It was a real dilemma. A patient of mine came to see me last week for acne. He is the star quarterback for one of the local high schools and is having a great season. At the same time that his passing-yards-per-game increased, so have the number of pimples on his face. Interestingly, his acne is confined to his chin and jaw.
So here is this handsome kid who is the new star on campus with big red pimples all over his chin. Could his acne be related to football?
It is. Acne is common in teenagers, over 80% have some acne during these years. While we have dispelled some of the myths, like eating greasy foods makes acne worse, there are things in a teenager’s life that can exacerbate the problem: in this case, football equipment.
There is a skin condition called acne mechanica that occurs in areas where the skin is occluded. This often happens under athletic equipment. It is common in high school athletes, especially hockey and football players. When solid or nonbreathable materials, such as pads or straps, rest on the skin, it occludes the pores. Heat and friction under the material makes the problem worse.
It can be improved by applying a breathable fabric such as cotton between the equipment and the skin. Treating the skin with mild exfoliants such as salicylic acid acne washes or with antibiotics like benzoyl peroxide washes can improve the acne. Sometimes oral antibiotics are needed to clear things up.
A similar condition to acne mechanica is folliculitis. This inflammation of hair follicles can be difficult to distinguish from acne; it is treated in the same way. Anytime you have an infection of the skin it important to see a physician — sometimes red, pus filled bumps can be a staph infection such as methicillin resistant staphlococcus aureus (MRSA). MRSA infections are not uncommon in high school athletes and can spread in the locker room or lead to more serious infections.
My patient put a cotton pad under his chin strap and took oral antibiotics. His acne is already better. So is his pass rating; maybe its just coincidence, but I don’t think so.
Photo: Edward Leger