In addition to the collegiality and competitive spirit that typifies team sports, one dermatologist cautions that players may be sharing something far less desirable: contagious skin infections.
"Outbreaks of ringworm, herpes and methicillin-resistant Staphylococcus aureus (MRSA) have occurred at every sporting level throughout the world," dermatologist Dr Brian B. Adams, an associate professor of dermatology at the University of Cincinnati School of Medicine.
"These skin conditions are highly contagious and can spread through sports teams quite quickly, especially if they are not immediately diagnosed and contained. That is why athletes need to be aware of these risks and how to spot the warning signs of a skin infection," he noted.
The physical contact (and subsequent skin trauma) at the heart of many team sports are the driving forces behind such skin infections, he notes, as is the use of shared facilities and equipment, in addition to some cases of poor hygiene.
MRSA infections in athletes
By way of example, Adams noted that wrestlers face a risk for spreading the bacterial infection known as impetigo, marked by blister and itchy, honey-coloured, crusty red areas, while football is the most common vehicle for the spread of MRSA, a staph infection resistant to many antibiotics.
On the skin, MRSA may resemble a pimple, boil or abscess that itches or hurts. In the early stages, most are treated easily, but in the rare case that the infection becomes systemic, it can be life-threatening.
In an earlier published review, Adams found shared equipment, hygiene and even artificial turf burns can increase the risk of developing MRSA.
Skin-to-skin contact is the most likely way to spread MRSA, although shared equipment also plays a role, says Dr Stanley Deresinski, a Stanford University infectious disease specialist and pro sports consultant. "These days, whenever you suspect staph, you should suspect MRSA," he adds. "Whenever there is a boil, pimple or rash that is red, painful, lumpy or hot to the touch, or if there are systemic problems, you should seek medical help."
Sports and herpes
On the viral front, herpes is a major concern, because the blisters and sores it causes can occur anywhere on the skin.
"Herpes simplex is so common among wrestlers where skin-to-skin contact is unavoidable that the condition is termed herpes gladiatorum," said Adams. "Treatment includes oral antiviral medications and the athlete can return to practise and competition after four to five days of treatment. Wrestlers who spar with an infected partner have a one-in-three chance of contracting this skin infection, so it is crucial that the virus is treated and athletes avoid competition during the period of infection."
Not to be minimised, warns Adams, is the threat of the rashy fungal infection "tinea corporis," better known as ringworm, which commonly takes root on the head, neck and arms following contact with an infected individual. (Ringworm usually appears as a red, circular rash with clear skin in the middle.)
"Any athlete with skin-to-skin contact could develop ringworm," noted Adams, "but the intensity of close contact and exposed skin makes wrestling the highest risk sport for this particular fungal infection. Early detection and treatment are essential in containing the spread of infection, and currently there are no evidence-based recommendations as to how long athletes with ringworm should avoid competition."
Athlete's foot is another fungal risk, since sweaty feet are an ideal environment for the darkness-seeking fungus to proliferate. The best prevention, says Adams, is to use moisture-wicking socks, wear flip-flops in the locker room and shower immediately after exercise.
Adams says that athletes, coaches and trainers alike need to be informed about such risks so they can learn how to prevent them and seek medical help if skin infections do appear.
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