Sports Induced Acne From Helmets, Pads, and Other Gear

Posted on 01 Oct 2011 23:57

Acne caused by sports activities is often a type of acne called acne mechanica. This acne is caused by the combination of pressure, friction, heat, humidity, and occlusion. Any repeated and prolonged mechanical irritation to the skin, such as rubbing, pressure, friction, pinching or pulling can produce these inflammatory papules and pustules.1 Severe cases may progress to nodules and cysts. Rather than being a primary acne, it is an exacerbation of an underlying acne, where the inflammatory lesions become much worse.

This often occurs under protective equipment during sports such as football and hockey, so acne mechanica is prevalent in athletes. Therefore, it is sometimes called sports-induced acne and football acne. It can also be a result of contact with other types of athletic clothing such as tight spandex. It may be more severe in young athletes who already have trouble with pediatric acne.

Acne mechanica can occur on the areas that come into contact with helmets, shoulder pads, chin straps, and various braces: the forehead, chin, shoulders, and upper back, especially. However, it can occur anywhere else, as well. To help prevent the condition, athletes and others should wear cotton or polypropylene t-shirts beneath protective equipment, when possible. Sweat soaked clothing should be removed quickly after training and play, and a shower should be taken as soon as possible.

This type of acne is also not uncommon in strength training, especially in those who bench press often, where the back comes into contact with the vinyl-covered bench under pressure and friction from the barbell being lifted and manipulated, resulting in an acne breakout on the back. This may tend to be more likely with high volume and long periods of time spent on the bench and is more likely in the upper back where the most pressure is applied do to the arching of the back during the bench. Olympic weightlifters can also develop acne on the middle part of their upper chest, caused from bringing the barbell to rest in this region during the clean. The same preventatives apply.

Truck drivers can be prone as well because of the pressure and rubbing of the seat against the driver's back. Also, the use of face masks, such as in hospital workers or those who work with hazardous materials may be vulnerable. Belts, straps, hats, telephone headsets, and even violins against the neck are also associated. See the chart at the end of this article for athletes prone to acne mechanica together with the associated areas and causes.

Severe cases of acne mechanica may sometimes progress to acne keloidalis, especially in darker skinned athletes. Typically occurring on the posterior neck and scalp from helmet irritation, multiple small keloids develop in the affected region. Keloids are similar to hypertrophic scars except these lesions can expand beyond the original area and do not resolve, either on their own or with treatment. Although usually asymptomatic, they may sometimes be puritic, painful, or tender. Although prevalent in darker skinned people, they can occur in anyone.

Although acne mechanica can be treated with topical or systemic antibiotics, topical retinoids (Retin A), salicylic acid, or benzoyl peroxide, it usually goes away on it's own after the playing season ends or the offending activity is ceased, except for severe chronic cases. Systemic antibiotics are generally only prescribed when topical treatments fail or when the acne occurs on the back, where it is difficult to apply topicals. Some of these treatments have disadvantages and side-effects, which should be thoroughly discussed with your doctor. This condition could be mistaken for contact dermatitis or folliculitis.

If you have acne-prone skin and have acne mechanica, it may also help to wash the affected area with a benzoyl peroxide wash as soon as possible after workouts or sports participation. A salicylic acid acne wash may alse be used.

Body Wipes for In Between Matches

Athletes, and especially wrestlers, who are prone to this type of acne and have a need to quickly clean up in between matches or during long tournaments can use any one of various brands of body wipes. Wipes with antibacterial herbal ingredients are available, such as eucalyptus wipes. However, the scent may be annoying and these will slightly "oil" the skin. They are also uneconomical and there is no way, as well, to gauge their efficacy. The common "wet nap" wipes found in grocery stores and drug stores are too small to be used on the body, being intended for the hands and face. Some of these products may also contain alcohol, which is drying to the skin. Simple "soap and water" clean up wipes are a better option, being the most affordable, if not the most soothing. One cost-effective product, marketed especially for athletes and wrestlers, is Kennedy Athletic Body Cleaning Wipes. These come in a dispenser tub. Less affordable but individually wrapped, are Qwik Shower Gym Class Wipes. Unfortunately, wipes are difficult to use on the back, without assistance.

Athletes Who May Develop Acne Mechanica

Besides athlete who wear protective clothing, wrestlers, weight lifters, as mentioned above, some other athletes may be prone to this condition. Shot putters, for instance, must hold a sweaty shot against their necks, making them prone to breakouts in this region. Golfers can get acne mechanica on the side of their lower back, caused from walking for long periods with the golf bag resting in this area. The chart below shows sports or athletes who may be prone to acne mechanica and lists the a breakout areas and specific causes:

Sport/Athlete Location of Acne Cause of Acne
Strength Athletes/Weightlifting upper Back and medial upper chest vinyl covered bench or barbell
Football chin, shoulders, inner part of upper arm, forehead, cheeks chin straps, shoulder pads and straps, helmet
Hockey chin, shoulders, inner part of upper arm, forehead, cheeks chin straps, shoulder pads and straps, helmet
Wrestling chin, neck, elbows, knees headgear, elbow pads and knee pads
Shot Put neck resting shot put against neck before launch
Tennis back heavy clothing
Golf lateral part of lower back carrying gold bag
Dancing trunk tight leotard
1. Adams, Brian B. Sports Dermatology. New York: Springer Science Business Media, 2006.
2. O'Connor, Daniel P., and A. Louise Fincher. "Chapter 12." Clinical Pathology for Athletic Trainers: Recognizing Systemic Disease. Thorofare, NJ: SLACK, 2008. 300.
3. Kanerva, L. Handbook of Occupational Dermatology. Berlin: Springer, 2000. 226.
4. Landry, Gregory L., and David T. Bernhardt. Essentials of Primary Care Sports Medicine. Champaign, IL: Human Kinetics, 2003. 102.

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