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Skin infections common in U.S. high school wrestlers, other athletes

Wrestly. Image courtesy washer_dreier via Wikimedia Commons, licensed under the Creative Commons Attribution-Share Alike 2.0 Generic license

Image courtesy washer_dreier via Wikimedia Commons, licensed under the Creative Commons Attribution-Share Alike 2.0 Generic license

A U.S. national survey of high school students has found that skin infections are extremely common among student athletes, with wrestlers being most prone, according to a paper published online in the Journal of the American Academy of Dermatology (Feb. 2, 2016).

The survey, which tracked data over five years in a representative sample of U.S. high schools, found that wrestlers were far and away the most prone to skin infections among school athletes. A total of 73.6% of all skin infections were found in high school wrestlers, compared to 17.9% in the second most frequent group, football players.

"Given the nature of the sport, it's not surprising that wrestlers suffer the most skin infections," senior author Robert Dellavalle, MD, associate professor of dermatology at the University of Colorado School of Medicine, said in a press release. "Most of the infections were bacterial and fungal."

Data from the National High School Sports-Related Injury Surveillance System, High School RIO (Reportin Information Online). Among the 22 different sports examined, a total of 474 infections were reported in 20,858,781 ‘athlete exposures’ – defined as a single athlete competing in a practice, competition, or performance. Wrestlers had 28.56 infections per 100,000 athlete exposures, compared to 2.32 per 100,000 for football players and less than 1.0 per 100,000 for other sports. Eight sports reported no infections at all.

Most (60.6%) infections were bacterial, with tinea (ringworm) second in frequency at 28.4%, and herpetic lesions third at 5.2%.

Most of the infections were found on the head or neck, and most resolved in under a week, according to the study, but some were more serious. "While most skin infections require a week recovery on average, others may have more serious eye and neurological involvement from a primary Herpes Simplex Virus," study co-first author Kurt Ashak, a fourth year medical student at Michigan State University who helped conduct the research during a recent dermatology rotation at the University of Colorado’s Anschutz campus, said in the release.

The authors note that the U.S. Centres for Disease Control and Prevention recommend that athletes shower immediately after competition. If that is not possible, the existing literature suggests that infection frequency decreases if athletes use soap and water skin wipes.

Dr. Dellavalle said in the release that most schools wipe down wrestling mats before and after competitions, but that may not be the best approach considering the finding that most infections occur on the head and face.

"Wrestlers are not rubbing their heads and faces on the mats," he said. "The problem may be not keeping headgear properly cleaned before each match."

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