Int J Sports Med 2021; 42(14): 1297-1304
DOI: 10.1055/a-1446-9828
Training and Testing

Skin Diseases in Elite Athletes

1   Dermatologie im Zentrum, Dermazent, Munich, Germany
V. Vanessa Wegin
2   Department of Sport and Health Sciences, Technical University of Munich, Munich, Germany
Christine Marquart
1   Dermatologie im Zentrum, Dermazent, Munich, Germany
Irene Schubert
1   Dermatologie im Zentrum, Dermazent, Munich, Germany
Marie-Luise von Bruehl
1   Dermatologie im Zentrum, Dermazent, Munich, Germany
Martin Halle
3   Department of Prevention and Sports Medicine, Centre for Sports Cardiology/EAPC, Medical Faculty, University hospital "Klinikum rechts der Isar", Technical University of Munich, Munich, Germany
Renate Oberhoffer
4   Department of Preventive Pediatrics, Technical University of Munich, Munich, Germany
Bernd Wolfarth
5   Department of Sport Medicine Humboldt University and Charité University School of Medicine, Charité Universitätsmedizin Berlin, Berlin, Germany
› Author Affiliations


An athlete’s skin has to cope with various stressors that influence skin integrity. This study investigated the effect of intense sporting activity at a competitive level on skin health, independent of the type of sport. The prevalence of dermatoses in elite athletes who exercise 8 or more hours per week was compared to recreational athletes. By applying a questionnaire, we acquired data from n=492 recruited athletes and recreational athletes regarding the prevalence of dermatoses, the extent of physical activity, and sports discipline practiced. Compared to the reference group, elite athletes showed less inflammatory, traumatic, infectious, and sebaceous skin diseases and especially neurodermitis, pruritus, bullae, tinea pedis, acne, and herpes were less common. Women suffered from skin diseases more often than men. With advanced age, the incidence of dermatoses increased, but less so among elite athletes. The discipline practiced and the duration of training, especially when performed outdoors, strongly influenced the development of dermatoses. Even though the skin of athletes is exposed to higher stress levels and physical strain, we can state that intensive physical activity seems to act as a protecting factor against skin diseases and significantly promotes skin health.

Supplementary Material

Publication History

Received: 28 July 2020

Accepted: 08 March 2021

Article published online:
11 May 2021

© 2021. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

  • References

  • 1 Adams BB. Dermatologic disorders of the athlete. Sports Med 2002; 32: 309-321
  • 2 Carr PC, Cropley TG. Sports dermatology: Skin disease in athletes. Clin Sports Med 2019; 38: 597-618
  • 3 Emer J, Sivek R, Marciniak B. Sports dermatology: Part 1 of 2 traumatic or mechanical injuries, inflammatory conditions, and exacerbations of pre-existing conditions. J Clin Aesthet Dermatol 2015; 8: 31-43
  • 4 Freeman MJ, Bergfeld WF. Skin diseases of football and wrestling participants. Cutis 1977; 20: 333-341
  • 5 Ahmadinejad Z, Razaghi A, Noori A. et al. Prevalence of fungal skin infections in Iranian wrestlers. Asian J Sports Med 2013; 4: 29-33
  • 6 Collins CJ, O'Connell B. Infectious disease outbreaks in competitive sports, 2005–2010. J Athl Train 2012; 47: 516-518
  • 7 Likness LP. Common dermatologic infections in athletes and return-to-play guidelines. J Am Osteopath Assoc 2011; 111: 373-379
  • 8 Pickup TL, Adams BB. Prevalence of tinea pedis in professional and college soccer players versus non-athletes. Clin J Sport Med 2007; 17: 52-54
  • 9 Weesner T. Skin Infections: Which student-athletes are at greatest risk?. NASN Sch Nurse 2017; 32: 235-237
  • 10 Harriss DJ, MacSween A, Atkinson G. Ethical standards in sport and exercise science research: 2020 update. Int J Sports Med 2019; 40: 813-817
  • 11 Nieman DC. Immune response to heavy exertion. J Appl Physiol (1985) 1997; 82: 1385-1394
  • 12 Sugama K, Suzuki K, Yoshitani K. et al. Urinary excretion of cytokines versus their plasma levels after endurance exercise. Exerc Immunol Rev 2013; 19: 29-48
  • 13 Suzuki K, Yamada M, Kurakake S. et al. Circulating cytokines and hormones with immunosuppressive but neutrophil-priming potentials rise after endurance exercise in humans. Eur J Appl Physiol 2000; 81: 281-287
  • 14 Dustin C, Nabhan WJM. Chad Barylski. laboratory tests ordered by a chiropractic sports physician on elite athletes over a 1-year period. J Chiropr Med 2015; 14: 68-76
  • 15 Mastorakos G, Pavlatou M, Diamanti-Kandarakis E. et al. Exercise and the stress system. Hormones (Athens) 2005; 4: 73-89
  • 16 Cirillo N, Prime SS. Keratinocytes synthesize and activate cortisol. J Cell Biochem 2011; 112: 1499-1505
  • 17 Rogoff D, Gomez-Sanchez CE, Foecking MF. et al. Steroidogenesis in the human skin: 21-hydroxylation in cultured keratinocytes. J Steroid Biochem Mol Biol 2001; 78: 77-81
  • 18 Slominski A, Ermak G, Mihm M. ACTH receptor, CYP11A1, CYP17 and CYP21A2 genes are expressed in skin. J Clin Endocrinol Metab 1996; 81: 2746-2749
  • 19 Slominski A, Zbytek B, Semak I. et al. CRH stimulates POMC activity and corticosterone production in dermal fibroblasts. J Neuroimmunol 2005; 162: 97-102
  • 20 Campbell JP, Turner JE. Debunking the myth of exercise-induced immune suppression: redefining the impact of exercise on immunological health across the lifespan. Front Immunol 2018; 9: 648
  • 21 Liu D, Wang R, Grant AR. et al. Immune adaptation to chronic intense exercise training: new microarray evidence. BMC Genomics 2017; 18: 29
  • 22 Simpson RJ, Kunz H, Agha N. et al. Exercise and the regulation of immune functions. Prog Mol Biol Transl Sci 2015; 135: 355-380
  • 23 Walsh NP, Gleeson M, Shephard RJ. et al. Position statement. Part one: immune function and exercise. Exerc Immunol Rev 2011; 17: 6-63
  • 24 Wolkenstein P, Machovcova A, Szepietowski JC. et al. Acne prevalence and associations with lifestyle: a cross-sectional online survey of adolescents/young adults in 7 European countries. J Eur Acad Dermatol Venereol 2018; 32: 298-306
  • 25 Derya A, Ilgen E, Metin E. Characteristics of sports-related dermatoses for different types of sports: A cross-sectional study. J Dermatol 2005; 32: 620-625
  • 26 Gudnadottir G, Hilmarsdottir I, Sigurgeirsson B. Onychomycosis in Icelandic swimmers. Acta Derm Venereol 1999; 79: 376-377
  • 27 Kamihama T, Kimura T, Hosokawa JI. et al. Tinea pedis outbreak in swimming pools in Japan. Public Health 1997; 111: 249-253
  • 28 Shemer A, Gupta AK, Amichai B. et al. Increased risk of tinea pedis and onychomycosis among swimming pool employees in Netanya area, Israel. Mycopathologia 2016; 181: 851-856
  • 29 Peterson AR, Nash E, Anderson BJ. Infectious disease in contact sports. Sports Health 2019; 11: 47-58
  • 30 Svensson A, Ofenloch RF, Bruze M. et al. Prevalence of skin disease in a population-based sample of adults from five European Countries. Br J Dermatol 2018; 178: 1111-1118
  • 31 Andersen LK, Davis MD. Sex differences in the incidence of skin and skin-related diseases in Olmsted County, Minnesota, United States, and a comparison with other rates published worldwide. Int J Dermatol 2016; 55: 939-955
  • 32 Chen W, Mempel M, Traidl-Hofmann C. et al. Gender aspects in skin diseases. J Eur Acad Dermatol Venereol 2010; 24: 1378-1385