Dermatology for Swimmers - Appalachian Spring Dermatology

As many of you know, my most recent favorite form of exercise is swimming. I love the peacefulness of swimming, head down, focusing on the rhythm of my stroke and kicking. But swimming is hard work, and even harder on your skin and hair.

Swimming for exercise and sport usually involves swimming in a pool so this post will focus on issues with skin and hair related to pool swimming, particularly the effects of chlorine on the skin and hair. I realize there are salt water pools and pools that use bromine in place of chlorine, but the majority of swimmers are swimming in a chlorinated pool. Swimming also involves much more gear than I realized: goggles, swim cap, fins, kickboards, pull buoys and more. Plus, there are all those damp, bare feet on the pool deck. Much of what I am writing here is from personal experience and poolside curbsides. There are not any recent scientific articles or reviews that look at skin disease in swimmers.

*In spite of how hard it can be on your skin and hair, swimming is still Dr. Rosenberger’s favorite way to get exercise and she thinks the pros far outweigh the cons.*

Dry Skin

It sounds counterintuitive, but all that water dries out the skin. Theoretically, it is recommended to shower and apply a good moisturizer immediately after swimming. Cetaphil Restoraderm and Cerave both have extra nourishing ingredients for those whose skin barrier is impaired and dry.

Molluscum Contagiosum

Molluscum contagiosum is a viral growth that occurs on the skin and causes flesh colored umbilicated shiny papules. Numbers often quickly increase from a few to a few hundred and typically occur in areas sensitive skin and friction – axilla, groin, inner elbow, behind the knee. Popping or scraping open one of these bumps can release hundreds if not thousands of viral particles. Transmission of Molluscum within swimming pool environments has long been suspected, but not proven. Cover any molluscum infected areas as much as possible with a waterproof bandage. Spreading is common with these particular to oneself, much more than others. Seek professional treatment.

Warts

Warts are also caused by a virus, Human Papilloma Virus. Warts can occur anywhere, but in swimmers, they most commonly are seen on the hands, feet, and lower legs. Openings in the skin of the feet allow the virus a portal of entry into the skin. Treat all warts when they are small. Many OTC preparations of salicylic acid are available, and all are pretty equally effective. For larger or multiple lesions seek professional help.

Athlete’s Foot

Fungal infection from moist environments and equipment breeding fungus are quite common. Surprisingly, jock itch or fungus in the groin is not nearly as common. Again, openings in the skin of the feet allow the fungus a portal of entry. Consider applying Lamisil cream between the toes and on the feet once a week for a preventative measure and aggressively treating any active infections with topical Lamisil cream.

MRSA Methicillin Resistant Staph Aureus

This aggressive bacterial infection of the skin seems quite common in swimmers, with small wounds requiring quick attention. Skin to skin contact, sharing towels and sharing equipment are all likely to impact the increased incidence of MRSA. Treat all small wounds and cracks in the skin with mupirocin ointment twice a day to prevent the development of serious infection.

Goggle Dermatitis

This can happen most often due to an irritant or allergic contact dermatitis to the suctioning component of the goggles. Replace goggles and treat the affected area with Vaseline and a mild cortisone cream sparingly.

Hair Texture and Hair Color Alteration

This is usually a reaction to chlorine and chlorine by-products in the pool water. There are a number of commercially available post swim shampoos to chelate the chlorine and take it out of the hair. We have used TriSwim and Malibu C Swim Shampoo with success. Wearing a swim cap and pre-rinsing with water prior to swimming seems to help.

Finally, I strongly recommend having ones own swimming gear and towels and not sharing!

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