Healing the skin and keeping it healthy are important to prevent further damage and enhance quality of life. Developing and sticking with a daily skin care routine is critical to preventing flares. Tanning also is responsible for chronic sun damage including wrinkles, leathery skin texture, and mottling or “age spots” (really “sun” spots). Actually, there’s no such thing as a healthy tan; a tan is just a “precancerous glow.” So, enjoy the spring and summer days, just be sensible, too!
When it comes to aerobic exercise in a hot, stuffy indoor environment such as a gym, drinking an adequate supply of water is not so much a matter of comfort as a matter of urgency. When you are dehydrated, the blood flow to your skin is reduced, and over time this can result in a kind of grey pallor. In the long term, you will also find that the diminishing number of nutrients reaching the skin affects its daily renewal process, meaning skin can become dry and flaky, and washing several times a day will only exacerbate this.
The changing of the season brings cooler weather, shorter days and more people heading to health clubs for a healthy dose of indoor exercise. While experts agree that exercise is one of the most beneficial activities a person can do to improve one’s overall health, dermatologists want gym goers to be aware of the hidden dangers of exercise – bothersome skin conditions that can be painful and inhibit further physical activity if left untreated.
The low humidity of winter or the dry year-round climate of some geographic areas can make the disease worse, as can overheated indoor areas and long or hot baths and showers. Alternately sweating and chilling can trigger a flare in some people. Bacterial infections can also trigger or increase the severity of atopic dermatitis. Urticaria; another skin disorder appears as hives (red, raised bumps) that may occur after exposure to an allergen, at the beginning of flares, or after exercise or a hot bath.
Exercise-induced urticaria is a condition that causes hives and other allergic symptoms. It can occur during or after exercise. Hives or "welts" are usually raised, flat bumps on the skin that are redder around the edge than in the middle. Hives may also look like red spots, blotches or blisters. They can occur on any part of the body.
Skin disorders of the foot are common in patients who exercise. Knowing the causes, diagnostic indications, and treatment of seven common skin conditions—friction blisters, calluses, corns, talon noir, tennis toe, plantar warts, and tinea pedis—can help physicians manage these disorders in active patients. Cholinergic urticaria results from sweating. In severe cases, hundreds of tiny red itchy spots develop after running, when warm, or when concentrating.
Scientists suspect that changes in the skin's protective barrier make people with atopic dermatitis more sensitive to irritants. Such people have lower levels of fatty acids (substances that provide moisture and elasticity) in their skin, which causes dryness and reduces the skin's ability to control inflammation. There's a lot of indirect evidence that shows that when you exercise your level of stress diminishes. So your adrenal glands are producing less of these male-type hormones that are part of any acne flare-up.
Cold, dry air and indoor heat take their toll on your skin during the winter months. Winter is a tough time for our skin. Cold temperatures, low humidity and indoor heating all rob skin of moisture and leave it dry and flaky. Inflammatory skin conditions can present obstacles that affect athletic participation. In eczema and psoriasis, cutaneous lesions can lead to skin breakdown, which may disqualify an athlete from participation and may also contribute to secondary infection.
Few who pursue vigorous activities in the name of fitness and fun entirely escape insults to the vast organ that is meant to serve as a barrier to invaders from without. Whether covered by skimpy shorts and tank top, sweat suit, leotard or regulation uniform, the skin can suffer from its direct exposure to the exercise environment. Exercise-induced afflictions range from minor irritations, corns, calluses and blisters to hazardous microbial infections, unsightly acne and smelly feet. That is not to mention sunburn, windburn, frostbite or chilblains, which can accompany any prolonged or frequent exposure to the outdoors.
Heat exhaustion is a milder form of heat-related illness that can develop after several days of exposure to high temperatures and inadequate or unbalanced replacement of fluids. Those most prone to heat exhaustion are elderly people, people with high blood pressure, and people working or exercising in a hot environment. Heat rash is a skin irritation caused by excessive sweating during hot, humid weather. It can occur at any age but is most common in young children. Heat rash looks like a red cluster of pimples or small blisters. It is more likely to occur on the neck and upper chest, in the groin, under the breasts, and in elbow creases.
In recognition of National Healthy Skin Month, dermatologist Brian B. Adams, MD, MPH, FAAD, associate professor of dermatology at the University of Cincinnati and director of dermatology at the Veterans Administration Medical Center, both in Cincinnati, Ohio, spoke at the American Academy of Dermatology’s (Academy) SKIN Academy on the most common skin conditions to which people who engage in regular indoor exercise are susceptible and how to treat them.
“Despite its positive effect on a person’s physical and psychological health, regular exercise does not necessarily improve our skin health and may in fact lead to a rash of skin conditions that require treatment,” said Dr. Adams. “While exercising indoors eliminates the threat of skin cancer and sun damage, it is important for people who frequent health clubs to be aware of the risks to their skin as well.”
Blisters
Blisters form when friction between an area of the body and athletic equipment causes a splitting of the top layer of skin, allowing fluid build-up. Runners and those who routinely lift weights often develop blisters. Dr. Adams suggests that the key to preventing blisters is to reduce friction by creating more distance from the equipment to the skin.
“Wearing moisture-wicking socks, applying a thin layer of petroleum jelly between the sock and the shoe, and using gloves to lift weights can help prevent blisters from forming,” said Dr. Adams. “Also, there is no better dressing for blisters than your own skin, so you should not peel off the top layer of a blister. If it comes off, keep the blister covered with petroleum jelly and a bandage.”
While blisters normally do not become infected, Dr. Adams cautioned that redness appearing on the skin in the vicinity of the blister could indicate an infection and should be treated by a dermatologist.
Fungus/Athlete’s Foot.
Unfortunately, health clubs are breeding grounds for all kinds of fungus – from swimming pool floors and diving boards to showers and locker rooms. The most common contagious fungal infection that exercise enthusiasts are prone to developing is tinea pedis, or athlete’s foot. This fungus grows best in dark, moist and warm environments, making sweaty feet tucked inside running shoes perfect targets.
Perhaps the most bothersome symptom of athlete’s foot is the itching and burning sensation people feel on their feet. In some individuals, the skin between the toes peels, cracks and scales, while others may experience redness, scaling or dryness on the soles and along the sides of the feet. Some people who develop athlete’s foot also may be at risk for toenail fungus, which can be difficult to treat without dermatologic care.
“The best defense against athlete’s foot is to never go barefoot in a health club,” advised Dr. Adams. “Wear shoes, socks, sandals or aquatic shoes at all times.”
Dr. Adams added that most cases of athlete’s foot respond well to over-the-counter medications, but persistent or recurring infections will require prescription-strength medications from a dermatologist.
Acne Mechanica:
Regular exercisers also may be susceptible to acne mechanica, a form of acne that can occur under athletic equipment or tight-fitting clothing. Acne mechanica typically develops in warm, moist environments – especially areas prone to friction. Wearing tight-fitting exercise shorts made of non-breathable fabrics can even cause an acne flare-up on the buttocks.
“Changing your workout attire by eliminating tight-fighting clothing and adding more breathable, moisture-wicking fabrics can help prevent acne mechanica,” said Dr. Adams. “If these preventive measures are not working, your dermatologist can prescribe prescription medications that are effective in treating this type of acne.”
Turf Burns:
Originally termed for outdoor athletes, turf burns (or road rash) are nasty abrasions that can occur on an area of the body – usually the arms or legs – if athletic padding is not used. Most cases of indoor turf burns are caused by sliding on the basketball court or from constant contact with exercise mats or carpet.
“For the quickest healing and to avoid scarring, turf burns need to be cleaned and covered with petroleum jelly and a bandage,” said Dr. Adams. “If there are any signs of an infection or it doesn’t seem to be healing properly, see your dermatologist.”
Indoor Tanning: Take a Pass
Unfortunately, not everything in a health club is “healthy.” Perhaps the biggest health threat is indoor tanning devices, which are still offered at some health clubs across the country despite their link to skin cancer. Ultraviolet light, whether from natural sunlight or artificial light sources, increases a person’s risk of developing skin cancer.
In September 2007, President Bush signed the Tanning Accountability and Notification Act (TAN Act) into law, which calls for the U.S. Food and Drug Administration (FDA) to determine if the current language and positioning of warning labels on indoor tanning devices is adequate to effectively warn consumers of the known dangers of indoor tanning – including the risk of skin cancer.
“As dermatologists, we see the serious health consequences skin cancer poses for patients every day,” said Dr. Adams. “There is absolutely nothing healthy about indoor tanning that should allow it to be offered to health club patrons, who are in some cases being misled to think that this form of UV-exposure is safe and that a tan is somehow healthy. Hopefully this new law will force health clubs to re-examine their choice about offering a disservice like indoor tanning to their patrons.”
In addition, Dr. Adams offered these sun-safety tips for outdoor fitness buffs:
* If possible, seek shade between 10 a.m. and 4 p.m. when UV rays are the strongest.
* Runners and those engaging in other outdoor sports should wear broad-spectrum sunscreen with an SPF of 15 or higher and reapply frequently when sweating. Stash sunscreen in your pockets as a reminder to reapply and wear dark-colored clothing which has built-in SPF, if possible. Hats should always be worn, and men should never run with their shirts off.
* Skiers should be aware that snow is 80 percent reflective, even in shaded areas, and skiers are more likely to burn at higher altitudes.
* You should stop exercising as soon as you notice the hives don't go away in 5 to 10 minutes, or if you have other symptoms. Symptoms may be life-threatening, but this is very rare.
* “Being aware of the skin problems that can arise from indoor or outdoor exercise is a crucial first step in keeping your skin healthy and getting the most out of your workouts,” said Dr. Adams. “If you have a concern about your skin, whether or not it’s related to exercise, it’s important to see a dermatologist for diagnosis and treatment.”
* There are several triggers known to cause rosacea to flare. People with rosacea can work at keeping it under control by avoiding the following environmental triggers: foods that are spicy, alcoholic beverages, weather that's hot or cold, beverages that have been heated, hot baths/saunas, strenuous exercise and stress that's caused by emotional swings.
* Drink 500ml (1 pint) of water around two hours before exercise, then 250ml (1/2 pint) when you arrive at the gym-and around every fifteen minutes during your workout.
* Cold urticaria affects skin warming up after a reduction in temperature, especially in winter. Weal’s can be widespread and may cause fainting attacks. Affected individuals should not expose large areas of the skin to the cold or wind. They should never swim alone.
* People with atopic dermatitis should exercise caution when coming into close physical contact with a person who has been recently vaccinated, and make certain the vaccinated person has covered the vaccination site or taken other precautions until the scab falls off (about 3 weeks). Those who have had physical contact with a vaccinated person's unhealed vaccination site or to their bedding or other items that might have touched that site should notify their doctor, particularly if they develop a new or unusual rash.
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