Allergic Skin Reactions in Athletes
Updated: Aug 16, 2020
Can you be allergic to work? Well, you can certainly be allergic to some of the tools or equipment or other exposures in your workplace. I've written about this topic before, because it's such an important cause of allergic skin reactions.
These types of allergic skin reactions can even impact athletes. Even professional athletes who compete in sports for a living may be impacted.
I read a recent report about Marian Hossa, a star hockey player. Mr. Hossa is a professional hockey player for the Chicago Blackhawks, and a recent report indicated that he may have to stop playing professionally due to side effects from a medication used to treat a chronic skin condition. Reports have indicated that he has experienced serious allergic reactions due to his equipment.
When I read that report, I suspected allergic contact dermatitis.
Allergic contact dermatitis (ACD) is one type of allergic skin reaction, and it can be triggered by a number of different chemicals and substances. When you encounter those substances while doing your job, the reaction is known as occupational allergic contact dermatitis. I've written about triggers in mechanics, hairdressers, physicians, and even office workers.
Professional athletes are another group at risk for occupational ACD.
Athletes, whether they're professional or recreational, come into contact with a number of different items that can serve as triggers for ACD.
The dyes that are used in uniforms, especially dark blue textile dyes, can trigger allergic reactions.
Back when Continental Airlines existed, I treated multiple flight attendants for allergic reactions to their uniforms. (I'm from Houston, the home of Continental Airlines). The Continental uniform was a dark blue, and these flight attendants had developed allergic reactions to the blue dye that was used in their uniform. Specifically, they were reacting to either disperse blue 106 or disperse blue 124 textile dyes.
Clothing dyes can be used in all types of clothing. While I've seen reactions to red, orange, and yellow dyes, the most common clothing dyes that trigger allergic reactions are the blue disperse dyes. These can be used in blue clothing, but they can also be used in black, green, purple, or potentially any dark-colored clothing.
These dyes can be very challenging to avoid, because the labeling laws in the United States do not require any disclosure of which specific dyes have gone into a product.
The most common clothing triggers that I've seen have been items of clothing that are worn tight against the skin AND that are made of synthetic materials.That's because the dyes in synthetic clothing are more easily leached out when sweating.
What specific articles of clothing can be a trigger?
One of the most frequent triggers that I see nowadays is workout clothing. That's because these items are worn while sweating, they're frequently made of synthetic materials, and they're often worn tight against the skin. When they're worn tight against the skin, there's more of a chance for friction and irritation. That means there's more of a chance for an allergic reaction. I've seen this type of reaction triggered by workout leggings, by workout shirts, and by sports bras. I've even seen children who have reacted to the T-shirts (dark colored and made of a synthetic fabric) that they've worn while competing.
Uniforms are definitely a potential trigger. These may be made of cotton/polyester blends, or of synthetic fabrics. They may be tight against the skin. For my flight attendant patients, I would see the reaction more commonly on the legs, especially on the thighs, where the clothing rubbed against the skin the most. I've also seen this reaction commonly at the waistband.
2. Protective equipment
Even protective equipment can trigger allergic reactions. The rubber chemicals in gloves are one example.
I've seen many cases of allergic reactions to different types of protective equipment.
The rubber chemicals that are used in gloves or padding are one of the more common triggers. While many people think of latex when they think of allergy to rubber, there are actually a number of other different chemicals that are used in the rubber manufacturing process. These other chemicals can trigger allergic reactions. Rubber accelerators are a common cause of ACD to rubber objects, and include chemicals such as carbamates, thiurams, and mercaptobenzathiazole. These chemicals may be used in all sorts of rubber objects, from gloves to protective padding to elastic in clothing to materials in shoes.
I've also seen multiple cases of reactions to neoprene. Neoprene is the soft spongy rubber material that's used in computer mouse pads or koozis. It's also often used for elbow, hand, and knee braces. Neoprene rubber can also be used a lining for shinguards, and can trigger reactions on the legs.
Whether it's personal cleansers (shower gels) or the cleansers used to wipe down sporting equipment, the fragrance additives and other ingredients used in these products can trigger allergic reactions.
You might not think of this one, but it's a common one in athletes. I've had several patients who have reacted to the shower gel that's used in their gym. Common triggers are common, and one of the most frequent triggers for allergic skin reactions in general are fragrance additives. Another frequent trigger are the preservatives that are used in skin care products. That's why soaps and shower gels are often triggers of ACD.
I've also seen reactions to the cleansers that are used to clean yoga mats or wrestling mats. The wipes that are available at the gym to wipe down equipment contain preservatives. That's because any time you have a product that contains water, it must also contain preservatives to prevent the growth of mold and bacteria. These preservatives can trigger allergic reactions. One of my patients had a serious reaction to methylisothiazolinone, which was used as the preservative in the cleansing wipes at her gym.
Nickel is easily transferred via sweat, which means that lifting metal weights and then wiping the sweat off your face can lead to the transfer of small nickel particles.
I've treated many patients who are allergic to nickel. Nickel is a metal, and most of us will many exposures to nickel in the course of an average day. Nickel is cheap and very strong, so it's used in all types of metal objects, from jewelry to cell phone cases. It's also frequently used in metal weights.
If you're handling metal weights, and then sweating, and then wiping your eyes, you may be transferring nickel. You can actually transfer tiny particles of nickel via your fingertips. That's because nickel is leached out from metal objects more easily with sweat. Some of my patients with eyelid dermatitis have actually reacted from transfer of nickel via their fingertips to their eyelids. I've seen this happen via cell phones, via metal eyeglass frames, and via metal weights.
5. Other exposures
Shoes are another potential trigger of allergic skin reactions.
I've discussed uniforms and protective gear, but there are certainly other potential triggers, such as shoes. Remember, this is a delayed reaction, which means it can be hard to figure out the trigger. ACD is a delayed reaction, and reactions usually take 2-3 days to develop, although they can develop as soon as a few hours later, or as long as a week later. If you hit the field on Saturday morning, you may not develop an allergic skin reaction until Monday morning.
Whether you're a casual athlete, a weekend warrior, or a professional, it's important to recognize that your clothing, equipment, and protective gear may all have the potential to trigger an allergic reaction.