Out with the jackets, in with the swimsuits. It’s summertime! Nothing beats these fun-filled weeks with your children. Memories are in the making while everyone is splashing at water parks and beaches and you’re cheering your kids on at games and practice. Warm-weather activities may cause or aggravate skin conditions, and protecting against the ones that follow is your children’s first line of defense.
You may feel protected in chemically treated water and may think that beaches and lakes are too large to harbor anything harmful. However, according to the Centers for Disease Control and Prevention (CDC), recreational water illnesses (RWI) are caused by various germs found in swimming water. RWI are transmitted by ingestion, inhalation or contact with contaminated water from treated and untreated water sources, and can affect kids (and grown-ups) by causing a wide variety of infections — including ear, respiratory, gastrointestinal, skin and wound infections. Here are some opponents to watch for.
Hot Tub Rash
Hot tub rash is an infection of the skin’s hair follicles, causing itchy, red bumps and tender, pus-filled blisters. Occurring after prolonged exposure to contaminated water — often with the germ Pseudomonas aeruginosa — this rash usually appears within a few days of exposure. It is found in poorly maintained hot tubs and all recreational swimming venues. Taking frequent breaks and rinsing immediately after swimming will help stop it. If your child develops a rash that lasts longer than a few days, consult your healthcare provider.
Follow safety recommendations from The Association of Pool & Spa Professionals (APSP), including reducing temperature from the maximum 104 degrees to 98 degrees and only using the tub in 15-minute segments. Excessive heat can contribute to skin conditions, including burns.
Excessive summer heat, along with chemicals used to treat water, can affect children’s skin, especially those with eczema. Eczema is a noncontagious, inflammatory, itchy skin condition producing a hypersensitivity rash. During swimming, afflicted areas are generally submerged. Chlorine and other chemicals can have a drying effect, further aggravating eczema. If your child has eczema, note and discuss any worsening conditions with your provider.
Staphylococcus aureus, or staph, are bacteria commonly found on the skin or in the nose of one out of every three people, according to the CDC. Methicillin-resistant Staphylococcus aureus (MRSA) is staph that are resistant to certain antibiotics, making it a challenge to treat. In the general community, MRSA skin infections are common. Although MRSA doesn’t survive long in properly treated swimming water, it can still spread through direct contact, touching another person’s MRSA infection, or indirect contact by sharing items or touching surfaces contaminated with it. Frequent hand washing, as well as not sharing towels, sports gear and other items, is key to helping to prevent a MRSA infection. If you suspect a MRSA infection, cover the area with a bandage and contact your child’s provider for evaluation and treatment.
Sports involving close contact make the spread of skin infections easy and all too common. They can also be transmitted through shared equipment. Skin infections can yank your athlete out of the game.
Herpes gladiatorum, also known as mat herpes, is spread by direct skin-to-skin contact with herpes simplex virus type 1 (HSV-1), the same virus that causes cold sores on the lips. Lesions generally appear within eight days of exposure. Some kids may experience a sore throat, swollen lymph nodes, fever or tingling on the skin where the future lesions will erupt. They appear as a cluster of blisters to the face, head, neck, extremities or trunk. Frequent handwashing and showering immediately after a sporting event will help prevent infection. If your child develops any signs or symptoms, especially involving the eye or surrounding area, notify your provider right away. Although the herpes virus can have inactive, dormant periods, when an outbreak does occur it can be treated with medication prescribed by your provider.
Athlete + summer = mountains of sweaty clothes, locker room showers, foul-smelling gear and the risk of getting a fungal infection. Ringworm, athlete’s foot and jock itch are different skin infections known collectively as tinea. Caused by fungi called dermatophytes that live on skin, hair and nails, they thrive in warm, moist areas. They are shared in locker rooms and in public showers, and through sports gear and towels. Symptoms and treatment vary depending on where the infection appears.
Not a worm, ringworm gets its name from the ring-like rash it causes. Called tinea capitis when found on the scalp and tinea corporis on the body, it has a scaly, red, circular appearance and it itches. Balding will occur to affected areas with tinea capitis. See your provider regarding treatment for either form, if infected.
Tinea pedis, commonly known as athlete’s foot, typically affects the soles of the feet, between the toes and sometimes the toenails. Its name is well-deserved because it commonly occurs in athletes whose feet tend to be damp and sweaty. Symptoms include itching, burning, redness and stinging in the area that may flake, peel, blister or crack. Athlete’s foot is highly contagious.
Jock itch got its name because it’s commonly seen in those who perspire a lot while playing sports. But don’t be fooled! The fungus that causes tinea cruris (jock itch) can thrive on the skin of any child who spends time in hot and humid weather, wears tight clothing such as bathing suits, shares towels and doesn’t completely dry off the skin. Symptoms include redness, chafing, itching or burning in the groin, upper thigh or anal area.
Proper and frequent hygiene techniques, wearing waterproof sandals or flip-flops in public bathrooms, locker rooms and showers, in addition to drying well, will help prevent fungal infections. Tinea cruris or tinea pedis can usually be treated with over-the-counter (OTC) antifungal creams and sprays. If these treatments are ineffective in your child’s case, your provider can prescribe other treatment.
Warts are skin infections caused by viruses in the human papillomavirus (HPV) family. Commonly seen in children, warts can affect any area of the body, but tend to invade fingers, hands and feet. Plantar warts are found on the bottom of the foot and can cause much discomfort. They develop after direct contact with a surface a person with a plantar wart touches, such as a bathmat or shower floor. Wearing waterproof sandals or flip-flops will help prevent it. Consult your provider for treatment options if a plantar wart develops.
Sports acne, which is caused by sports activity, can affect both boys and girls of all ages. The most common form, acne mechanica, occurs when straps, pads or tight clothing trap sweat against the skin. This sweat provides a perfect environment for bacteria to grow, leading to irritation, clogged pores and pimples. Having your child shower immediately following sport activity — as well as wearing the loosest clothing permitted — will help prevent this condition. In addition, removing gear when the sport permits relieves tension on the skin.
Summer is a great time of year to kick back and enjoy your children. By following this summer-skin playbook, you will keep your child’s skin protected and itch-free.
Francine Bono-Neri, MA, RN, PNP, has been a PNP since 1997. She is currently a PhD student at Molloy College where she also works as an adjunct, teaching undergraduate nursing students for The Barbara H. Hagan School of Nursing.