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Skin Injuries Common Among Athletes, Expert Says

December 7, 1988

WASHINGTON (AP) _ Broken bones and strained muscles may worry athletes, but the more common sports injuries are skin problems such as ″black heel,″ ″bikini bottom,″ ″jogger’s nipples,″ and ″runner’s rump,″ a physician said Wednesday.

Dr. Rodney S.W. Basler, an assistant professor at the University of Nebraska Medical Center and a specialist in sports medicine, said the skin ″bears the brunt of the punishment″ from vigorous exercise and can develop injuries in unexpected ways.

″The percentage of people in fitness conditioning or good athletic programs who develop some types of skin problems is quite large,″ Basler said in an interview at the American Academy of Dermatology’s annual meeting. ″I wouldn’t be surprised if three-quarters or four-fifths of everybody in a fitness program has some type of skin injury.″

Most of the skin injuries will go away when the exercise is halted, and few represent any continuing problem, said Basler. But the injuries can cause irritation, pain and cosmetic concern.

Joggers and marathoners, whose skin must endure hours of punishment, are heir to a number of dermatological problems ranging from black heel to runner’s rump.

Black heel develops when constant flexing of the foot causes two layers of the skin, the dermis and the epidermis, to rub against each other in a shearing force, said Basler. This breaks small blood vessels and causes blood to pool between the skin layers, usually at the heel. The result is blackened skin.

The same problem can occur on the palms of baseball players, golfers, weight-lifters and mountain climbers, Basler said.

He said black heel will correct itself when the activity stops, but many patients seek treatment because they worry about cancer.

″Runner’s rump″ is a discoloration at the base of the spine, where the buttocks come together. The doctor said it is a pigmentation change caused by the friction of the buttocks rubbing against each other. The only concern, said Basler, is cosmetic.

″Jogger’s nipples″ is a more painful problem, usually experienced by men.

Basler said it develops among runners who wear shirts that are not soft. The friction of the cloth actually rubs the nipples raw. Few women experience the problem because they wear soft bras, he said.

″At the end of a marathon, you’ll see lots of men with blood stains on their shirt front because the nipples have been rubbed raw and are actually bleeding,″ Basler said. ″It’s surprising how big a problem this can be. It actually stops some people from running.″

Prevention is simple: wear a soft cotton undershirt, or cover the nipples with petroleum jelly or paper medical tape. Or run bare-chested.

Pool chemicals can cause swimmers to develop a variety of skin problems.

Basler said many pools use bromide instead of chlorine to control bacteria in the water. This can lead to a form of acne called ″bikini bottom,″ he said.

The ailment usually consists of acne-like pimples and nodules, most often on the backside.

″It looks very much like classic acne,″ said Basler, ″except it’s usually under the swimsuit.″

Treatment and prevention are both achieved by ″not sitting around in wet swimsuits,″ he said.

Basler said some patients who swim frequently also come to him because of light-colored hair that suddenly turns green.

The color change is a result of copper in the pool water that ″gives a real distinctive greenish tint to the hair,″ he said. The treatment is to bleach the hair with peroxide.

All athletes who spend hours exercising in sweaty sneakers can develop something that Basler calls ″toxic sock syndrome.″

The ailment is characterized by a strong foot odor and is caused by a bacterium related to acne that grows in the soft tissue of the feet. Left alone, it can cause pits to develop in the skin, he said.

Treatment is with over-the-counter acne medication containing benzoyl peroxide, and prevention is by using more absorbent socks and a foot powder.

Athlete’s foot, a fungal infection that can cause itching and cracking of the skin, remains one of the major skin problems of the locker room, the doctor said. Medication and care can clear it up for three months or so, but most people will get it again, he said, because the fungus takes advantage of a mild immune deficiency that many people have.

″It’s essentially an incurable problem,″ Basler said with a sigh. ″I’ve had it for 25 years myself.″

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