Figure 1 Great words to live by.
In October of 2022, Jiu-Jitsu Medicine published a post on what an athlete can do to help prevent infections while rolling. It was a broad overview and part of the article touched on the tea-tree oil containing soaps. But as many of you reading this likely know, there are so many products out there other than these soaps claiming to help prevent and protect athletes from skin infections.
This month’s post comes from a doc whose career has been deeply involved with competitive wrestling. Dr. BJ Anderson serves as a team physician for a collegiate wrestling team as well as the medical advisor for MN/USA Wrestling and a past member of the National Federation of State High School Associations (NFHS) Sports Medicine Advisory Committee. Not only that, but he has written numerous guidelines in peer-reviewed journals on this topic and has led and published the only prospective study to date on a personal hygiene intervention in wrestlers.1 Here are the quick bites, but read on for the wise and knowledgeable words of Dr. Anderson.
- The global market for antimicrobial additives is huge and very enticing to combat sports athletes.
- So far, there is no evidence these products will significantly reduce one’s risk of skin infections compared to the basics.
- You don’t need to break the bank to stay healthy, wash yourself and your stuff after each gym session.
Continue Reading: 10min Read
Overview
A recent article in the paper mentioned ‘Big Pharma doesn’t have any miracle drugs on the horizon’ and this made me start to think about our present situation with skin infections and their control. Non-pharmaceutical means to control these agents is a huge issue, let alone big business. Look at the various ads in wrestling/grappling sites and magazines and the narrative they sow: use this soap and prevent all skin infections; coat mats with this liquid and prevent outbreaks; wear this clothing and you’ll be guaranteed to never get an outbreak. Great ideas, but do they work?
At the NFHS and the Minnesota State High School League Sports Medicine Advisory Committees we get requests from companies all the time seeking approval of their products. With that stamp of approval it could mean millions of dollars in these companies’ pockets, so our job is to look at the data and see if their claim is justified and should be approved. Needless to say many of these products are based on associative and anecdotal evidence, rather than studies actually done on wrestlers or designed to prove causation. Let’s take a look at a few of these products.
Kenshield
A topical covering (barrier cream) that coats the skin and reduces the infectious agent’s contact with the skin. By reducing its contact with the skin it should reduce skin infections. Great idea, but a study done by Hand and Wroble published in 1999 showed it was no better at preventing ringworm than doing daily skin checks. Cost: $24 a can and each can would potentially serve one wrestler for an entire season.2
Figure 2 KS Skin Creme.
Antimicrobial Clothing
Figure 3 Example of an antimicrobial rash guard.
Antimicrobial Soaps/Wipes
Applied to the skin as a soap or wipe the claim is these products will reduce outbreaks of common skin infections such as impetigo, ringworm, etc. The active ingredient tea tree oil has been investigated and in the lab setting may reduce growth of CA-MRSA and other infectious agents, but no studies have been done in the wrestling venue showing its efficacy at actually preventing skin infections in athletes. Cost: $6 per bar, $6.50 for pump bottle. With that said, an article in the New England Journal of Medicine raises the question of possible harm in young males using this agent.5
Figure 4 D’Arce choke and wrestling soaps.
Antimicrobial Coatings
There are several products that serve to either coat the mat, locker, benches or other non-porous surfaces. Another product is washed into clothing or towels. All are needed to be repeatedly applied or washed into the garments monthly. Similar products are used in medical facilities and are part of a very strict regimen for hygiene and sterilization of surfaces to reduce or prevent bacterial growth. Extrapolating any of this and applying it to the athletic venue may have merit, but no studies have been performed showing efficacy. Cost: coating two 42’x42’ mats is about $66 per month. Washing clothing and towels costs about $15 per wrestler per month.
Figure 5 A logo of a now non-existent coating company that claimed their product would prevent infections.
Conclusion
Conclusion
If we utilize all of these products for a typical 40 man roster over a 4 month season, you’d be paying over $6,000 to get the latest and greatest products to control skin infections. But is it worth it? Obviously if you had an unlimited budget, why not? But most programs have financial constraints. At this time none of these products have definitive scientific data to show they work to reduce skin infections in this sport. Bottom line, focus on the basics with good hygiene.
- Have the athletes shower immediately after each practice/event.
- Daily skin checks. The most important thing you can do to reduce skin infections!
- Wash workout gear and towels after each practice/event.
- Work with one Health Care Provider. Continuity with the same HCP will reduce skin infections on your team.
Questions about a skin condition and don’t have access to a doc? Download the app for iPhone or Android…MATDOC. You can send photos and receive an evaluation within 24 hrs. Questions for Dr. Anderson? Email at: info@thematdoc.com
References
- Anderson BJ. Effectiveness of body wipes as an adjunct to reducing skin infections in high school wrestlers. Clin J Sport Med. 2012 Sep;22(5):424-9. doi: 10.1097/JSM.0b013e3182592439. PMID: 22695403.
- Hand JW, Wroble RR. Prevention of tinea corporis in collegiate wrestlers. J Athl Train. 1999 Oct;34(4):350-2. PMID: 16558587.
- Kermani F, Moosazadeh M, Hosseini SA, Bandalizadeh Z, Barzegari S, Shokohi T. Tinea Gladiatorum and Dermatophyte Contamination Among Wrestlers and in Wrestling Halls: A Systematic Review and Meta-analysis. Curr Microbiol. 2020 Apr;77(4):602-611. doi: 10.1007/s00284-019-01816-3. Epub 2019 Nov 26. PMID: 31773190.
- Peterson AR, Nash E, Anderson BJ. Infectious Disease in Contact Sports. Sports Health. 2019 Jan/Feb;11(1):47-58. doi: 10.1177/1941738118789954. Epub 2018 Aug 14. PMID: 30106670.
- Henley DV, Lipson N, Korach KS, Bloch CA. Prepubertal gynecomastia linked to lavender and tea tree oils. N Engl J Med. 2007 Feb 1;356(5):479-85. doi: 10.1056/NEJMoa064725. PMID: 17267908.
- Figures were created Dr. Walls, photos taken from publicly accessible web stores and content for example purposes and not as advertisement or endorsement.
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