NATA Releases Guidelines on the Prevention of Skin Diseases in Athletics

Contacts:               Robin Waxenberg               Ellen Satlof, NATA

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NATA annual meeting and clinical symposium offers comprehensive recommendations for avoiding, identifying and treating fungal, viral and bacterial skin infections in athletes at all levels


Drexel University wrestler discusses battle with MRSA

PHILADELPHIA, PA., June 23, 2010 –As part of an ongoing effort to reduce the incidence of skin diseases among athletes at all levels, today at its 61st annual meeting and clinical symposium at the Pennsylvania Convention Center in Philadelphia, the National Athletic Trainers’ Association (NATA) released a position statement on Preventing Skin Diseases in Athletics. The statement, which will be published in the July 2010 issue of the Journal of Athletic Training, NATA’s scientific publication,includes comprehensive recommendations for avoiding, identifying and treating fungal, viral and bacterial skin infections, some of which are life threatening. An electronic version of the complete statement is available at

A recent review of infectious disease outbreaks reported that skin diseases accounted for more than half (56 percent) of all infectious diseases in competitive sports from 1922 through 2005. Close quarters that promote skin-to-skin and bodily secretion contact make athletes particularly vulnerable to contracting skin diseases – some of which (e.g., MRSA) can be life threatening.  Understanding basic preventive measures, identifying clinical features and swift management of skin diseases is essential in preventing the spread of common and serious skin infections.

Guidelines for Skin Disease Prevention

Steven M. Zinder, PhD, ATC, assistant professor of exercise and sport science at the University of North Carolina at Chapel Hill and chair of the position statement writing groupprovided an overview of the statement. His presentation included seven key guidelines for preventing the spread of skin diseases, as follows:

  1. Institutions must provide adequate financial and human resources to implement a comprehensive infectious disease control policy.
  2. Maintenance of clean facilities is paramount in limiting the spread of infectious diseases.
  3. Adequate hand hygiene including frequent hand washing and showering after every sport activity may be one of the biggest factors in reducing the spread of infectious diseases.
  4. Athletes and coaches must be educated about, and encouraged to follow, good overall hygiene practices.
  5. Athletes must be discouraged from sharing towels, athletic gear, water bottles, disposable razors and hair clippers.
  6. All clothing and equipment should be laundered and/or disinfected on a daily basis.
  7. Athletes should be encouraged to complete daily skin surveillance and report any suspicious lesions for treatment.

“The burden of skin diseases extends far beyond the financial toll for medical services and lost productivity,” Zinder said. “We should concentrate our efforts on preventing these diseases rather than expending our resources attempting to treat them.”

Education: The first-line defense against skin diseases

Jack Foley, ATC, assistant athletic director and director of sports medicine, Lehigh University and part of the position statement writing group believes that education is the fundamental first step in halting the spread of skin diseases. “It is necessary to have well informed personnel and athletes in order to promote our best line of defense against skin infection outbreaks,” Foley said. “Putting a strategic plan in place, and using a team approach with the latest clinical knowledge available to us, is the absolute best insurance against skin infections in athletics.”

David B. Vasily, MD, FAAD, team physician/dermatologist at Lehigh University, president of Lehigh Valley Dermatology Associates and writing group member agreed with Foley that a preemptive, forward looking plan is also essential in preventing skin diseases among athletes and teams. “Until now the medical field has been by necessity focused on the reactive development of treatment regimens and drugs, rather than on prevention,” Vasily said. “It’s now clear that we need to re-focus our efforts in a more proactive and preventive way to achieve the greatest benefits.”

Mitigating MRSA

Skin diseases fall into the following three categories, based on the type of infectious agent: fungal (e.g., tinea pedis or athlete’s foot); viral (e.g., herpes simplex or cold sores); and bacterial (e.g., staphylococcus a or impetigo). One of the most insidious, dangerous and even life-threatening bacterial skin diseases athletes are dealing with today is the explosion of the common antibiotic-resistant pathogen known as methicillin resistant staphylococcus aureus (MRSA). According to data from the U.S. Centers for Disease Control and Prevention (CDC), in 1974 MRSA accounted for just 2 percent of all infections; however, by 2004 MRSA accounted for 63 percent of all infections.

James J. Leyden, MD, FAAD, emeritus professor of dermatology at the University of Pennsylvania and position statement reviewer believes it’s crucial that athletes, coaches, parents and health care providers be made aware of MRSA, among other infectious diseases as a major disease risk among athletes, since it can result in serious long-term illness or even death. “Everybody on the team and on the sidelines must follow infection control protocols, understand how MRSA spreads, and act in ways that will reduce the risk of contagion,” Leyden said. “Careful decisions regarding the safe and effective use of antibiotics will help slow or halt the development of additional drug resistant strains of this very serious pathogen.”

“There is nothing more important to coaches than the health and safety of their athletes,” according to Mike Moyer,executive director of the National Wrestling Coaches Association. “Skin infections can not only sideline the athlete from play, but also cause removal from school classes and social activities. MRSA and other skin conditions can be passed along from athlete to athlete very quickly, sometimes with fatal consequences, so prevention and detection efforts aren’t just nice to have. They’re imperative.”

A successful battle with infection reinforces recommendations

Kyle Frey, 21, a junior and wrestler at Drexel University in Philadelphia, shared with the audience his own battle with MRSA while competing in January of this year. What started as a small “pimple” grew to the size of his left bicep in just two days. He was diagnosed with MRSA, spent five days in quarantine at Hahnemann University Hospital and was given antibiotics which he was initially resistant to. He was then given a different set of antibiotics and had his arm surgically cleaned to control infection. He remained on these drugs and his arm was stitched and bandaged so he could return to play.

“The whole experience taught me the importance of prevention and early treatment when it comes to skin infections,” said Frey. “My athletic trainer, coach and doctors knew immediately what do to. My mom and teammates provided additional support and we are all much more aware of our personal hygiene in the locker room and with team equipment and mats.”

National Athletic Trainers’ Association (NATA) – Health Care for Life & Sport

Athletic trainers are health care professionals who specialize in the prevention, diagnosis, treatment and rehabilitation of injuries and sport-related illnesses. They prevent and treat chronic musculoskeletal injuries from sports, physical and occupational activity, and provide immediate care for acute injuries. Athletic trainers offer a continuum of care that is unparalleled in health care. The National Athletic Trainers' Association represents and supports 32,000 members of the athletic training profession. NATA supports the Athletic Trainers’ Equal Access to Medicare Act (H.R. 1137). Visit


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