Athletic skin afflictions: Sports cause inflammation, traumatic events and fungal infections

August 1, 2008

A wide variety of athletic pursuits can result in various skin problems, ranging from fungal conditions to inflammatory issues. Some can easily be mistaken for other skin conditions, and physicians should make themselves aware of what to look for.

Key Points

Tucson, Ariz. - Whether it's from running, bicycling, swimming or playing tennis, there is likely a skin-related condition that can send an athlete to the dermatologist.

Conditions range from inflammatory afflictions to traumatic events, and, of course, the combination of moist sweat and heat makes the athletic body a perfect Petri dish for fungal growth.

And the more popular the sport, the more common the condition.

Tennis players actually aren't the only ones who can develop the condition - runners, racquetball players, basketball players or players of any other sport that can send the toe jamming into the edge of the shoe can develop tennis toe, says Richard Hoshaw, M.D., a dermatologist in private practice in Tucson, Ariz.

"We see a lot tennis toe," Dr. Hoshaw says. "Often, if a tennis player or other athlete is wearing shoes that are loose-fitting or have a hard toe, the toenail will be jammed against the end of the shoe.

"That causes a little hematoma under the toenail, turning the toenail black and sometimes causing quite a bit of pain," he says.

If the condition is particularly painful and a lot of fresh blood has accumulated under the toenail, a small hole can be made in the toenail to allow the blood to escape, but if the blood has hardened, the condition needs to just run its own course, Dr. Hoshaw says.

Cases that are not severe will often heal on their own.

One way to prevent tennis toe is to keep the toenails well-trimmed and making sure shoes fit properly and are laced up well, he says.

Fungal infections

Tinea pedis, or fungal infections of the feet, are also common among athletes who spend a lot of time sweating in shoes.

Patients should be advised to wear shoes that breathe or have air holes in order to prevent such problems.

Another fungal infection that can be seen in athletes is tinea versicolor, which typically involves the chest and back.

"Tinea versicolor seems to like to grow on skin that gets hot and sweaty, so any kind of athlete - or even just people who go to the gym and work out a lot - can get it," Dr. Hoshaw says.

"It's the continuous hot, moist skin that keeps the fungus growing," he says.

The condition presents as spots on the skin that could be white, brown or pink, and treatment can include a topical antifungal.

The condition could be confused with various other problems, Dr. Hoshaw tells Dermatology Times.

"If it is white, it could be mistaken for vitiligo, or if it's brown, it might just look like an irritation of the skin. And if it's the pinkish type, it could be misread as some kind of dermatitis," he says.

If the skin develops a fine scale, diagnosis may be easier. "If possible, we'll take a little scraping of that skin with a potassium hydroxide preparation and look at it under the microscope," Dr. Hoshaw says.

Fungal infections can show up in bicyclists as well, and those who ride for long periods of time can develop the fungal condition intertrigo.

"We do see people with fungal or yeast infections of the groin or just irritation of the groin from bicycling," Dr. Hoshaw says.

"For prevention, we'll have them use a dry powder or just put on Vaseline as a lubricant," he says.

While chlorine in swimming pools can dry out the skin, those who relax in the hot tub following a swim often expose their skin to much higher levels of the chemical.