In 1347, a plague struck Europe that killed approximately one-third of the entire population. It was called the “Black Death” and later known as the Bubonic Plague. In just five short years, 25 million people died. That number is absolutely staggering if you think about it. As a percentage, that would be equivalent to 108 million people dying today in the United States. Medieval medicine had no way to combat the disease. There was no treatment because there was no understanding of what it was or how it was spread. And with no understanding, there was no way to offer preventative measures to the public.
Now, I want to apologize for leading an article on skin infections with a comparison to the Bubonic Plague. The comparison may be a bit extreme. However, I’m not sorry enough to go back and delete what’s already been written. The reason is the topic of skin infections makes a lot of guys in the jiu-jitsu community nervous. If skin infections don’t make you nervous, you’re training in a blissful world of rainbows and unicorns. By leading off with some good old “Black Death” talk my hope is you’ll realize most skin infections are minor, but have the potential to be very dangerous. I’ll even go a step further and tell you that if you train jiu-jitsu (or any other grappling art), odds are you will come down with some type of skin infection at some point. Consider it an eventuality.
The most important thing to realize is that most skin infections are highly contagious, but also relatively easy to treat when properly medicated. Good hygiene habits and simple awareness can go a long way in preventing most infections. First thing first, let’s take a look at the different types of infections you may encounter on the mat.
Different Types of Infections
Basically, there are 3 types of skin infections that are associated with jiu-jitsu training. They are the same infections that are seen in wrestling, judo and even defensive tactics rooms across the world. They are:
- Fungal – Fungal infections are spread through the dispersal of spores into the skin. These infections are very contagious and thrive in warm, moist environments. Can be passed with skin-to-skin contact or by contact with contaminated objects. Treatment for fungal infections is typically done with over-the-counter medications.
- Bacterial – Bacterial infections are spread through open wounds in the skin. Bacteria is basically found everywhere, but only becomes a problem when it gets into and under your skin and begins to “colonize”. These types of infections tend to be very infectious and needs to be treated by a medical professional.
- Viral-Microscopic – Viral infections are not quite as easy to transmit as fungal or bacterial infections, but they need to be taken extremely seriously. The major concern with these, and we’ll use Herpes Simplex Type-1 (Herpes) for example, is that once you have it, you have it for life. Medical treatment is required.
Most Common to Jiu-Jitsu
Have I got your attention yet? Hopefully this article doesn’t turn you into a germophobe and prevent you from training. In the big scheme of things skin infections are actually pretty rare. But they do suck when you get one, so it’s important to know the scoop. Education is the key to prevention, and I want all my students and training partners to be aware of what’s out there and why it’s important to maintain proper hygiene. Knowing what’s common and recognizing the symptoms plays a critical role in prevention. So, for each of the different types mentioned above, I’ve listed one common example to be aware of while training (or competing).
Ringworm (Fungal) – Ringworm is a highly contagious fungal infection of the skin. Like all infections, ringworm can pop up anywhere on your body. In jiu-jitsu, common places include the hands, face and neck. That’s because wearing a gi does offer an initial layer of protection from skin-to-skin contact. Symptoms include itchy skin, scaly/cracked skin, a “ring-shaped” rash, and loss of hair in the affected area.
Ringworm is typically spread from direct skin-to-skin contact. However, it can also be passed by touching an infected object or surface that is contaminated. Examples include uniforms, towels, or any other gym equipment. The spores that cause the infection thrive in warm, moist environments like a gym. Good hygiene and proper cleaning after training is a must. But more on that in the prevention portion of the article.
So, what does a ringworm look like? An infection usually starts out as a red or pink skin patch that may be either flat or slightly raised. The sores may be moist when the start, but more often they are dry, scaly and itchy. As the infection grows, it forms a red ring-shape. As the ring expands, the center of the infection will look like it’s clearing up. Scratching the infection may cause the skin to break and that could potentially lead to a secondary bacterial infection so be cautious.
Ringworm can be successfully treated with over-the-counter antifungal medications. It’s the same treatment someone would take for athlete’s foot or jock itch (both are fungal infections). The medications can be a cream, gel, lotion, spray or powder. No doctor visit or prescription is needed, although it’s never a bad idea to consult a medical professional just to be sure the infection is properly identified. Important note, don’t be “that guy” and try to treat this or any other type of infection with bleach. That will burn and damage the skin, causing more damage than good. When treated properly, the infection should clear up relatively quickly.
Impetigo (Bacterial) – Impetigo is a highly contagious bacterial infection of the skin. As with the ringworm described above, infections can appear on any part of the body. Impetigo is itchy and sometimes painful. While it can show on normal, healthy skin, impetigo more often develops in areas where the skin is already irritated or injured. Think of areas that have small cuts or breaks in the skin as well as areas (like your neck) that get damaged from the rubbing of the lapel.
Similar to fungal infections, bacteria thrive in warm, moist environments. But these environments may also be as simple as a gym bag or a boxing glove. Heed the advice given to you in health class – always use protection (precautions).
Signs of impetigo typically begin as small, red spots. As time goes on, the spots change to blisters that eventually break open. As the wound dries it forms a yellowish crust. These sores are typically not painful, but are often itchy. It is common for the spots and/or blisters to ooze a fluid and increase in size and number. The sores may be as small as a pimple or as large as a coin. These pus-filled lesions often form around the base of a hair and when they become more severe they become a boil.
Proper treatment begins by seeing a medical professional. Using a topical antibiotic can clear up most symptoms in 7-10 days. If left untreated, the infection could clear up on its own in 2-4 weeks. However, not treating the infection leaves a better chance for others to become infected and may lead to dangerous complications.
MRSA “Staph” (Bacterial) – I’ll cut right to the chase, MRSA is nothing to mess with or take lightly. MRSA stands for Methacillin-Resistant Staph Aureus. It’s also known as the “flesh eating bacteria”. Immediate treatment by a medical professional is absolutely critical to assure a full recovery. A proper diagnosis must be made before the infection spreads. Taking the wrong antibiotic will not clear the infection and may even make it worse.
Ever hear of the old UFC fighter Kevin Randleman? He had a famous run-in with MRSA that put a hole under his armpit big enough to be used as a birdhouse. It was absolutely disgusting and a great example for why we must take MRSA seriously.
So, what are some of the early symptoms of MRSA? Typically, an infection will start out as a bump, boil or pustule. The area will be red, swollen and full of pus. Visually MRSA lesions can be mistaken for spider bites. The area may also be painful and warm to the touch. Those symptoms will soon be accompanied by a fever.
MRSA can lead to septic shock, a very severe illness that can result in loss of limb or life. Signs and symptoms of septic shock include fever and malaise. Generally, when someone has reached that point it requires hospitalization and may even require surgery. These types of infections commonly occur either at sites of breaks in the skin such as cuts, and/or areas covered by hair.
Herpes Symplex Type-1 (Viral) – If the talk about MRSA didn’t make you squirm, the thought of getting herpes from jiu-jitsu will definitely give anyone a moment of pause. Although herpes is generally considered a sexually transmitted disease, it still can be passed from one person to another during training. This is because of the outbreaks that occur on an infected person’s face. Usually the infection shows around the lip, nose and cheek area. Contact with an infected person while they are having an outbreak could spread the virus.
Some of the signs or symptoms an infected person may experience include tingling, itching or burning for up to a day before the first signs of blistering appear. Typically, the blisters form in groups and appear as red, swollen areas that are tender and painful.
If you see someone with unusual sores on their face, it is important you ask the infected person for an explanation. That is not the time to worry about being rude or unsympathetic. Contracting herpes is a life-long problem. It is far better to be direct on the front end than have a lifetime of regret.
The best way to deal with the threat of skin infections is prevention. Staying proactive and observant can lead to reduced outbreaks and shorten treatment time. Some quick tips include:
- Wear a gi or rash guard at all times. It limits the amount of exposed skin susceptible to infection.
- Shower immediately after a training session. Don’t let more than 30 minutes go by without taking a full body shower and use antibacterial soap.
- Conduct “skin checks” of yourself daily.
- Wash workout clothes after each use with antimicrobial detergent.
- Do not share equipment.
- If you have an area that appears red or itches, show your coach. Don’t be selfish and try to hide a possible infection from your training partners.
- If you come in contact with an opponent who has an open lesion, clean the areas and clothing that came in contact with that person immediately.
While reading about things like MRSA and herpes is fairly sobering, I want to assure you neither of those are overly common. The happen enough to warrant discussion and education, but the chances of you contracting either one of those through jiu-jitsu is slim. Much more common are infections caused by ringworm and impetigo. For example, I have been training jiu-jitsu for 20 years. I’ve gotten ringworm probably a half-dozen times. I’ve gotten impetigo once for sure and another time I’m sure was some variant of impetigo. Most of my exposures resulted either from tournaments or from visiting other gyms. It’s just the nature of the beast. If you enjoy grappling, at some point you’ll be grappling strangers who frankly may not care as much about hygiene as you.
There is no way to 100% prevent catching a skin infection. Something like ringworm can be just as easily passed along by things like pets or even dirt. Infections are just out there waiting for their opportunity to annoy grapplers. The best you can hope for is limiting the opportunities to become infected. Good hygiene and proper equipment cleaning is a critical factor that you have full control over. The problem is always the other guy. You don’t get to choose who you roll with at tournaments. No one is doing skin checks on everyone through a four-round bracket. It’s just the nature of the beast. The best we can do as grapplers is to do our best, remain vigilant, and stay educated.
Disclaimer: The views expressed in this article are entirely my own and are not to be taken as official views from the city or law enforcement agency where I work. Any techniques that are demonstrated or discussed are to be done at your own risk. Consult with your local district attorney and your agency policy before implementing anything learned on this site. Federal law, State law, and agency policy always trump my opinion.
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