Skin Care For Athletes: Calluses, Blisters, and Rips, OH MY!

This is a guest post by Michi Shinohara, MD is a board certified dermatologist and dermatopathogist (skin pathologist) who specializes in medical dermatology at the University of Washington Medical Center and Roosevelt Clinic. When she isn’t teaching, seeing patients, or looking at slides she spends time with her husband and crazy cute 17 month old. She has been crossfitting for almost 5 years, the last 2 ½ at SLU/FCF.

Yay Michi


As a dermatologist, I get a lot of questions about skin care. That, and people try to show me their business in public (you know, “I’ve got this spot here…” For the record, if you are worried about any spot on your skin, I am always happy to look but it’s dark at FCF at 6am so I can also give you some names of some great dermatologists in town. Also check out https://www.aad.org/spot-skin-cancer/understanding-skin-cancer/how-do-i-check-my-skin/what-to-look-for).

One of biggest misconceptions is how to take care of your hands. CrossFitters build a lot of calluses, and eventually those calluses become a lot of rips. A callus is just thickening of the top layer of skin, or stratum corneum, and is a response to repetitive trauma.

Should you remove your calluses? It depends.

Zeb's calluses. After shaving them down.

If you completely remove calluses, it defeats the purpose for getting them in the first place, and your baby-skin hands will hurt every time you hang from the pullup bar or pick up a barbell. Remember Foundations? If you leave calluses to grow, it’s guaranteed your hands will rip the next time you try to do too many toes-to-bar or “MURPH”.

What do I do? I pare my hands now and then. Use a cheese grater, the Ped Egg Soak (my favorite), the Micro Pedi (AB’s favorite), or soak your hands in warm water and use a pumice stone or file (side notedon’t share these. Really. So. Gross. Things live in the skin, like wart virus and fungus. Ick.)

OK, so you forgot to pare down your calluses, “CHELSEA” is programmed for Friday , and you ripped your hand(s). Now what?

photo

Once you wipe the blood off (again, ick) the pullup cage, clean your hands with water or a gentle soap and water. This is going to hurt. The tender underlayer of skin (dermis) is now exposed, and it’s where all the nerve endings live. The nerves aren’t meant to be exposed like that, and they are telling you that you are injured. The next step illustrates an important principle of dermatology – moist wound healing.

LEAVE THE SKIN FLAP ON YOUR HAND. This is really important!

DO NOT CUT OFF THE TORN SKIN.

Skin cells (keratinocytes) heal wounds by either crawling from the sides of the wounds or by coming up from hair follicles. Since most of us don’t have hairy palms, the little baby keratinocytes need to crawl across the wound, making a new top layer (epidermis). Keratinocytes can’t get through dried up old cracked scab. They like moist, mushy dermis. Keeping the dead skin on creates a “biologic dressing”. So as soon as you can, try to pull that dead skin back down over the rip, and then keep it moist with some Vaseline or Aquaphor ointment. If you have access to it, you could also use a skin adhesive, like New Skin® or even (gasp!) Super Glue. Same thing if you get a blister; leave the blister intact; you can drain the fluid out, but keep the top on. You will heal much faster.

What do you do for chafed butts from too many situps or ankles from rope climbs? Again, moist wound healing. If you have ever had this, you know what happens when you get into the shower for the first time. Slather on a layer of Vaseline or Aquaphor ointment* on your chafed area and this won’t happen (*why not antibiotic ointment? Some people develop contact allergies to the antibiotics, and these probably help healing because they are greasy. So just use the grease without antibiotics). Then keep the area covered with a big non-stick bandage until it’s healed.