Eczema and cycling - I need your help!

I know this is a very niche topic, but the TR community is huge and amazing, so there must be some others out there that have struggled with eczema and irritated skin through cycling.

I have been plagued over the last year by recurrent eczema flare ups, mainly due to the interaction with my saddle. My whole cycling routine is now solely devoted to skin-care (moisturising an hour before, applying lots of chamois cream, only wearing clean bibs, showering immediately after my ride and re-moisturising straight after) but this has not been enough to improve or even sustain the situation. I can use steroid creams or some time off the bike to help the situation, but this is only a temporary fix. Obviously with COVID at the moment its almost impossible to get a doctor’s appointment and referral to dermatology is likely to mean waiting a year for what is likely to be a telephone call.

I am really at my wits end and rapidly heading towards an extended period off the bike (likely several months) which may not even fix the situation, or even having to give up cycling all together.

Does anyone have any advice, experience, tips or ANYTHING they can share about their experiences with eczema or skin conditions and cycling, that could help. Any routines that have worked? brands you find work well etc?

I found just one related mention that might be worth a read, but far from complete.

Do you shave the legs?
I have some issues with acne on the legs and sometimes on the saddle/butt intersection. I have always associated with shaving and my liberal use of petroleum jelly for running (and porous clogging).

Sounds like you are doing the right things. Agree with the poster above about not shaving, or even trimming the the area contacting the saddle.

I have generally minor psoriasis and have some nagging up usually not too irritating spots in that area. A few other things that have helped me are

  • salt scrub in shower (sounds counterintuitive, but helps, especially prior to putting on a topical)

  • coal tar shampoo (tarsum has worked surprisingly well)

  • finding super airy underwear (like one of the mack weldon’s) or going commando - especially at bedtime

  • if you have a desk job, a chair that ventilates (or frequent standing), helps avoid swamp a$$

I have a long experience with eczema, which at it’s worst threatened my career as a General Surgeon. Two things I did which I think made a difference was to completely change my diet, eliminating grains and dairy. The other thing I did at the time was quit training and racing, to reduce the overall stress in life. I was able to continue working after a 9 month hiatus, and have since retired and taken up cycling again.

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So I signed up just so I can provide some input haha.
I also struggle with eczema flare up and what I’ve learned so far is that you need to reduce sweat in the areas where there are flare up and you also need to increase the acidity of your affected skin areas (as the skin in individuals with eczema is more alkaline than typical and this leads to additional irritations by bacteria which then continuously trigger immune responses which lead to exacerbated symptoms and continued flareups).

So, there are a couple of things you can do. One thing you can do is add an acid to your chamois cream (somewhere between 5-10% of ascorbic acid or salicylic acid–at this concentration your skin may peel after several applications, but the peeling gets rid of the post-inflammation hyperpigmentation); this will make sure that your cream increases the acidity of your skin as well as aiding in reducing the amount of bacteria on your skin. Best to use a natural chamois cream or make your own (e.g., https://coachlevi.com/cycling/my-homemade-chamois-cream-recipe/).

Another potential solution is to add .03% melatonin to your chamois cream as it has been found to reduce inflammation on the skin and one conceptual model of atopic dermatitis partially implicates depleted melatonin levels.

Lastly, stay hydrated, try to reduce any stressors, and use a barrier (gauze, bandage, etc.) on the affected area to reduce additional inflammation. Let me know if this helps!

P.S.- If you have a severe flareup and no creams are working, using ice or a cold compress on your skin will prevent the nerve endings in your skin from producing the “itch”

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Hadn’t seen this thread before, but… I’m also an eczema sufferer, although not in the saddle area. I do have issues from the bike - mainly around bib straps. 100% sweat is an issue with me.

Notwithstanding the impact on training adpatations which has been covered in the podcast, anti-histamines definitely help me (for both eczema and sinus’)

Things that also affect me are soaps (fun times in a pandemic!)/ shampoos/ moisturising creams and washing detergent.

I find a lot of moisturising skin creams actually cause me to flare up, rather than soothing. I do wonder is that contributing to the problem rather than providing any solution? I use Aqueous Cream or Silcocks Base (an Emollient Moisturiser) for moisturising my skin, and as a body soap. These are readily available here in Ireland, I haven’t found Silcocks when I’ve been in the UK, so I’ve no idea if it’s a naming thing. Aveeno is another option I have used in the past, but to no better effect than the cheaper options.

I’ve never felt the need for chamois cream, either for “normal” cycling saddle area reasons or for eczema so I can’t really comment on options in that aspect.

Washing detergent wise, it has to be non-bio for me. Occasionally, some gear has to go through with a biological detergent, but then I at the very least do a second rinse.

Mine always somewhat flares this time of year - home heating dries the air, which dries the skin. I think this has been exacerbated this autumn being. Sleep/ Recovery/ Stress/ Overall wellbeing all impact on mine too, but if it’s on-going it’s probably not massively impacted by it.

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@kambrose I really appreciate the effort of you signing up to create that post, thank-you so much and welcome to the TR community. This is so helpful and definitely things that I did not know about previously that could make a real big difference to my skin health. I have been wondering if a more natural chamois cream was available, as it could only be a good thing for my super sensitive skin. In all my research on eczema the acid and melatonin concepts are something that I have never come across, so I especially keen to follow these up and I will update the thread at a later date with my findings. Fingers crossed they might be a real difference maker.

Also, using a barrier has proven to be beneficial and have found some good results using reskin bike patches, which I am going to keep experimenting with and would potentially recommend to others struggling with similar issues.

@Macy Thank-you so much for this info. I definitely agree sweating is a massive factor and I have found a lot of relief as the weather has gotten colder, but am already starting to dread summer next year. Washing detergent is something I have gotten a bit slack on recently, will make sure I get back to designated non-bio everything. I share your concern with moisturising creams and often wonder whether they are working considering the amount of time I spend applying them. I will have a look into Silcocks Base or an equivalent that we might have here in the UK as it is one I have not tried, and sometimes I find simply rotating creams and treatments is enough to get good relief.

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Not to go too in depth here but I have had a very long battle with eczema to the point where it has impacted my overall life significantly. I am a highly competitive triathlete, so it is absolutely possible to life with the condition. However, I implore you to talk to a derm and see what options there are available for you.

For this, theres the route of medication to help control or maintain your eczema. There are a ton of options and depending on how serious your condition is, you may be able to control it with less extreme methods. Options I know of are light therapy, immuno suppressants, corticoid steroids and the newest method biologics. I am currently on a biologic and it has been life changing, but I have had severe eczema for my whole life and I cannot explain how impactful it has been to my life. The biologic I am on is literally life changing, and its amazing what a normal person feels like.

Not to go in too deep here, and this will depend on where you live and what methods you try (you can try diet change, environmental changes etc.) but typically the moment you get in with the derm they will try to control your eczema with topicals first. If they can control it with those (use as required) then you are golden. If not, it may require you to try other methods which have some complications; I have taken methotrixate but there are other alternatives out there. Light therapy is another method that has had some positive effects, but I am unsure how available it is now with the current situation and where you live. Lastly, biologics are the newest and IMO the most amazing thing if they work for you, but they are expensive AF so typically insurance will require you to try 2+ topicals, methotrexate or an alternative, light therapy and potentially some other stuff plus a derm to prescribe it. Cost is stupidly high, but there are programs to cover it. It is not available for coverage everywhere, but it appears to be one of the main drugs getting approval for most public health systems, as it is a new drug and mechanism of action that is novel to eczema. There are obviously side effects and you need to weigh these and talk to your derm if it truly is something that you want to look into.

My advice is to talk to a derm ASAP to get this under control. There are options and more options are being developed as we speak, which is an exciting time as an eczema sufferer. Unfortunately the meds are expensive, but I am confident they will eventually become accessible to everyone. There are also other classes of drugs being brought out (JAK inhibitors) which are promising, but the side effects may be more “wide spread” than biologics.

Feel free to message me if you have more in depth questions, I have been around the block on this more than most people. It is not a fun journey but hopefully you can control this with the options available, and the next few years will see a slew of new options as well.

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I will add to this that you may have a reaction to the detergent you use, or a material or something in the material. Other thing it could be is a bacterial infection, so it may be worth considering bleach baths for this, as it has been shown to help some people.

The problem with eczema is that there seems to be a lot of pseudo science on it, similar to like weight loss or diet fads. Unfortunately its hard to read through what is “legit science” and what is actual accepted medical science. I am familiar with medical science side of it and I tend to try not to be swayed with what is “popular now”. There is some evidence for diet, say eliminating eggs, milk etc. and seeing how it works. This IMO is kind of a shot in the dark, but it may be a trigger that might help, although I suspect this is more of an acute case for you (seems to be bike only) so I am not sure a diet change will help, but it may be worth doing a food journal and trying to eliminate things and seeing how it works. Also try swapping out your detergent and seeing if that helps. It could be contact dermatitis as well, which is something the derm might be able to help you on.

I am not sure how sever your eczema is but I still think a derm is the best person to help you here. You can try all sorts of “methods” you read on the internet about but you should get in line to at least speak to the derm while trying alternative methods. Your normal doctor may be able to prescribe some topical steroids in the meaning time but understand that for prolonged use, the skin barrier thins with topicals. There are some other options for topicals (low dosage steroids for sensitive areas) or looking at calcium inhibitors, but again that might be a derm area and also there are side effects (potentially) for them, so please talk to a medical expert.

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Thank-you for sharing your story and this information. It certainly sounds like you have been through a lot and I’m very glad to hear that you have found real positive results from some of these new treatments.

I agree about the pseudo-science, it has been so frustrating trying to find meaningful information that can actual have a positive affect on my skin. I will definitely try changing my detergent and see if this helps, as it is an area I can easily improve.

My skin does react and heal very well with the topicals, however it only stays good for a couple of rides before it breaks down very quickly and sometimes even 1 short ride is enough to cause real problems. Therefore, I am very very reliant on topicals, which is not good in the long-term. I really would love to speak to a dermatologist about it, however getting a referral in the UK for this can be a long and challenging process (especially with everything going on at the moment). But I will push for this though as I need a better long term plan and their medical input could be so valuable.

Let me know how your eczema responds if you use any of my suggestions!

Indeed. Eczema research is rapidly producing some useful products. I’m most looking forward to this bacterial treatment (essentially no side effects)

its argued parasites help reduce eczema, and there is a theory that since we basically have no parasites for many generations, this may be a reason why eczema may becoming a huge issue (some intestinal parasitic worms reduce immuno-responses, although i dont think anyone would suggest you start trying to harbor intestinal parasites).

I’m a researcher so I really only rely on conceptually sound, evidence-based theories. but I’m sure there are a lot of interesting theories out there!

Really don’t feel like reading too much into this myself but there is a decent amount of evidence based theories

Fair enough. Though, glancing at recent studies on this theory, it’s been 14 years and researchers have not been able to determine a causal link between specific parasitic infections and allergies. With the r. mucosa therapy I’ve been following, they are actively running clinical trials and already have causal evidence supporting a therapeutic benefit.

Regardless, though, you are right: many theories with some level of evidence base exist. The human body is complex and multiple pathways exist to trigger and treat allergic responses.

I should’ve said it my earlier post on detergent, and soaps/ shampoos, it can often be a change to the formula which sets me off. “New and Improved” on the side of the detergent is always a bad thing for me! Fairy non-bio has been the most consistent for me fwiw.

Lots of good ideas in the thread. I’ve had eczema since childhood, though mostly on hands and feet. Some suggestions:

  • get a prescription cream. They work, and are topical. Use to control outbreaks.
  • limiting dairy made a big difference for me
  • for an outbreak on my hands I smother them in Vaseline before bed and then pull on a rubber glove. Not good for love life but effective. I will leave it to you to figure out how to apply to your saddle area…
  • Aveeno has good moisturizers including one specifically for eczema. Looks to be available in the UK.
    https://www.google.ca/search?q=aveeno+ecxema+uk&ie=UTF-8&oe=UTF-8&hl=en-ca&client=safari

Good luck

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I sleep while wearing big winter gloves, to reduce the chances that I’ll scratch myself bloody while half-asleep (without realizing what I’m doing).