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Acne and Sport: What’s the Connection?

Active people of all ages can develop sports acne, but acne caused by sports activity is usually easy to prevent and treat.

Chest acne caused by friction
The most common type of sports acne is friction acne, which occurs where tight clothing or straps holds sweat against the skin.

Summary:

  • Men and women and boys and girls of all ages can get acne associated with sport activity1.
  • The most common kind of sports acne is acne mechanica, or friction acne.
  • Friction acne occurs wear tight clothing or straps holds sweat against the skin. The irritation caused by the sweat increases sebum production in pores, which then produce whiteheads, blackheads, and pimples.
  • Tight chin straps, jock straps, brassieres, and wetsuits can cause friction acne.
  • The most important thing to do to prevent friction acne is to take a shower as soon as possible after getting sweaty while working out or participating in sports.
  • Cotton causes less friction acne than Lycra.
  • Benzoyl peroxide is useful for treating sports acne. Many people who cannot use benzoyl peroxide on their faces get good results when they use it elsewhere on their bodies.

Acne Mechanica and Athletic Activity

Medical texts usually refer to acne due to sport as acne mechanica, or friction acne2. This form acne can occur in elementary school children and in senior citizens, and in active people of all ages in between.

Friction acne is not due to wearing away of skin, although it can occur on patches of skin that have been chafed by tight or rough clothing. This kind of acne is primarily due to the trapping of sweat underneath tight fitting clothes, straps, or pads. The sweat provides a medium for growing bacteria, and the bacteria irritate the skin and clog pores3. Whiteheads, blackheads, and, when a pore becomes infected, pimples follow.

Sports acne pops up in unusual places. Women may break out around their breasts when brassieres are too tight. Men may break on the groin under tight jockstraps. Sports acne often breaks out on the neck and shoulders under pads, and on the chin and jawline under straps for hats and helmets. Even the feet can break out in acne when shoes or socks are too tight.

People Who Are Especially Sensitive to Sports Acne

People who have oily skin and black skin tones are especially susceptible to sports acne caused by heat. Wearing tight athletic uniforms in hot or humid conditions causes serious acne breakouts all over the torso and possibly even the buttocks and groin.

People who have Japanese skin types often get pimples after they have allergies to elastic. Those who are allergic to melons, papaya, fish, or latex get especially severe sports acne when they work out in heat and humidity wearing uniforms that are fitted too tight.

Divers and cold-water surfers often get all-over acne when they wear tight wetsuits. Japanese skin types are extra sensitive to this problem.

What to Do to Prevent Sports Acne

The obvious way to prevent sports acne is to wear the loosest clothing possible in athletic events4. Women who experience breast swelling just before their menstrual period should adjust their bras accordingly. Men should use sweat-absorbing5 powders under jock straps. Cotton is preferable to Lycra. Helmets should be taken off when the sport permits to relieve tension on the neck and chin6.

If you wear a wetsuit, it is important to have a fit at the neck that keeps water out of the suit, but that does not “hug” the skin. The neck is especially prone to acne mechanica when wearing a wetsuit. Wetsuits that are flexible and buoyant will help you swim better, and also reduce friction on the skin. Wetsuits become looser with wear, so it is a good idea to use a wetsuit for short periods to “break it in” before using it for a longer event.

What to Do to Treat Sports Acne7

The most important thing you can do to treat sports acne is to shower immediately after your event—especially if it involves a wetsuit. Rinsing your skin stops the inflammation caused by contact of sweat on skin. Gently rubbing your skin with a shower mitt while you shower removes any dead skin cells that clog pores after you towel off.

It also helps to moisturize8. Chafed skin is often dry skin. Applying a light, alcohol-free moisturizer to areas of skin where your athletic uniform fits tight can accelerate healing of the skin and also help keep dead skin out of pores.

Japanese scientists have made a study of acne on the feet. Lotions containing9 eucalyptus can treat acne on top of the foot as well as athlete’s foot between the toes. Foot acne is most common in type 2 diabetics, and in people who wear tight-fitting shoes that do not allow the skin of the feet to dry.

Benzoyl Peroxide for Sports Acne

Many people just can’t use benzoyl peroxide for treating acne10 on their faces. Even the 2% concentration of benzoyl peroxide will make their skin itch, peel, and turn red. The more commonly prescribed 5% concentration is out of the question.

Those same people, however, often get good results from benzoyl peroxide treating pimples on the neck, shoulders, back, chest, and groin. The key is to apply just a dot of benzoyl peroxide on a pimple surrounded by unbroken skin. Never apply benzoyl peroxide to chafed, scratched, or cut skin. Clean the skin first, and wear white clothing over the area you have treated with benzoyl peroxide. This acne treatment can bleach clothing and hair.

Benzoyl peroxide only works on pimples. It is not helpful for whiteheads or blackheads, and it does not kill the bacteria that cause impetigo or staph infections. If you do have a problem with “pimples” that ooze clear yellow pus, commonly caused by staph bacteria you pick up in a locker room, use tea tree oil.

It takes at least 10% tea tree oil to kill staph bacteria11 on contact. The best way to make sure you are getting this concentration of tea tree oil is to buy pure tea tree oil—not some skin care product that just smells like tea tree oil—and apply directly to the infected area with a clean cotton swab you only use once. Throw away the cotton swab immediately after you use it to avoid infecting other parts of your body.

Body washes made with calendula also help fight staph and impetigo. The first time you use any product, test a tiny dot of the product on the skin of your inner forearm. Leave the product there a few hours to make sure it does not cause inflammation or redness. If it does not cause an adverse reaction on your arm, it is probably safe to use on the rest of your body.

References:

  1. Emer J, Sivek R, Marciniak B. Sports Dermatology: Part 1 of 2 Traumatic or Mechanical Injuries, Inflammatory Conditions, and Exacerbations of Pre-existing Conditions. J Clin Aesthet Dermatol. 2015 Apr;8(4):31-43.
  2. Basler RS. Acne mechanica in athletes. Cutis. 1992 Aug;50(2):125-8.
  3. Mazhar M, Simpson M, Marathe K. Inner thigh friction as a cause of acne mechanica. Pediatr Dermatol. 2019 Mar 18.
  4. Hudson A. How I Manage Acne in Athletes. Phys Sportsmed. 1983 Sep;11(9):116-20.
  5. Reichel M, Laub DA. From Acne to Black Heel: Common Skin Injuries in Sports. Phys Sportsmed. 1992 Feb;20(2):111-118.
  6. Debra Rose Wilson C. Butt acne: Home and natural treatments for folliculitis. Medical NewChularojanamontri L, Tuchinda P, Kulthanan K, Pongparit K. Moisturizers for Acne: What are their Constituents? J Clin Aesthet Dermatol. 2014 May;7(5):36-44.
  7. Botros PA, Tsai G, Pujalte GG. Evaluation and Management of Acne. Prim Care. 2015 Dec;42(4):465-71. doi: 10.1016/j.pop.2015.07.007. Epub 2015 Oct 23.
  8. Chularojanamontri L, Tuchinda P, Kulthanan K, Pongparit K. Moisturizers for Acne: What are their Constituents? J Clin Aesthet Dermatol. 2014 May;7(5):36-44. \
  9. Goh CL, Noppakun N, Micali G, Azizan NZ, Boonchai W, Chan Y, Cheong WK, Chiu PC, Etnawati K, Gulmatico-Flores Z, Foong H, Kubba R, Paz-Lao P, Lee YY, Loo S, Modi F, Nguyen TH, Pham TL, Shih YH, Sitohang IB, Wong SN. Meeting the Challenges of Acne Treatment in Asian Patients: A Review of the Role of Dermocosmetics as Adjunctive Therapy. J Cutan Aesthet Surg. 2016 Apr-Jun;9(2):85-92. \
  10. Kawashima M, Nagare T, Doi M. Clinical efficacy and safety of benzoyl peroxide for acne vulgaris: Comparison between Japanese and Western patients. J Dermatol. 2017 Nov;44(11):1212-1218.
  11. Oliva A, Costantini S, De Angelis M, Garzoli S, Božović M, Mascellino MT, Vullo V, Ragno R. High Potency of Melaleuca alternifolia Essential Oil against Multi-Drug Resistant Gram-Negative Bacteria and Methicillin-Resistant Staphylococcus aureus. Molecules. 2018 Oct 9;23(10):2584.

 

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