Skin Health in Brazilian Jiu Jitsu: A Dermatologist/Grappler’s Insights

By Princeton BJJ Staff

The close contact of Brazilian Jiu Jitsu (BJJ) places a premium on maintaining excellent skin health, not only for individual practitioners but for the entire training community. In a recent episode of the BJJ Meditations podcast, Dr. Clayton Green, a board-certified dermatologist and BJJ blue belt, shared some of the best practices for caring for your skin, your gear, and training facilities. What follows is a summary of his evidence-based guidance.

Common Skin Conditions in BJJ

Brazilian Jiu Jitsu practitioners are prone to a variety of skin conditions, given the close physical contact inherent in the sport. According to Dr. Green, the most common issues include:

• Staph Infections: Ranging from mild to severe, these infections can manifest as painful, red sores, particularly in areas of skin-to-skin contact.
• Herpes Gladiatorum: Caused by the herpes simplex virus, this condition can lead to painful outbreaks, especially in areas not protected by clothing or gear.
• Ringworm: A fungal infection presenting as round, itchy patches on the skin, ringworm is a common nuisance in grappling sports.
• Impetigo: A type of staph infection that commonly affects grapplers, impetigo is characterized by red sores that quickly rupture, ooze for a few days, then form a yellowish-brown crust. Impetigo is highly contagious.
• Molluscum Contagiosum: A viral infection that presents as small, dome-shaped bumps on the skin. These bumps are usually painless but can become itchy or sore, and in a grappling context, they are easily spread through direct skin-to-skin contact. The condition is generally benign and tends to resolve on its own.

Prevention and Treatment

The cornerstone of prevention, as emphasized by Dr. Green, revolves around meticulous hygiene practices. Always do the following:

• Wash hands with soap and water after using the restroom and after training.
• Trim and file your fingernails and toenails.
• Change out of training gear before heading home.
• Shower immediately after every training session. 
• Moisturize your skin after showering.
• Do not reuse towels, wash cloths, sponges, etc. Use once, then wash.

For treatment, Dr. Green advises:

• Prompt medical attention: Seeking early treatment for any suspicious skin lesion is crucial.
• Following prescribed treatments: Whether topical creams for fungal infections or antibiotics for bacterial concerns, adhering to treatment regimens is key to recovery.

What to Do If You Suspect You Have a Skin Infection

Above all, don’t wait: Go see a qualified healthcare provider – preferably a dermatologist – as soon as possible. Please know that Princeton BJJ is a stigma-free school. Skin infections are a normal part of grappling. Do not feel embarrassed – we’ve all had issues with our skin from our beloved sport. Here’s what to do:

• Report any signs of skin infection to an instructor or staff member. We will respect your privacy and point you in the right direction for medical care.
• Tell your healthcare provider that you participate in a contact sport. If they don’t know what Jiu Jitsu is, tell them it’s like wrestling.
• Do not cover or hide skin infections.

To return to training:

• Schedule a visit with a qualified healthcare provider – preferably a dermatologist.
• Receive a diagnosis and treatment that is compliant with the N.J. Interscholastic Athletic Association Medical Release for Wrestler to Participate with Skin Lesion.
  • For staph, MRSA, impetigo, and other bacterial diseases:  “All lesions must be scabbed over with no oozing or discharge and no new lesions should have occurred in the preceding 48 hours. Oral antibiotic for three days is considered a minimum to achieve that status.”
  • For herpes: “All lesions must be scabbed over with no oozing or discharge and no new lesions should have occurred in the preceding 48 hours. For primary (first episode of Herpes Gladiatorum), wrestlers should be treated and not allowed to compete for a minimum of 10 days. If general body signs and symptoms like fever and swollen lymph nodes are present, that minimum period of treatment should be extended to 14 days. Recurrent outbreaks require a minimum of 120 hours or five full days of oral antiviral treatment, again so long as no new lesions have developed and all lesions are scabbed over.”
  • For ringworm: “Oral or topical treatment for 72 hours on skin and 14 days on scalp.”
  • For molluscum: “24 hours after curettage.”
• Tell a staff member when your treatment has successfully concluded and you are free to train again.

Caring for Your BJJ Gear: Beyond the Basics

Dr. Green underscores the significance of meticulous care for all BJJ gear, not just the gi. This comprehensive approach to gear maintenance is pivotal in preventing skin infections and ensuring the longevity and safety of your equipment.

• Immediate Washing: Post-training, gear should be washed as soon as possible to minimize the risk of bacterial and fungal growth. Procrastination can turn your gear into a breeding ground for microbes.
• Correct Detergent Use: Utilize a detergent that’s suitable for the fabric of your gear. Pay attention to the recommended amount and water temperature to ensure effective cleaning.
• Dryer Is Your Ally: Dr. Green points out that while washing is crucial, the drying process is equally vital. High heat in the dryer not only helps in thoroughly drying the gear but also plays a role in killing any lingering bacteria or fungi.
• Wash your belt (and other items): It’s not just the gi that needs attention. Belts, rash guards, knee pads, and even your gym bag should be part of your regular cleaning routine. Remember, fungi and bacteria don’t discriminate; they can thrive on any neglected piece of equipment. A good rule of thumb is, if you wore it, or it contained anything you wore, it gets cleaned.
• Storage Matters: Store your gear in a clean, dry place. Moist environments can encourage microbial growth, undoing all your diligent cleaning efforts.

Maintaining a Clean Training Environment

Dr. Green stresses the importance of cleanliness in the training facility to prevent the spread of infections. Regular sweeping and mopping of mats with appropriate disinfectants, ensuring communal areas are sanitized, and encouraging a culture of cleanliness among practitioners contribute significantly to a safe training environment.

Key Takeaways for Practitioners

• Stay Informed: Understand the signs and symptoms of common skin infections.
• Prioritize Hygiene: Wash immediately after training, and ensure all gear and clothing are cleaned regularly.
• Seek Early Treatment: Don’t wait to see if a skin issue resolves on its own. Early intervention can prevent more serious complications.

Closing Thoughts

The health of your skin in Brazilian Jiu Jitsu is not just a personal matter; it’s a communal responsibility. By adopting rigorous hygiene practices, being vigilant about skin health, and fostering a clean training environment, we can all enjoy the myriad benefits of BJJ while minimizing health risks. Let’s roll safely, respect our training partners, and keep our skin as healthy as our love for the sport.