A Common Infection in Practising BJJ: Ringworm

Ringworm is a fungal infection that appears on the skin of humans and animals. From 1841 to 1845, the researcher Gruby investigated in England and other countries helped advance the knowledge of ringworm in the field of science, both clinically and pathologically. Several valuable documents reveal that ringworm in human beings is caused by two categories of fungus. One is called “microsporum” and the other is named “Trichophyton” which can be distinguished clinically, biologically, and culturally.

Ringworm is also referred to as “dermatophytosis” or “tinea.” There is a slight difference between both categories of ringworm in terms of the size of the spores. When the body is infected with fungus, raised red ring shapes form on the skin. They are red, dry, itchy and scaly. The patches may bleed or blister. The rash may spread on any part of the body, including the hands, arms, trunk, fingers, scalp, face, and nails. BJJ athletes use rash guards to cover their body and reduce the chance of getting ringworm in fights.

Many people feel better after scratching an itch but this relief is temporary. Heavy scratching may worsen the skin condition and cause unbearable pain. Itching skin with fungal infection can spread and become unbearable because the area is dry and scaly. While itching, the fungi spores may attach and spread to your hands, the skin to skin contact making the condition worse. During research, results from tests demonstrate why people continue itching their skin until they start bleeding. The researcher Zhou-Feng Chen found from his studies,

“People scratch because the pain inhibits the itch,” he says – but because serotonin controls the pain, they then have to scratch harder to register pain strong enough to suppress the itch, creating a feedback loop. The brain wants to control the pain so it puts out more and more serotonin.’’

In some cases of tinea patients, a bad odour was coming from the infected patients.

BJJ trainers and wrestlers need to be cautious if there is an outbreak of a skin infection like ringworm. This highly contagious disease may worsen if left untreated or ignored. During grappling, there is a lot of skin-to-skin contact which increases the probability of disease and germs being transferred.

A sign that you have ringworm is if your skin has a red ring shaped rash with red dots in the centre. The rash may appear in the cracks between the toes which is commonly referred to as athlete foot. Fungal disease may spread to the fingers and toenails, scalp, face or groin area which is also known as jock itch.

Scalp infection can be inflammatory or non-inflammatory. Inflammation in the hair follicles can cause hair loss, creating bald spots along the entire scalp. Non-inflammatory infection destroys the hair shafts along the scalp, resulting in random spots of hair loss.

This fungal infection can also be found on the webbed areas of the hands and feet of BJJ trainers. The skin becomes dry and cracked, resulting in redness and constant itching. The white scaled epidermis destroys your body’s natural barriers necessary to protect you from bacteria, resulting in the feet getting infected and causing sores and swelling.

Nail infection causes tan to brown discoloration to the skin under the nails. It becomes difficult to cut the split, rigid, and brittle nails.

Jock itch causes redness and irritation on the inner thighs. These rashes are often confused with yeast infections which typically have a number of small rashes outside the border of the main rash.

Frequent competitions in BJJ athletes are where ringworm diseases are frequently carried between BJJ fighters. A study conducted in Iran on 656 participants showed that most ringworm infections were found in athletes involved in combat sports. The general population is less affected by this highly contagious disease. Especially during rigorous training, fighters are more likely to be exposed to skin diseases. It was mentioned in the research that most commonly, high contact sports were the major reason for the spread of ringworm or skin infections. The most common area that ringworm appeared on the bodies of the study group was the trunk. The major risk factor highlighted in the propagation of the infection in this research was a delay in a shower after BJJ training that resulted in heavy sweating.

 Fungal diseases are found on unclean surfaces, closets, or BJJ equipment that were previously infected with germs and not properly cleaned. Proper cleanliness is required after training and fights, preferably a complete wash. Suppose your training partner is infected; there is a huge risk of parasites transferring to you during grappling. Not every sweating person has a fungal disease but ringworm may nurture in damp, dark, and moist areas.

Ringworm affects the upper layer of skin but few cases have been reported that dermatophytes may attack deeply under the skin if serious physical trauma occurs during BJJ fightsand championships. Some cases in medical history have found that patients with human immunodeficiency virus may get infected with ringworm under deep layers of skin. Diabetic patients are also more likely to be infected with ringworm. HIV patients should monitor their skin frequently to prevent ringworm parasites. A person with a weakened immune system is more prone to fungal diseases.

Dermatophyte parasites thrive on dry or moist surfaces, especially skin layers rich with keratin protein. Other environmental factors contribute to the spread of ringworm disease such as household crowding, tight clothing and recreational activities. Many doctors, due to the highly contagious nature of the ringworm, recommend staying away from the infected person and his/her belongings.

This fungus not only remains alive on the skin but on many places like the floor, mat, carpets, clothes or bedding. The infection can also be transferred from your pets.

Some researchers claim that despite the long history of treatment guidelines, there is no reliable way to deal with fungal diseases in combat sports. Discontinuing practice hinders a fighter’s performance invariably due to needing time to recover from and hide their skin infections. Bandaging infections may reduce the chances of being infected by another person or spreading it to others. Unfortunately, many fighters are reluctant to share their health issues or are unaware they have a disease.

The best solution recommended to deal with ringworm is proper skin screening which can help prevent skin infection but may prevent practitioners from joining competitions. Fighters should try to deal with ringworm as early as possible so they can still join competitions without letting their skills get rusty.

To prevent ringworm infection in BJJ training session, some protective measures should be incorporated such as :

• Disinfection of BJJ Equipment
• Take shower immediately after training session
• Avoid games with infected skins
• Use antifungal soaps, wipes, creams, tea tree oil and garlic extracts
• Never share your personal items In
• Go for skin screening
•  Apply Athletes foot powder

The following ringworm treatments are available for this disease. Generally, the fungal disease lasts for 12-14 days on the skin.

Medical practitioners and physicists follow the ringworm treatment in two ways.

• Topical medication
• Systemic medications

This route of medication is suitable to treat in the initial stage of the fungal infection unless the infection involves an extensive area in BJJ fighters. Topical medication involves the treatment with antifungal creams like clotrimazole, ketoconazole, terbinafine etc, applied once or twice a day on the infected area and beyond the boundaries of rash up to a minimum of four weeks. Rash may disappear with proper treatment even after one week but you should continue the medication till next week.

The systemic medication treats tinea capitis and other skin infections which are resistant to topical medication with the medicine griseofulvin once a day up to 4-8 weeks. Rash may disappear after two weeks but the patient should continue to apply the cream on the infected area. In some cases, it is found that medical practitioners consider oral terbinafine better for adults and children as the first line of therapy.

Some side effects are linked with griseofulvin headaches and gastrointestinal infections like causing the disturbance in normal liver enzymes. Its usage requires constant monitoring of the liver function if the usage is prolonged and the dosage is 20mg/kg or higher.

Nail infections take a long time to be cured and they are resistant to griseofulvin. For the treatment of nails better option is terbinafine and itraconazole. The former treatment continues till three weeks and the latter treatment till three months or as prescribed by the doctor. Both terbinafine and itraconazole cause a negative impact on the functioning of the liver. The nails which are resistant to antifungal therapies are removed from the nail bed.

The use of a cap on the scalp is discouraged on the infected skin. Anti dandruff shampoos having selenium sulphide can be used for the elimination of spores from the scalp to some extent. Such shampoo can be used on the rest of the body to inhibit or slow down the multiplying process of infection.

There is still a wide range of formulas available for the treatment of fungal infection but not all are effective. One can work better than the other depending on the intensity of the infection in the specific area.

Practically, it is possible to keep on training sessions with the Ringworm infection while wearing Rash guard. But when you know it is a contagious disease then ask yourself a question. Is it ethically right to fight and spread the disease?

Everyone knows, BJJ strengthens the immune system but taking a break helps to recover faster from the skin infection.

The incubation period for Ringworm lasts for one to two weeks. There is a tendency to get caught in the infection before it breaks on the training partner. Some cases are highlighted in the medical history that humans and pets with no symptoms of ringworm disease can even transfer the parasites to the body due to skin to skin contact.

Once the treatment is started, and the spores get eliminated the chances of spreading the disease is narrowed. but still, the point to ponder is that the fungal spores remain alive on dead skin cells. They can be found anywhere near your surroundings like BJJ Gi’s, Spat Pants, Belts in humid and hot areas until the environment is favourable for their nurturing.

Still, sometimes it takes months to get fungal infection eliminated from the body.

Ringworm is not a lifelong disease but it may react differently at different stages. On the body, Ringworm may occur at any stage of life but infants on the scalp,up to three years old do not acquire this disease. If acquired, it can be cured easily. After four years to puberty and lifetime this disease is suspected greatly, it may appear mild to chronic stage and can last up to months, weeks or years. The body which is liable to this disease does not lose it easily.

Shaving or cutting of the hair cleans the skin and accelerates the healing process. Pulling out the hair from the infected area aids in the curative methods. Sometimes the regeneration of hairs is considered that the disease is cured but this is not the case, the broken off hairs remain and the disease exists for months or years.

Dr. T. Fox says,
“ Ringworm is obstinate in proportion as this or that patient offers a favourable soil in his texture for the growth of the fungus or parasite.”

It is a great mistake to think that ringworm is due to dirt but of course the neglected head covered with dirt is more likely to get infected. The clean heads can be constantly involved in the fungal disease due to the untreated case in their surroundings.

When the untreated disease is left uncured it may become contagious disease as the dry particles of the epidermis are easily disseminated through the air.

Dr. T. Fox comments that
“ Something more than mere contact is needed in the adult to insure contagion”

It is further found from the studies that ringworm infection is more common in boys than the girls.

When it comes to being a BJJ Practitioner, it’s the reality that ringworm infection can be part of your journey anytime. The skin infected with fungus is always annoying with cruising pain. Grappling arts players are mostly targeted with this disease on their body. The desire for itching again and again causes lesions on the skin. In the presence of Tinea the ratio of bald patches is increased and when the fungus diseases spreads to fingers or toenails, not any cosmetic is going to minimise or reduce the effect of the disease. But still the issues related to it are not serious. Meditation is easy and prevention requires little attention to monitor and work on personal hygiene.

Protect your family's health, if you find your pet infected with this fungal disease. Maintaining good hygiene and washing the body, BJJ equipment and Bjj Gi’s with lukewarm water can cure the infection and cease the expansion of the disease.

Infection may occur anytime, anywhere during the training session, but it is most difficult to eradicate from the head. Ringworm from the body can be cured by any parasiticide because the fungus close on hand can easily be destroyed.