Seborrheic Dermatitis/Rosacea and Wrestling

[Akello]

Hello,

I am seeking advice regarding rosacea and contact sports. For the past few years I'd occasionally get a small red, sometimes flaky, patch on my right cheek below the eye. It would occur a couple times a month and pass within a day or two. After one particularly annoying flareup, I went out and bought a non-drying moisturizing face wash from a company called Simple. It was over the counter and cleared up the redness/patching to the point that I forgot about it.

With time, I got lazy and used to the fact that the moisturizer got rid of the problem so I stopped using it. It came back stronger and spread to the left cheek. I went to see a doctor and he diagnosed me with seborrheic dermatitis and added rosacea after I mentioned that my mother had a similar condition that went away after a course of laser treatment. He prescribed 3 different creams two of which were antibiotics and the other contained sulfa to which I am allergic. He told me to hold off on the third and agreed that laser treatment is worth looking into especially since he considered my case to be mild.

I am reluctant to start the creams especially after being told that it's for the rest of my life. I am looking into the laser treatment but that is a ways off. In the meantime I need to know how it factors in with sports. I've been grappling (Judo and Brazilian Jiu Jitsu) a long time and skin infection is always a concern. Staph and ringworm are the most common threat and we are told to be particularly careful of open wounds, burns, etc. that may get infected. Since the patches tend to get red and flaky when they are inflamed, I began to wonder how susceptible they make me to infection. I haven't had any issue so far and have been keeping the inflammation under control by using the moisturizer, avoiding hot showers and minimizing stress.

The doctor said that I am clear to grapple but he didn't specify if he meant with or without the creams.

Would appreciate your opinion.    

[Akello]

Dr. Kaur,

I realize that we are entering the holidays and response times are slowed but I would really appreciate an answer to my original question so I could know whether to go ahead with wrestling.

Do these conditions (rosacea/seborrheic dermatitis) make you more vulnerable to skin infections?

Hope to hear from you.

[Akello]

Dr. Kaur,

Thank you for your reply, we are so close!

Please let me clarify; I was aware that seborrhoeic dermatitis and rosacea were not contagious. What I was trying to find out with my question was whether they make one more vulnerable to skin infections.

For example; a wrestler must always be on the look out for ring worm. When I spilled boiling water on myself, I was told to abstain from training until the burn healed because it would make me more vulnerable to a skin infection like ring worm. Do the conditions we discussed cause the same vulnerability? That is; will seborrhoeic dermatitis or rosacea make me more likely to get ring worm?

Hope to hear from you soon so we can resolve my confusion.

[Bhupinder Kaur, MD]

Hello,
Thanks for writing back to me.

Seborrhoeic dermatitis is not contagious and nor is rosacea. Hence they cannot be transmitted as fungal infections during wrestling. However some factors may cause its aggravation. It is not related to diet, but it may be aggravated by illness, psychological stress, fatigue, change of season and reduced general health.

Update 1/31/2014:

Hello,

Thanks for writing back. Apologies for the slight delay in follow up.

I can understand your concern but seborrheic dermatitis and rosacea do not predispose an individual to have an infection with ringworm. It may be a coincidence in some individuals that they are having any of these conditions and have got ring worm as well.

Some people are more exposed to the spores at home or during recreational activities and wrestling is one such activity in which you are coming in close contact with the person who may be having ringworm infection. So you may get the transmitted from him but these skin conditions do not predispose you to any contagious fungal infection. So you can indulge in wrestling.

Hope that this information helps and hope that you get better soon.

Wishing you good health and good luck for your wrestling matches.

[Akello]

Thank you for your reply.

To clarify on my original post, the diagnosis was made by a dermatologist who prescribed some of the treatments you mentioned. Since I have the condition more or less under control with lifestyle modification, I am looking into laser treatment. In the meantime, I would prefer to hold of on the creams due to their content and the prescription for prolonged use.

Currently my main issue of concern is how susceptible to infection this condition makes me during wrestling. As I mentioned, in my original post, we are always looking out for things like staph and ringworm and are told to make sure cuts and burns heal before getting on the mat. I want to know if this condition falls into the same category and makes me more vulnerable or if it is different and I can continue wrestling.

I did could not find this question addressed in your reply, please advise.

[Bhupinder Kaur, MD]

Hello,
Thanks for posting your query.

I can understand your concern for these symptoms and from the symptoms I agree with your doctor that it is most likely to be due to seborrheic dermatitis. It is an inflammatory disorder affecting the sebaceous-gland-rich areas of skin which is more likely to occur on face, scalp etc. It is very difficult to differentiate rosacea and seborrheic dermatitis without lab investigations but they seem to be co existant at the same time. Although the two disorders are unrelated, a recent clinical study found that 26 percent of patients with rosacea also had facial seborrheic dermatitis.

Typically, seborrheic dermatitis presents with scaly, flaky, itchy, and red skin. This skin disease commonly affects adolescents and young adults, especially in warm and humid climates and is aggravated by sweating and humidity. It is related to the proliferation of normal skin habitant Malassezia – a yeast, which produces toxic substances that infect and irate the skin.

Treatment of rosacea and seborrheic dermatitis are different. Topical antifungals and mild steroids are the usual treatment and combination of the two can be used to treat stubborn patches in seborrheic dermatitis. Oral antifungal drugs and immunomodulators such as tacrolimus and pimecrolimus are used in very severe cases.

Treatment options for rosacea vary from antibiotic creams, antihistaminics, sun screens to laser treatment.
In face the use of topical steroids on the rosacea may exacerbate the seborrheic dermatitis. Topical tacrolimus or pimecrolimus does not exacerbate acne rosacea and is very effective for thin plaques of seborrheic dermatitis. These are the agents of choice for the treatment of combined seborrheic dermatitis/rosacea.

Hence you should first get the diagnosis confirmed and then get the treatment prescribed. You need to get it examined from a dermatologist. He will examine it by a dermatoscope and maybe send a skin biopsy sample containing few skin cells for examination to the laboratory.

Hope that this information helps and hope that you will get better soon.

Wishing you good health.