What is it?
There are many types of skin conditions that can affect athletes. Some can be passed on to others and are caused by infections, while others are not. Sports that are at higher risk of infections include football and wrestling. The infections can be caused by a virus (Herpes simplex virus), fungus (“ringworm”), or bacteria, such as in methicillin-resistant Staphyloccus aureus (“MRSA”) infections or in impetigo. Some infections can be passed from skin-to-skin contact, while others can be passed by touching a contaminated surface. Athletes are at a higher risk of skin infections due to frequent close contact, having open wounds, poor hygiene practices, and sharing towels or equipment. It is important to know which type of infection an athlete has because some infections can still be passed to others even after the skin is covered.

Symptoms
Most skin infections start out with the athlete noticing a new rash or lesion on his or her body. The rash may be itchy, painful, swollen, or reddish in color. Some rashes have a unique pattern, such as ring worm, which usually has a raised, circular area with a clear area in the middle. Impetigo can have a “honey-crusted” appearance. Some infections might start out looking like a bug bite or pimple. It is possible that the athlete could have a fever with a skin infection as well.

Sports Medicine Evaluation and Treatment
It is important that the athlete report any new skin rash to the athletic trainer, coach or parent, in order to help decide if they need to see their doctor. If there is any concern of a skin infection, the athlete should be referred to a physician.  When the athlete is seen by the doctor, it is possible that the diagnosis can be made by the appearance alone.  Sometimes a scraping or sample of the rash needs to be taken and sent to the lab for confirmation. Depending on the type of infection, the athlete may need to use a topical cream or take a medication. Some infections that have swelling and pus may need to be drained.

Injury Prevention
There are several ways that athletes can prevent skin infections. They should keep wounds covered. Athletes should shower immediately after participation and before using a whirlpool or other shared area. Their uniforms should also be washed and dried after each use. All athletes should report possible infections to their coach, athletic trainer, school nurse, other healthcare providers or parents as soon as possible.

Return to Play
The athlete can return to play once the infection has been treated and symptoms related to the infection have resolved. There are guidelines for high school and college sports that state how long treatment is needed before the athlete can return to sport, depending on the type of infection. These guidelines are the strictest for wrestling due to the frequent skin contact. The athlete might need to have a form filled out by their athletic trainer or doctor to allow them to return to play.

AMSSM Member Author: Kris Fayock, MD

Reference

5 Steps to Take if You Think an Athlete Might Have a Skin Infection. Centers for Disease Control Website. http://www.cdc.gov/mrsa/community/team-hc-providers/index.html. Updated September 10, 2013. Accessed April 15, 2014.