Best plan to prevent saddle sores on a tour
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I rode this saddle three thousand miles. Problems started after about 1,000. I replaced it with a Specialized Romin Evo and the saddle sores literally healed while I rode without any change in hygiene or anything else.
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Saddle sores, crotch rot, and other such unwelcome divertments
It sounds like you have been doing all the right and proper things that are Conventional Wisdom on this subject but I would offer a different take on your situation and the general subject of pelvic hygiene. First of all let's enumerate the things that "everybody" says is the right thing to do.
1. Get out of the wet, sweaty clothes as soon as your day is ended.
2. Wash the crotch area (and the rest of your body for that matter) every day after riding.
3. Completely dry the area after washing.
4. Put on clean riding clothes each day.
5. In the event of skin breakdown, treat the lesions by keeping the area dry, or soaking it in warm water or Epsom salts, then applying antibiotic ointments or creams, drying unguents or powders, anti-inflammatory creams or ointments, or antiseptic, astringent liquids, and then cover the area with a clean bandage or leave the area open to the air to form a scab.
As you can see from item 5, there is some confusion on how to treat crotch/butt sores. At least part of this is because what people call saddle sores can be caused by several different mechanisms.
1. Pressure sores - caused by continued pressure on an area of tissue that prevents proper blood flow to keep the tissue vital and hence you get cellular death and tissue breakdown from lack of blood perfusion.
2. Folliculitis - caused by clogging of one or more skin sebaceous glands creating a soup of sebum, white blood cells, bacteria and lysed bacterial products. A pimple is a simple folliculitis, a carbuncle (look it up if you never seen one) is a bad one.
3. Abrasion both simple and infected - caused by a break in an area of the skin by friction.
4. Contact dermatitis - allergic reaction to something that contacted your skin. BTW, soaps, fragrances and anti-perspirants are common offenders.
5. Fungal infection - crotch rot, formally known as Tinea Cruris.
6. Insect bites - mosquitoes, black flies, ticks, fleas, crabs, scabies, chiggers. Spend some time in the woods and these guys will find you.
and 7. Any or all of the above in any combination.
I won't try to cover treatments for all of these but what is the usual cause for tissue breakdown during a tour is a either or a combination of pressure sore and folliculitis. Sitting too long in one position will cause a sore spot just from ischemia alone but because the blood flow is compromised, so is immune response to local invasions of pathological bacteria. To prevent it, move around on your saddle, stand up and ride, stop and walk around. But if you do get an infected/ingrown hair, or pimple, treat it by washing the area and applying a spot of antibiotic ointment and cover it with a Band-Aid. Change it daily. This is a simple local infection. If you don't treat it, it will not stay local.
Pressure sores are larger and look just like a red area (at first). If they persist then you will get total tissue breakdown that can look like a big seeping hole in your backside - a very painful seeping hole. Though pressure sore can get infected, they don't necessarily have to be. Treatment is first of all STOP PUTTING THE PRESSURE ON THAT SPOT UNTIL IT HEALS! Second, keep the area clean and dry. If the skin is intact you can use talcum powder. Do NOT use corn starch unless you want to "Meet My Leetle Friend" Tinea Cruris. Tinea eats starch. Talcum is a non-nutritive mineral.
Contact dermatitis can be caused by nearly anything and the way your immune system works, it might even be something that you have used or had contact with for years without problems. Primary treatment first involved stopping contact with whatever it is that is causing the problem. Sometimes that isn't as easy as it seems. I was 55 years old when I suddenly started to get uncontrollable itching in the middle of the morning. After weeks of suffering, I found I was now allergic to the fabric softener in my underwear. Never had the problem before. Treatment is to use soothing creams or ointments. OTC Hydrocortisone cream is the gold standard for rashes but there are stronger steroid creams with a prescription. Oral Anti-histamines will control itching (Benadryl) I heard of one poor guy who became allergic to the Proofhide he put on his Brooks saddle. The rash only showed up after riding for about 50 miles when enough sweat had built up to transfer whatever chemical in the Proofhide was causing the problem.
Now the part that will raise your eyebrows in disbelief.
The amazing thing is that most of the time you DON'T have skin lesions. The body is very efficient in dealing with all the environmental insults that assault it on a daily basis. Over eons it has evolved remarkable mechanisms to cope. Primary among these is what is called (and you've heard it before) homeostasis. It turns out that the best way to beat pathological bacteria and fungi is to keep a healthy population of benign bacteria and natural oils on your skin at all times. Unfortunately some of our best intentions and efforts to stay healthy wipe out these friendly bacteria. Frequent washing, washing with caustic soaps, and antibacterial soaps kill not just the bad bacteria but ALL bacteria. And after your skin gets a scorched earth cleansing, repopulating it with bacteria means all kinds of bacteria have a shot at setting up shop. Fortunately the benign bacteria that normally populates our skin is by far the most common kinds in our usual environment, but they are not the only ones out there and if you happen to have an irritated hair follicle, or a little abrasion, the bad guys can get established in their own little haven.
So what I am saying here is, yes, wash at the end of the day. But don't use lye soap (Ivory), deodorant soaps (Dial, Irish Spring), or antibacterial soaps (Betadine). These kill off your normal flora and strip the skin of its proper oils. Rather use a mild soap, something like Dove, which will clean but not scourge your skin. "Body Washes" are even more drying to the skin than lye soaps because they are not even soap, they are detergents. When you live in a protected environment like a house and work indoors, your body (specifically your sebaceous glands) can keep up with the daily stripping of oils but if you are on tour, you are in a much richer biological environment and it can cause problems.
I can see that this entry has gone on quite long enough so I will quit here. There is actually a great deal more information but fortunately most of it you don't need to know in order for it to work. The human body is an amazing machine - even more amazing than a bicycle, and that's a lot.
200k
1. Get out of the wet, sweaty clothes as soon as your day is ended.
2. Wash the crotch area (and the rest of your body for that matter) every day after riding.
3. Completely dry the area after washing.
4. Put on clean riding clothes each day.
5. In the event of skin breakdown, treat the lesions by keeping the area dry, or soaking it in warm water or Epsom salts, then applying antibiotic ointments or creams, drying unguents or powders, anti-inflammatory creams or ointments, or antiseptic, astringent liquids, and then cover the area with a clean bandage or leave the area open to the air to form a scab.
As you can see from item 5, there is some confusion on how to treat crotch/butt sores. At least part of this is because what people call saddle sores can be caused by several different mechanisms.
1. Pressure sores - caused by continued pressure on an area of tissue that prevents proper blood flow to keep the tissue vital and hence you get cellular death and tissue breakdown from lack of blood perfusion.
2. Folliculitis - caused by clogging of one or more skin sebaceous glands creating a soup of sebum, white blood cells, bacteria and lysed bacterial products. A pimple is a simple folliculitis, a carbuncle (look it up if you never seen one) is a bad one.
3. Abrasion both simple and infected - caused by a break in an area of the skin by friction.
4. Contact dermatitis - allergic reaction to something that contacted your skin. BTW, soaps, fragrances and anti-perspirants are common offenders.
5. Fungal infection - crotch rot, formally known as Tinea Cruris.
6. Insect bites - mosquitoes, black flies, ticks, fleas, crabs, scabies, chiggers. Spend some time in the woods and these guys will find you.
and 7. Any or all of the above in any combination.
I won't try to cover treatments for all of these but what is the usual cause for tissue breakdown during a tour is a either or a combination of pressure sore and folliculitis. Sitting too long in one position will cause a sore spot just from ischemia alone but because the blood flow is compromised, so is immune response to local invasions of pathological bacteria. To prevent it, move around on your saddle, stand up and ride, stop and walk around. But if you do get an infected/ingrown hair, or pimple, treat it by washing the area and applying a spot of antibiotic ointment and cover it with a Band-Aid. Change it daily. This is a simple local infection. If you don't treat it, it will not stay local.
Pressure sores are larger and look just like a red area (at first). If they persist then you will get total tissue breakdown that can look like a big seeping hole in your backside - a very painful seeping hole. Though pressure sore can get infected, they don't necessarily have to be. Treatment is first of all STOP PUTTING THE PRESSURE ON THAT SPOT UNTIL IT HEALS! Second, keep the area clean and dry. If the skin is intact you can use talcum powder. Do NOT use corn starch unless you want to "Meet My Leetle Friend" Tinea Cruris. Tinea eats starch. Talcum is a non-nutritive mineral.
Contact dermatitis can be caused by nearly anything and the way your immune system works, it might even be something that you have used or had contact with for years without problems. Primary treatment first involved stopping contact with whatever it is that is causing the problem. Sometimes that isn't as easy as it seems. I was 55 years old when I suddenly started to get uncontrollable itching in the middle of the morning. After weeks of suffering, I found I was now allergic to the fabric softener in my underwear. Never had the problem before. Treatment is to use soothing creams or ointments. OTC Hydrocortisone cream is the gold standard for rashes but there are stronger steroid creams with a prescription. Oral Anti-histamines will control itching (Benadryl) I heard of one poor guy who became allergic to the Proofhide he put on his Brooks saddle. The rash only showed up after riding for about 50 miles when enough sweat had built up to transfer whatever chemical in the Proofhide was causing the problem.
Now the part that will raise your eyebrows in disbelief.
The amazing thing is that most of the time you DON'T have skin lesions. The body is very efficient in dealing with all the environmental insults that assault it on a daily basis. Over eons it has evolved remarkable mechanisms to cope. Primary among these is what is called (and you've heard it before) homeostasis. It turns out that the best way to beat pathological bacteria and fungi is to keep a healthy population of benign bacteria and natural oils on your skin at all times. Unfortunately some of our best intentions and efforts to stay healthy wipe out these friendly bacteria. Frequent washing, washing with caustic soaps, and antibacterial soaps kill not just the bad bacteria but ALL bacteria. And after your skin gets a scorched earth cleansing, repopulating it with bacteria means all kinds of bacteria have a shot at setting up shop. Fortunately the benign bacteria that normally populates our skin is by far the most common kinds in our usual environment, but they are not the only ones out there and if you happen to have an irritated hair follicle, or a little abrasion, the bad guys can get established in their own little haven.
So what I am saying here is, yes, wash at the end of the day. But don't use lye soap (Ivory), deodorant soaps (Dial, Irish Spring), or antibacterial soaps (Betadine). These kill off your normal flora and strip the skin of its proper oils. Rather use a mild soap, something like Dove, which will clean but not scourge your skin. "Body Washes" are even more drying to the skin than lye soaps because they are not even soap, they are detergents. When you live in a protected environment like a house and work indoors, your body (specifically your sebaceous glands) can keep up with the daily stripping of oils but if you are on tour, you are in a much richer biological environment and it can cause problems.
I can see that this entry has gone on quite long enough so I will quit here. There is actually a great deal more information but fortunately most of it you don't need to know in order for it to work. The human body is an amazing machine - even more amazing than a bicycle, and that's a lot.
200k
#30
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I didn't see anyone recommend chamois cream. I think it would be worthwhile to carry some along. I have shorts that work great except for a few points where chamois cream makes all the difference. I carry little bags of it on long rides.
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#32
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FWIW, I've never found any other relationship to cleanliness, time in cycling shorts, etc to those sores. In fact, I got it most when being OCD about cleanliness and using a chamois cream regularly. YMMV
#33
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That doesn't surprise me. I do not find that the incidence of problems is any worse when I am traveling where I go several days at a time without washing as compared to places I can shower every day. Similarly, I saw no additional problems when I went to only taking a single pair of bike shorts.
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You can get Bag Balm in a 1 oz (green) can, which costs half as much as the one pound(?) can. I've saved my old little cans, and now refill them from the big can.
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That doesn't surprise me. I do not find that the incidence of problems is any worse when I am traveling where I go several days at a time without washing as compared to places I can shower every day. Similarly, I saw no additional problems when I went to only taking a single pair of bike shorts.
https://cid.oxfordjournals.org/content/29/5/1287.full