Diagnosing and Treating Saddle Sores

I decided to put a few of my favorite bits from the book into a post here, because you know what? This stuff is important! I had a busy weekend with a  lot of on-and-off the bike stuff, and frankly, I am really glad I had done the research because even knowing what I should be doing, I wasn’t always 100% about it. Still, knowing what’s healthiest—i.e getting the heck out of your chamois ASAP—was helpful!

Anyway, on to the fun topics. By that, I mean saddle sores.

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First of all, not every little bump “down there” is a saddle sore, so don’t panic. In fact, more often than not, it’s not a saddle sore at all.

A few of the common issues include:
1. Ingrown hairs: between the irritation of wearing tight-fitting, sweaty spandex and shaving (or even waxing), ingrown hairs are a distinct possibility and may present similarly to a saddle sore. Treatment for this one is similar though, so even if you do the same thing, it will heal.
2. Acne: self-explanatory, and ultimately a saddle sore is just a really big pimple, but smaller breakouts are possible. For this, try an over-the-counter acne cream at night, and sleep either in the buff or in cotton panties to allow for a good amount of air flow.
3. Jock Itch: not just for guys anymore, unfortunately. This fungal infection (think athletes foot for your nether regions) presents in a few ways, and usually in a larger area than a single saddle sore would be. Visually, jock itch can range from dry, red, scaly skin to a whole lot of painful small bumps. It will usually be in “fold” areas, so if you have a rash right where your butt cheek meets your thigh, it might be jock itch, not just a pesky rash. Again, there are over-the-counter antifungals, but if the two-week treatment doesn’t clear it up, check with your doctor.
4. A simple rash: maybe you’re allergic to your chamois cream, maybe you aren’t rinsing your shorts well enough after washing, or maybe you just need a few days off the bike. The best thing to do for a rash—before taking more extreme measures—is to take a cool shower, wash carefully, and give it some time to let it breath before assuming the worst. And double rinse your chamois next time you wash it!
5. Hives: You may have an allergy to something in your chamois, or just a weird allergic reaction in general.
6. A saddle sore: it will look like an extra large pimple, and most likely will hurt like the dickens. Most likely, if it is a saddle sore, it will be between your genitals and anus.

Of course, to prevent all of these issues, check out the chapters on proper chamois and saddle fit, as well as the one on post-ride care.

How do I know if I have a saddle sore?
From Coach Peter Glassford:
A saddle sore is like a pimple, a mound. It may seem similar to an ingrown hair. If you get a sunburn, that’ll be similar to a friction rash you might get on your inner thigh, and isn’t a saddle sore.
In the saddle contact area, that’s the most common area—between your genitalia and your anus—where you’ll end up with it most often. You’ll be more likely to get rashes or simple breakouts on your thighs or butt cheeks. Saddle sores are from really abusing the tissue while riding and bacteria gets in there, and the best way to describe it is a big pimple.
Doing a Daily Check is a great way to prevent a major sore. The first thing you should do is shower when you get off the bike, and do an inspection. See when things are starting to get red, starting to get swollen.

How can I prevent saddle sores?
From Gynecologist Esther Yun:
Saddle sores are not only very uncomfortable, but can turn into a very serious medical issue if not properly addressed early in the process.
First off, equipment is important. Your bike should fit you properly. If you’re not sure about this, you may want to visit your LBS [local bike shop] for a fitting. Having your weight balanced in the wrong way can predispose you to poor riding position and undue weight on the saddle as a result. Your saddle should be appropriate both for your pelvis (see above) as well as type of activity in order to decrease pressure/chafing to the buttocks.
You should hopefully have a comfortable chamois. Always start your ride with a clean, dry chamois. Some people use chamois creams/butters to help with chafing and as a protectant to help prevent damage to the skin. You may want to consider this if you have very sensitive or delicate skin. Do remember that you are adding another skin product, so beware of allergies/sensitivities as well. Avoid products with perfumes, dyes, or large amounts of preservatives.
Changing positions on the saddle and standing during your ride will also help prevent sores, as it redistributes and relieves pressure.

What should I do about saddle sores?
From Gynecologist Kristi Angevine:
Saddle sores start when friction breaks the surface of the skin enough for bacteria that normally lives on our skin’s surface, to get underneath. This defect plus bacteria forms a sore that can be difficult to care for given its location.
Prevention of sores is best, but if you get one, here’s how to care for it:
1. When off the bike, keep it clean and dry. Wash it with plain soap and water. Let the area breathe by avoiding underwear made of satin or silk. Opt for cotton, wool, any breathable fabrics or no underwear at all.
2. Warm baths and hot compresses can be soothing.
3. Don’t squeeze it! That prolongs healing and increases the chances of a larger infection.
4. If it gets really irritated or is very painful when riding, take a few days off the saddle.
5. For general perineal and vaginal health and not just when there is a saddle sore: wear only clean shorts, not ones that have been worn on a ride before and haven’t been washed. Also, after doing any exercise, change out of your workout clothing and get clean soon. This means, get out of that chamois before you drive home!
6. See a doctor if the skin around the area gets red, hot, or swollen or if you get a fever.

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