Do all wrestlers get Ringworms

[violin89014]

My son wants to join the wrestling team....but i'm not sure if he should because i've heard that all wrestlers get ringworms....could you please tell me if that is true...and what ringworms is also...thank you for your time

[Nilda]

No, not all wrestlers get Ringworms but the avenue is present to easily spread it (i.e., shared mats, skin-to-skin contact).  In recent years, skin disease in wrestling has finally received the attention it deserves. With the NCAA mandating skin inspections prior to each competition, the wrestling community was forced to address the issue. For many years it was a taboo subject, similar to "cutting weight". Many ignored the problem or attempted to cover it up with make-up. Others treated the skin lesion with a variety of home remedies in an attempt to kill it. There was a fear that it would keep the wrestler from competition. Holding one wrestler from competition is better than infecting many.



A big factor in these problems was the lack of education among the wrestling and medical community. Physicians, coaches, athletic trainers and wrestlers needed to recognize the signs, symptoms and appearance of various skin diseases. Another problem was identifying the proper treatment for each skin disease. Many of the traditional medications used on the general population were not working effectively with wrestlers. It seemed to be a more resistant strain and more difficult to attack.



Recent research and education has greatly improved the diagnosis and treatment of skin disease in wrestling. One person leading the charge has been Dr. David Vasily, Team Dermatologist at Lehigh University in Bethlehem, PA. Along with Jack Foley, Director of Sports Medicine at Lehigh, they have increased awareness of the importance of controlling skin disease in wrestling. They wrote NCAA guidelines and were a big factor in the NCAA mandating skin inspections. They have also developed treatment protocols and continue to try new medications for various skin problems.





Ringworm (Tinea Corporis)

Tinea is the term used for fungal infection of the skin. Commonly referred to by the location of the infection, tinea unguum (nails), tinea pedis (athlete's foot), tinea cruris (jock itch), tinea corporis (body) and tinea capitis (scalp and hair). In wrestlers, Tinea corporis is know as tinea gladiatorum commonly known as "ring worm". The fungus causes a characteristic lesion which is often clear in the center with a rough, scaly, circular border. The lesions vary in size from very small circular patches to large patches. The dermatologist often uses a scraping to examine the fungus under the microscope. A KOH prep test can be used by a dermatologist to determine the activity of the tinea. Tinea corporis is contagious and is spread through direct contact with infected individuals and, very likely, from infections spores on inanimate objects such as clothing, mats, etc. The organism responsible for tinea gladiatorum, trichophyton tonsurans, is quite contagious and very difficult to treat.



Treatment for "ring worm" includes application of an anti-fungal cream to the affected area. The most effective anti-fungal cream has been Lamisil (terbinafine hydrochloride). Lamisil cream 1% should be applied to cover the affected and immediately surrounding areas at least twice per day. Lamisil should be applied for at least two weeks. Although only a few applications of the cream may render the fungus non contagious, it may take 4-6 weeks for the pink spot to resolve. It is very important to continue the use of anti-fungal cream for one week after the lesions have cleared because the fungus may be living under the skin, invisible to the naked eye. Most treatment failures occur because the patient stops the medication too early. According to Dr. Vasily, over the counter anti-fungal creams such as tolnaftate (Tinactin) or clotrimazole (Lotrimin) only suppress the fungus.



An oral medication may be indicated by a dermatologist when multiple tinea lesions or scalp involvement are present. Dr. Vasily recommends Lamisil 250mg 1 tablet per day for 4 weeks. Lamisil cream has been shown to be less effective on lesions of the scalp, thus oral Lamisil is needed. Shampooing with selenium (selson blue) may prevent contagious spores from infecting others and is also used preventively after contact.



Prevention of tinea should be a major priority in wrestling. Prevention begins with cleaning all mats pre and post practice with a hospital grade disinfectant. Second, wrestlers should be educated on what to look for and inspect their own bodies daily. Third, wrestlers must wash all workout gear daily and be sure to wash knee pads and head gear twice a week. Fourth, wrestlers should shower immediately after workouts and use an antibacterial soap and selenium shampoo. It is also important to keep the skin from drying out creating portals of entry for infection. Finally, when a lesion is noticed, they must consult their physician or athletic trainer and use the proper medication. The lesion should be covered prior to wrestling according to NCAA guidelines outlined below.



If a wrestler is identified as having a tinea lesion, the NCAA uses the following guidelines to determine the wrestlers competition status:





1. A minimum of 72 hours of topical therapy is required for skin lesions. The topic antifungals terbinafine or naftifine (lamisil or naftin) are suggested for treatment. A minimum of two weeks of systemic antifungal therapy (oral medication) is required for scalp lesions.

2. Wrestlers with extensive and active lesions will be disqualified. Activity of treated lesions can be judged by examination of KOH prep and the therapeutic regimen. Wrestlers with solitary, or closely clustered, localized lesions will be disqualified if lesions are in a body location that cannot be covered securely. Covering routine should include selenium sulfide or ketoconazole shampoo (nizeral) washing of the lesion followed by application of naftifine gel or cream (naftin) or terbinafine cream (lamisil). A gas-permeable dressing such as Op-site, bioclusive or duoderm should be applied over the lesion, followed by prowrap and stretch tape. Dressing changes should be done after each workout so that lesion can air dry.

3. The dispensation of tinea cases will be decided on an individual basis, as determined by the examining physician and/or certified athletic trainer.

According to Jack Fole