Sports Dermatology Is More Than a Skins Game

“The skin is a window into the inside of the body.” Brian Adams, M.D., on how he helped create a new field of study by blending his interests in athletics and dermatology.

Illustration by Paul Ryding

Brian Adams, M.D.
Sports Dermatology
UC Health – Dermatology Department Chair

Back in medical school, dermatology was interesting to me—and still is—for two reasons. First, you could just look at someone’s skin and figure out if it was linked to something internally or, like Sherlock Holmes, discover what kind of job they had or if they had pets. The skin is a window into the inside of the body. Second, it’s a perfect blend of preventative medical management and surgical approaches.

When I first joined the UC faculty in 1999, the chairman asked me what was going to be my specialty. I grew up with my dad as an athlete and my mom an academic, and I played sports throughout my life, and I wanted to blend those two facets of my life—so I said I wanted to focus on sports dermatology. I ended up being one of the first academics to specialize in the field, and I wrote a textbook in 2006 (Sports Dermatology) that’s still widely used.

Initially, I probably realized that athletes get more sun exposure than the rest of us, but I really didn’t know what other skin challenges were present for them. It turns out there’s a ton of different challenges, from infections to traumatic events to tumors—a lot of conditions athletes get much more commonly because of skin-to-skin contact, abrasions, and being occluded by equipment. Then there are conditions unique to being a sports participant, things a doctor will only see if they’re treating a gymnast or only see if they’re treating a football player. For instance, a dermatologist might see a wart and decide to destroy it with liquid nitrogen. But that’s not a great idea if the patient is a wide receiver for the Bengals and can’t catch the ball on Sunday because they have blisters on their fingers from the wart treatment. So you have to put their diagnosis and treatment in the context of their sport and how it might affect their training.

Our current research study, which isn’t published yet, focuses on reflected UV rays from playing surfaces. Athletes think, Oh, I can wear a wide-brim hat and I’m protected, but a “second sun” is reflecting from playing surfaces and even metal benches to your legs and your arms.

For the WTA tennis pros and other athletes, one of my favorite things is to ask them what color shirt they should wear for the best sun protection. Most people say white, thinking it reflects the sun, but by far the best color is black. Dark colors like black reflect most UV rays but absorb infrared rays, which cause heat, so black can be hot. Luckily, equipment companies have come up with new dark fabrics that wick away sweat so you don’t get overheated but still block the sun really well. —As told to John Fox

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