Skin Infections in Athletes

Brian B Adams

Disclosures

Expert Rev Dermatol. 2010;5(5):567-577. 

In This Article

Five-year View

The advancement of the field of sports dermatology in the next 5 years looks promising. Coaches, trainers and sports medicine clinicians increasingly understand the importance of optimizing treatment and prevention regimes. Furthermore, the number of studies examining the epidemiology, treatment and prevention of skin infections among athletes continues to increase. Unfortunately, many critical questions remain unanswered and not all stakeholders currently acquire the education to make ideal decisions for their athletes.

Heightened awareness and education of the clinicians who primarily care for athletes signify the cornerstones of eliminating sports-related skin infection epidemics. Dermatologists must commit to the education of primary care sports clinicians and their fellows, as well as athletic trainers and the students of the field. While these sports clinicians possess different types of medical training, they interface closely with myriad athletes on a day-to-day basis. Through this dermatologist-led education, these sports clinicians' diagnostic and therapeutic approaches will improve, thus ultimately averting skin infection epidemics.

Local high schools, universities and fellowship training programs also need dermatologists to not only dedicate time to teaching, but also offer consultative services for complex cases. Ultimately, athletic communities, even those below the collegiate level, will need to invest time and energy in identifying local dermatologic experts who can provide leadership. This 'grass roots' educational and clinical care effort must evolve in the next 5 years to result in a successful assault on cutaneous infections in athletes.

Evidence-based recommendations for the detection, treatment and prevention of skin infections are long overdue. Clinicians need a rapid, universally available, cost-effective test for the herpes virus that will both correctly identify uninfected wrestlers as safe to compete and disqualify infected athletes. Large, multicenter trials need to determine both the optimal treatment regimes and the number of days until the athlete can safely return to practice and competition. Small studies have documented the effectiveness of pharmacologic prevention of tinea corporis gladiatorum and herpes gladiatorum at the individual level; however, larger, multicenter trials are needed to confirm these results and help optimize dosing regimes aimed at prevention for not only the individual, but also the teams and leagues.

The issue of asymptomatic scalp carriers of tinea corporis gladiatorum needs clarification and requires examination of potential topical and oral regimes to prevent its transmission. Standardization of the pharmacologic treatment and prevention plans will necessarily decrease the vagaries that often exist in the care of the athlete with skin infections.

Sports dermatology continues to blossom as the interest in exercise expands. With attention to education, research and clinical care in the next 5 years, the epidemics of sports-related skin infections of the past 10 years will become mere memories.

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