If they never threaten the vital prognosis, skin diseases have a significant impact on the quality of life (1). Not only are they visible, but they also cause symptoms…
If they never threaten the vital prognosis, skin diseases have a significant impact on the quality of life (1). Not only are they visible, but they also cause symptoms that can be aggravated by sports. However, make no mistake about it, no physical activity is harmful to the skin, what is, are the conditions in which one engages in it. By the way, all dermatologists recommend exercising.
Activity reduces stress
Whatever it is, physical effort helps to fight against stress which promotes inflammation of the skin such as eczema or psoriasis, the two most common skin diseases in France after acne. A study has even demonstrated its protective effect on the appearance of psoriasis plaques when they are severe (2).
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People regularly practicing vigorous physical activity (1h30 of running, swimming or tennis per week) would thus have 20 to 30% less risk of developing this disease which manifests itself, most often, in the form of well-defined red patches. , covered with more or less thick and dry white scales, especially on the elbows, knees, scalp, feet and lower back. The skin behaves as if it had been attacked (by reacting to stress, tobacco, alcohol, an infection, etc.) and renews itself too quickly. The accumulation of new cells then accompanies the inflammatory reaction.
This is the number of people in France who suffer from a skin disease. Among the most common conditions, acne comes first, followed by eczema, psoriasis, scalp diseases and fungal infections.
Source: SFD, 2017
Different, atopic dermatitis, the most common form of eczema, results in oozing red patches, very dry skin and severe itching. “Due to an immune disorder, people who have it genetically have very permeable skin that absorbs everything, including allergens and irritants.“, emphasizes Dr. Marc Perrussel, dermatologist and vice-president of the National Syndicate of Dermatologists Venerologists (SNDV). The immune system then responds in an exaggerated way to these attacks. This causes skin inflammation and then lesions. These two chronic illnesses which evolve by pushing can be accentuated under the influence of environmental factors.
Protect yourself from cold and heat
Sick skin does not like extreme temperatures. Hot and dry or very cold atmospheres lead to ambient dryness causing faster evaporation of the water contained in the skin tissues. The skin is only more fragile.
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It also becomes more vulnerable to allergens and irritations. Burning sensations, crevices, cracks and itching then develop. As for the sun, if its rays have an immunosuppressive effect which can improve psoriasis plaques (UVB and UVA rays are also used in treatment), it further weakens atopic skin and can lead to major eczema attacks, in due to photo-allergy phenomena (allergy to sunlight). It also promotes skin cancer, carcinoma, in people who practice outdoor sports without sun protection and clothing.
Some treatments used in dermatology can have annoying side effects for sports practice: ciclosporin in particular, which causes a lack of magnesium (source of cramps), and methotrexate which causes fatigue.
People who suffer from atopic dermatitis are particularly vulnerable to pollens. They should also avoid jogging or horseback riding in the countryside in the spring due to the presence of many plants and pollens, sources of allergies. Unless you go out between two showers, outdoor activities (walking, running, golfing or cycling) are also not recommended on windy days.
Testimony: Franck, 42 years old, suffering from psoriasis and under biotherapy for about ten years. An additional constraint.
“I had my first attack of psoriasis at 7 years old following chicken pox. I was covered in patches from head to toe almost overnight. At the time I played football, a real passion! The diagnosis of the disease did not change anything, I continued to practice sport with the same comrades without asking myself any questions. Besides, no one has ever commented to me. Today, looking back, it surprises me and I wonder how I could continue to undress in front of them.
From college, it became more difficult: I was ashamed of my illness, I started to hide my plaques by always wearing covering clothes. After a sports session, I was waiting to go home to shower. I asked for medical certificates from my doctor to be exempted from swimming pool. I lived through hell with a long period of therapeutic wandering. Perspiration caused me very painful burning sensations and in winter, playing football in the cold favored the formation of cracks on an already very dry skin.
Today, I wouldn’t be able to. Fortunately, for 10 years thanks to biotherapies (1 injection every 2 weeks), I no longer have any lesions, I have changed my sports practice by running and swimming while continuing to play football as a for fun.»
Any physical effort promotes perspiration because the muscles generate heat by contracting. To lower the body temperature, the body will evacuate this excess heat by producing sweat. However, perspiration can be very irritating and trigger an outbreak of eczema or psoriasis, due to its acid pH and the salts it contains. In atopic dermatitis, by aggravating the alteration of the cutaneous barrier, perspiration causes itching. In people with psoriasis, it promotes friction and the formation of scarring plaques.
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Burning, tingling, tightness… Sweat often rhymes with pain. Beware, in particular, of perspiration concentrated in the folds (knees, groin, etc.), which can cause maceration. It is therefore preferable to avoid any physical activity during the hottest hours of the day (preferably dawn or dusk) or to reduce the intensity. It is necessary to provide something to refresh your skin with a mist of thermal water kept in the refrigerator and a soft towel to be able to wipe the sweat. It is also best not to go bare-chested, as clothing helps absorb perspiration.
Finally, it is necessary to choose your equipment carefully. Combined with chlorinated water, foam “fries” and floating polystyrene “noodles” can irritate delicate skin. Be careful also with textiles such as lycra or neoprene of diving suits which retain humidity and promote maceration. Beware of magnesia, the powder with which we coat our hands to use apparatus or practice climbing. It can be a source of allergy and cause an attack of atopic dermatitis.
Fungal infections and warts: beware of contagion
Already weakened, skin affected by eczema or psoriasis is more vulnerable to infections, including fungal infections (caused by microscopic fungi) and warts (due to an HPV virus). The latter contract more easily in swimming pools, on the floor of changing rooms, but also in sports shoes, on judo and karate mats, etc.
People with atopic dermatosis or psoriasis will take care to adopt even stricter hygiene: plastic shoes for walking by the pool and shower before swimming. As for those who have fungal infections or warts, they should avoid going to the swimming pool, in the showers or on the tatami until they are cured, because they are very contagious.
Opt for the right sport
If aquatic activities are to be encouraged in people suffering from psoriasis, those with atopic eczema must take precautions. The chlorinated water of swimming pools and salt water in the marine environment dries out the skin and attacks it. It is therefore advisable to apply a barrier cream before the bath, and to rinse with clear water afterwards. In the event of a severe crisis or when the plaques are very inflammatory, it is better to avoid salt water completely.
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Activities that generate friction (cycling, horse riding) or contact (martial arts) risk inducing a Koebner phenomenon: either the appearance or increase of a plaque of psoriasis on the friction zone or on a wound . “In general, pay attention to intensive practices”, recalls Dr. Perrussel.
The precautions to take
Good reflexes are essential before, during and after a sports session so as not to amplify your skin problems.
• Choose the right time for outdoor sports: in summer, rather in the morning “in the cool”, in winter at lunchtime.
• Moisturize your skin with an emollient (a third of a tube per application) or a barrier cream 1 hour beforehand if you go into the water. For outdoor activities, do not forget sunscreen (50 index) if the UV index is greater than 2.
• To drink a lot of water.
• Wear loose clothing to limit friction, and light colors to reflect radiation, favoring technical anti-perspiration fabrics. If necessary, put on a headband or wristbands.
• Warm up gradually, split the sessions by alternating phases of effort and rest.
• During the rest phases, dab your skin with a towel, drink water and, in case of dry heat, cool off with thermal water sprays or ice cubes to relieve itching.
• Quickly take a cool shower (between 32 and 34°C) with your usual product (cleansing oil, surgras soap, etc.) to eliminate perspiration.
• Generously apply its emollient and, if necessary, its local treatment (dermocorticoids).
• Drink plenty of water.
• Put on dry, clean clothes, if possible cotton or linen, to avoid perspiration.
References: (1) Annals of Dermatology and Venereology, December 2018. (2) Jama. 2012; 148 (8): 918-924.
French Eczema Association: 15, rue du Val 35600 Redon
France Psoriasis: 01.42.39.02.55.