Consultant Dermatologist and Skin Surgeon
(Fellow of The Australasian College of Dermatologists).

Also completed sub-specialty training in scalp and hair disorders in Australia and the UK.
Her credentials are PhD FACD.
Country of residence: Australia 

June 2018

Dr. Leona Yip

Let’s start with all our concerns regarding our face. What do you think are the main problems for women who train regularly?
 

I think for these women, facial skin issues will either be directly related to our body’s response to the physical activity e.g. sweating, heat, friction, etc leading to aggravation of acne, seborrhoeic dermatitis (yeast-related dermatitis in oil-rich areas of the face) OR trauma-related e.g. post-inflammatory pigmentation, scars.

Why do we get spots?

Acne formation is related to an interplay of genetics, sensitivity of the skin oil glands to androgen hormones, and P. acnes bacterial activity in the skin. External factors e.g. sweat, friction from tight clothing, thick moisturisers and make-up can aggravate acne. Anabolic steroids and protein shakes can cause as well as aggravate acne. There is some evidence that dairy-rich and high glycaemic index (GI) foods e.g. white rice, white bread etc that break down quickly to trigger an insulin spike and blood sugar rise can also aggravate acne.

Quick links:

What should put on our skin before training? Any cream or moisturiser?

 

It is not necessary to put moisturiser on the body before training, as it may occlude the skin and cause acne breakouts etc. However, any broken skin areas with fissures or cuts especially the hands, should be protected with a greasy moisturiser to “seal” the skin to relieve discomfort, prevent further injury and to aid healing. I would also suggest deep cuts and fissures be covered with tape after applying moisturiser as this can really help healing.

What should we do after training?
 

Shower with soap-free wash to remove dirt, grime and sweat from the skin. It is important to dry the skin properly, especially skin folds like the underarms, groin and between the toes. These areas commonly get irritation dermatitis or fungal infections from moisture. Then, apply a moisturiser all over to replenish skin oils that are lost during washing.
 

How do we cope with the hard/soft water? Does that make any difference to our skin?
 

Hard water is hard on the skin, soft water is gentler on the skin! Hard water contains more dissolved minerals such as calcium and magnesium, that makes it difficult for body wash to lather and forms soap scums instead that can be difficult to wash off – the result is either it stays on the skin and forms free radicals that irritate the skin, clogs skin pores and cause acne breakouts, or you end up using more body wash because it doesn’t feel like your skin is properly cleaned.

 

Soft water helps body wash work more efficiently by forming a lather so you need to use less wash and therefore less stripping of moisture from the skin.
 

 

If we have breakout what’s the best plan of action?

Try to reduce excessive sweating and moisture on the skin, wear loose-fitting clothing to prevent friction, and don’t squeeze or pick at the spots! Stop taking anabolic steroids or protein shakes to see if the skin improves. Mild breakouts can be addressed with over-the-counter topical treatments e.g. salicylic acid, benzoyl peroxide. More extensive breakouts will need prescription medications that can range from antibiotics, hormonal e.g. contraceptive pill, to a vitamin A-based treatment called isotretinoin.
 

 

What are common skin conditions/infections for athletes (athlete’s foot, ring-worm, rash, eczema)? Any ways how to eliminate/prevent them?
 

The top 3 I see:

 

Ring-worm or fungal infections

Keeping the feet and toe webspaces dry
This usually starts off between the toes as mild scaling and white macerated skin, then untreated it can extend to involve the toenails and rest of the feet, and also upper body
.are important and avoid walking bare feet in public bathrooms with wet floors as much as possible. Footwear should be kept dry.
Athletes who experience excessive sweating of their feet tend to have more problems with fungal and bacterial feet infections. See your dermatologist for advice on treatments to reduce sweating.

 

Pityriasis versicolor

This is a form of dermatitis that flourishes in humidity due to overgrowth of a yeast that normally resides on human skin. It presents with extensive powdery-scaly tan or lighter-coloured spots on the trunk that are usually not itchy.
Over summer months, these lighter spots on
exposed skin look more obvious as the normal surrounding skin tans with sun exposure. It tends to be chronic and recurs over months to years. Reducing excessive skin moisture is important to prevent this condition from recurring. For active dermatitis, there will be fine powdery scales on the spots.
When inactive, there is usually no scaling on the spots although the darker or lighter
colour change remains for months. When active, treatments include imidazole creams, or direct application of anti-dandruff shampoo on affected skin. More extensive or resistant dermatitis may require prescribed oral anti-yeast treatments.

 

Skin “spots” breakouts


e.g. acne and folliculitis on the chest and back from sweating and friction.
Use an antiseptic wash in the shower regularly for regular breakouts. If extensive, a course of antibiotics for a few weeks or months may be required.
Grover’s disease is less common but can look like acne spots although without pustules.
Grover’s disease tends to affect skin exposed to heat, humidity, sweating, tight clothing and is caused by a disruption of the skin microstructure from rubbing. The scaly red spots are usually itchy unlike acne and are more difficult to treat with antibiotics or Vitamin A-based treatment alternatives.

 

 
 

Does stress affect your skin? How?

 

The role of stress in skin diseases is controversial as this is difficult to objectively prove. Anecdotally, stress can aggravate certain skin conditions via release of hormonal signals but stress does not directly cause skin problems per se.
Acne, eczema, psoriasis are amongst conditions that are commonly reported by patients to be aggravated by stress.

 

Why do we get spots in other places of our body (chest, bum etc)?
 

 

Common acne usually affects the face but the trunk and buttocks are also involved in many people, where there are high density of hair follicles and sweat glands. In sports people, tight clothing and sweating aggravate acne. Cyclists, in particular, get saddle sores, that are a variant of acne with painful abcesses.
 

 
 

What would you recommend for sensitive skin and training?
 

Use “breathable” clothing as much as possible, shower after training and moisturise. Avoid products with fragrances and natural oils e.g. lavender, tea tree oil etc as these can commonly sensitize the skin to cause allergic contact dermatitis. Seeking medical advice early on for effective treatments and maintenance will help minimize training disruptions from persistent skin issues.
 

 

Any natural ways/remedies for skin protection/ moisturising?
 

 

Use a skin moisturiser without fragrances or natural oils e.g. lavender, tea tree oil etc. Drinking water is not sufficient to restore skin moisture lost during training or washing – very little actually gets to the skin.

Eat healthy - Nutrients such as vitamins A, C, E and omega-3 and -6 help to maintain healthy skin through potent antioxidant characteristics by preventing cellular damage from free radicals. Keep up the colourful fruits, vegetables, walnuts, avocados, fatty fish, and green tea...to name a few.

Training with an open wound. Cover it or not? How shall we treat it before and after training?
 

Yes, definitely cover it with a tape or dressing. Depending on the location, type and depth of the wound, it may require more specific treatment. Generally, though, use a greasy moisturiser like Vaseline to “seal” the wound and then apply tape over it to protect it. This will aid healing and also reduce the risk of infections e.g. warts, bacteria. After training, the tape can be removed and skin washed. Tape can be re-applied after a shower if preferred, to protect the area and to aid healing.

 
 

Give us your top tips to maintain healthy skin free of spots.

  1. “Acne-free” genes – but realistically, this is beyond our control.
     

  2. Avoid aggravating factors e.g. occlusive products and make-up. Use “non-comedogenic” and mineral make up that is oil-free.
     

  3. Don’t pick or squeeze as this can cause scarring.
     

  4. See a dermatologist early – there are great medical treatments that can be prescribed to achieve complete acne clearance and to prevent scarring.