Skin Infections

Below are guidelines and resources in regards to skin infections. Please note that these recommendations should not be used in place of the advice and treatment of a healthcare provider. At the bottom of this page are links to the NDHSAA Wrestling page and associated resources. 

Athletes with skin infections MUST use the Skin Infection Release Form and have it signed by the Healthcare provider instituting the treatments. 

Skin infections in wrestling are common but preventable. It is important to familiarize yourself and your athlete with the best prevention methods. 

Hygienic Principles to Help Minimize Spread of Skin Infections

1. Shower immediately after practice or events. Do not share towels/soap/shower sponge/etc. Bring and use only your own toiletries. 

2. Avoid close shaving. Studies show that increased outbreaks of Methicillin-Resistant Staph aureus (MRSA) are associated. 

3. Always wear clean clothes for practice Everyday. Practice clothes (kneepads/sleeves/etc) should be cleaned daily. 

Wash clothing by itself on hot in the washer and high heat in the dryer.

4. Do not use a whirlpool tub if there is an open lesion. 

 5. Cover as much skin during practice as possible, with long sleeves & sweatpants.

•Anyone with a suspicious lesion should refrain from competing until evaluated and cleared by their Health Care Provider.

•Refrain from “Doctor Shopping.” That only serves as a means to promote misdiagnosis and further spread of the infection.

The healthcare provider for any given meet/dual/tournament withholds the right to remove an athlete from participation, REGARDLESS of documentation. If a referee or healthcare provider is concerned about the potential spread of infection they may remove the athlete. 

Common Infections and Treatments

There are three common types of infections viral, bacterial, and fungal. Each class of infections requires specific treatments. All lesions should be covered to prevent further spread of infection.

Bacterial: 

Impetigo: 

• Appears as small reddened lesions that secrete a fluid. Lesions will become crusty and bulbous.

• Contagious and will spread from the original lesion if not treated.

• Treatment includes cleaning the infected regions and antibacterial medications.

• Minimum Treatment: To be considered non-contagious ALL lesions must be scabbed over with no oozing or discharge having occurred within the preceding 48 hours. Prescription oral antibiotics for 72 hours is considered the minimum treatment period.

Folliculitis:

• Appears as small pustules at the base of the hair (hair follicle), filled with pus and looks similar to a white head.

• Cleanse the area and use over-the-counter topical antibacterials.

• Generally considered "non-contagious" area should still be covered and treated.

MRSA (Methicillin-Resistant Staphylococcus aureus)

• First appears a "spider-bite" like lesion that evolves into an abscess.

• Immediate evaluation and treatment is required. MRSA is a variation of a Staph infection and a potentially dangerous infection. Early recognition is key to reducing the chances of a severe outcome. 

• Symptoms include

  • Redness

  • Swelling

  • Pain

  • Warm to the touch

  • Full of pus

  • Fever

• Do not attempt to drain the lesion on your own, if needed the healthcare provider will do so. 

• Participation is dependent on the healthcare providers guidelines and treatments.

Viral:

Herpes( Simplex/cold sores/Zoster/Gladitorium):

• Grouping of small blisters or vesicles. Most commonly on the head, neck, or face. The base is often red and they may secrete clear or yellow fluid. 

• Other symptoms include; low fever, sore throat, fatigue, and swollen lymph nodes. 

• Herpes is a permanent condition, meaning no medication will completely kill or remove the virus. Outbreaks will occur throughout ones' life.

• Minimum Treatment:  To be considered "non-contagious" all lesions must be scabbed over with no oozing or discharge and no new lesions should have occurred in the preceding 72 hours. For the first episode of Herpes Gladitorium, wrestlers should be treated and can not compete for a minimum of 10 days. If signs of of fever and lymph node swelling are present that time will be extended to 14 days. Recurrent outbreaks require 120 hours of oral antiviral treatment, along with scabbing of lesions and no development of new lesions. 

Molluscum Contagiosum:

• Appears as small bumps (about 2 mm) on the skin.

• Rupture of lesions will lead to further infection.

• Often  treated via liquid nitrogen removal or cutting.

• Medications not always necessary 

• Minimum Treatment: Upon removal athlete may wrestle immediately.

Fungal:

Ringworm (Tinea Lesions):

• Appears first as a flat scaly rash. The lesion will begin to spread away in the shape of a circle, with an outer border often raised and red. The inner area will appear a lighter red than that of the border.

• Cleanse the area and use topical and or oral antifungal medications

• Minimum Treatment: Oral or topical treatment for 72 hours on the skin and oral treatment for 14 days on the scalp.

Other Infections:

Conjunctivitis(Pink Eye):

• Minimum Treatment: 24 hours of topical or oral medications and NO discharge from eyes. 

Scabies & Head Lice:

• Minimum Treatment: 24 hours after appropriate topical management.

NDHSAA Boy's Wrestling Page - https://ndhsaa.com/athletics/wrestling-boys 

CDC MRSA Among Athletes - https://d2q0tptsfejku7.cloudfront.net/uploads/files/MRSA_Among_Athletes.pdf

MRSA Fact Sheet - https://d2q0tptsfejku7.cloudfront.net/uploads/files/MRSA_Fact_Sheet.pdf 

NDHSAA Skin Infection Release Form - https://d2q0tptsfejku7.cloudfront.net/uploads/files/WrestlingReleaseSkinLesion.pdf