start with the usual signs of infection. The area is painful, swollen, red and warm to the touch. As the infection progresses, it can turn into a deep and painful abscess, which may need draining. There may be fever, chills, and a general unwell feeling.

If left untreated, the infection can penetrate deeper into the body, causing infections in bones, joints, bloodstream, heart and lungs. These can be life threatening.

How are CA-MRSA infections treated?

CA-MRSA infections are resistant to antibiotics such as penicillin, cloxacillin and methicillin. They are treated with antibiotics like clindamycin or vancomycin. If infection is very serious, antibiotics may be given intravenously, in a solution injected directly into a vein.

How can I prevent CA-MRSA infections?

Prevent the spread of MRSA infection by using the following guidelines:

Good personal hygiene

• Clean hands by frequently washing with soap and water or using an alcohol-based hand sanitizer.
  
• Shower and wash with soap after all practices and competitions.
  
• Use pump soap dispensers and avoid bar soap.
  
• Do not share personal items such as towels, razors, tooth or hairbrushes, and sports equipment.
  
• Clean shared sports equipment regularly, preferably before and after use.
  
• Check skin regularly for cuts and scrapes.

Wound care

• Keep cuts and scrapes clean and covered with a bandage until healed.
  
• If a wound cannot be covered adequately, do not participate in contact sports.
  
• Avoid contact with other people’s wounds and bandages.
• A coach, team trainer or parent should help monitor the healing of a wound. If there are signs of an infection, or if infection continues after a standard antibiotic has been tried, see your doctor.

By taking care to avoid skin infection and getting medical attention if you need it, you can stay in top form.