Background

Chafing is skin irritation due to repetitive friction. This may arise from contact between skin and skin or skin and clothing, especially during prolonged periods of exercise. The moisture from sweat makes skin more susceptible to chafing. Common areas of chafing seen in athletes include inner thighs, armpits, and the groin. “Runner’s nipple” is commonly used to specifically describe chafing of the nipples from repeated rubbing against upper body clothing. This is most commonly seen in male long distance runners wearing shirts made of hard fibers, such as cotton, after long runs in cool climates. Female runners less commonly suffer nipple chafing due to protection from soft padding in sports brassieres.

Symptoms

• Pain, stinging and burning
• Itching
• Inflammation and swelling
• Cracking of skin
• Bleeding

Sports Medicine Evaluation and Treatment

A sports medicine physician will review your symptoms and may ask about the type of sports activity performed, as well as clothing material worn during exercise. He or she will also look at the area of the skin irritation.

Treatment of chafing, including runner’s nipple, involves cleaning the area with soap and water, thoroughly drying and applying lubricating ointments like petroleum jelly or steroid ointment such as hydrocortisone to relieve inflammation. Occasionally, drying agents such as talcum and alum powder are used. In some cases, antibiotic ointment such as erythromycin may be needed.

Injury Prevention

Wearing dry and well-fitting clothing made of soft semi- synthetic or silk-type fabric, and applying lubricating ointment or petrolatum can prevent chafing by reducing friction. Shorts that cover the mid-thigh can help ward off thigh chafing. Preventative dressing can be worn by those susceptible to chafing over the shoulder area. Nipple chafing can be prevented by running without a shirt or wearing soft fabric shirts and avoiding those with rubberized logos. Furthermore, runners can place a mechanical barrier, such as circular pieces of adhesive tape, bandage or lubricating ointment, over nipples prior to exercise. Women are advised to wear brassieres composed of semi-synthetic material.

Return to Play

Although chafing does not usually require any interruption of sports activity, without treatment it can be a source of discomfort, distraction, and embarrassment for an athlete.

AMSSM Member Authors
Clifton L. Page, MD and Meredith Turner, MD

References
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