Contagious skin lesions, such as impetigo, herpes and ringworm are common in wrestling. MRSA is an uncommon bacterial infection that can be very dangerous. Any of these skin issues can quickly spread throughout a team resulting in a temporary wrestling program shutdown, and possibly extended downtime for a wrestler. During the past few seasons, we have implemented the following skin lesion prevention measures with great success, resulting in minimal skin issues. It is necessary for ALL WRESTLERS to follow these guidelines so that we can have a healthy and successful season. Remember it is YOUR responsibility to make every effort to prevent skin issues and to report them immediately to the coaches and athletic trainers if any occur.
Use an alcohol-based hand sanitizer before practice. A recent study found the highest bacteria amounts among wrestlers to be on the hands, and the use of alcohol-based gel reduced bacteria amounts by 73%.
Shower immediately after all practices and matches. Timely removal of skin microorganisms after activity is important in preventing skin infections. Shower as soon as you arrive home after practice or a match.
Wipe down your body immediately after each bout. Immediately after a match bout, wipe all sweat off your body with a clean, dry towel. Place the towel in a plastic bag and do not reuse. Then wipe down using a body wipe. Removal of sweat with a towel first beforehand will enhance the effectiveness of the wipe and provide some measure of prevention until a shower is possible.
Use an antifungal shampoo. An antifungal shampoo will help prevent tinea capitis (ringworm in the scalp). Tinea capitis treatment does not respond to a topical ointment and requires an oral medication for 14 days before the wrestler may return to participation.
Use Hibiclens every other day, when showering. Hibiclens medicated soap has been shown in studies to provide anti-bacterial protection, especially against impetigo and MRSA. Fewer than 5% of bacteria survive on the skin at the 4-hour point after using Hibiclens. According to the manufacturer’s guidelines, it should not be used in the genital area or on the face. Caution should be taken not to allow it to enter the eyes, mouth or ears. Wash your body first with regular soap, followed by Hibiclens. Since it is expensive, every other day use is recommended. Hibiclens should not be used to treat skin conditions. Consult with a physician before use.
Clean your head gear daily; wipe out with an anti-microbial wipe. Cases of impetigo on the ears and face can be prevented with this simple measure.
Wear clean wrestling practice clothes daily. Clean clothes will minimize transmission of microorganisms.
Clean knee sleeves, braces and other items worn while wrestling daily. These items are often the source of a skin infection.
Do not share towels, wrestling gear, knee sleeves, clothing, disposable razors, soap bars, deodorant, or other personal gear with others. These items are likely to transmit microorganisms to a teammate.
Clean out your gear bag on a regular basis, spray the inside with Lysol. Dirty clothes and gear harbor bacteria increasing the risk of skin infections.
Periodic skin checks are conducted with the athletic trainers; daily skin checks should be performed by the coaches, parents, and the wrestler should perform a daily self-checks. Frequent skin checks involving a team-approach will help identify and treat skin issues before they are spread throughout the team, or become more difficult to treat.
Wrestlers must immediately report any suspicious skin lesion to the coaches and athletic trainers as soon as they arise, and also notify the coaches and athletic trainers of any skin issues that have been evaluated by a physician. Immediate recognition of a potential skin issue, and proper communication will minimize spreading throughout the team, expedite treatment and potentially reduce downtime.
Wrestlers should follow-up for subsequent re-checks when requested by the athletic trainers. Sometimes a skin infection may initially appear as an abrasion, acne or other small skin wound, and evolve into an infectious lesion that worsens over the next few days. Follow-up is important to monitor any changes.
Cover all wounds. An open “port of entry” is how microorganisms enter the body and cause a skin infection. A wound such as an abrasion or cut should be evaluated by the athletic trainers or a physician. If the wound is infected, it should not be simply covered without appropriate treatment and physician clearance.
Stay hydrated and avoid excessive weight cutting. Get adequate sleep, rest and nutrition. A lowered immune system increases the risk of skin issues.
Use the official NJSIAA skin form when you go to your doctor. Please note wrestlers with a skin issues may only wrestle with this approved state form completed by their doctor. A doctor’s note on a ‘script’ cannot be accepted. The form is only good for 7 days from the date of the doctor’s exam. For example, if the exam occurred on a Friday, the note is only good until the following Thursday. Please be sure to use the most current form found on the NJSIAA website, and keep it to a front/back single copy (not 2 stapled pages).
Clean the mats before and after each practice with a “residual disinfectant.” Residual disinfectants (ie: KenClean) have long-term bacteria killing action compared to non-residual cleaners. In a recent study, cleaning a wrestling mat with a residual disinfectant reduced the average bacterial amounts by 76% compared to non-residual cleaners or bleach solution.
Use a backwards-walking mat cleaning procedure to avoid walking on a freshly cleaned mat. This will minimize contamination of the mat.
Do not walk on a cleaned mat with street shoes. If you must leave the wrestling room to go to the bathroom or for any other reason, change footwear. Walking on the mat with contaminated shoes will transfer bacteria to the mat and result in skin infections. Do not wear your wrestling shoes in the hallway or bathroom then come back on the mat with those same shoes.
References:
Ferrara, MS et al. Evaluation of Persistent Antimicrobial Effects of an Antimicrobial Formulation. Journal of Athletic Training. 2011:46(6):629-633
Young, LM et al. Recommendations for Best Disinfectant Practices to Reduce the Spread of Infection via Wrestling Mats. Journal of Athletic Training. 2017;52(2):82-88.
If you suspect a skin lesion, notify the athletic trainers first then bring this form with you to the doctor and return the form to the athletic trainers.