Monday, June 3, 2013

Monday Mailbox: Treating Saddle Sores

Treating Saddle Sores
Monday Mailbox is a series of posts dedicated to questions received over email. Here is one that pops up now and again:
This is embarrassing, but lately I've been getting what I think are saddle sores after long rides. How can I tell that is what they are? And do you have any advice for treating them?
Saddle sores are one of those common, yet mysterious problems that cyclists love to discuss endlessly. I am just one voice among many and by no means an expert. Happily, I was spared the affliction of saddle sores for my first three and a half years on the bike. It is only recently, when I started covering longer distances, that I began to get them occasionally.

What exactly is a saddle sore? Part of the reason there is so much mystique and different advice out there, is that there is no single medical definition. But at least everyone agrees about their location. Saddle sores appear on the crotch, where it comes in contact with the saddle. Popular spots include the uppermost inner thighs, the "taint," and that transitional ridge where leg becomes butt.

One opinion is that saddle sores are boils caused by abrasions. Another is that they are some special, horrible type of cyst that forms as a result of fluid buildup. But probably the most popular opinion is that they are infected hair follicles. It is very possible that in fact they can be any or all of these things, depending on the rider and cause - which also means that treatment and prevention methods might differ depending on what type it is. Based on my own observations, the infected follicle theory makes the most sense, so that is what I am going with. And as it happens, I've discovered a fairly quick and simple way to get rid of them. Who knows, it might work for you. So here is what I do:

After a ride, shower as soon as possible using non-perfumed soap. Once the area is clean, you will need two ingredients: tea tree oil and vaseline. It's important that the tea tree oil is just that, and not, say, a moisturiser containing it as an ingredient. Plain tea tree oil is now available in many mainstream pharmacies, so sourcing it should not be a problem. 

Using a cotton swab, apply tea tree oil to the affected areas - but be careful not to get it onto any mucus membranes, as that could hurt. Once it dries, follow up with vaseline. Repeat every few hours, washing the area before each re-application. 

While the sores heal, either stay off the bike, or ride a bike where the way your crotch contacts the saddle is sufficiently different. Wear breathable underwear made of natural fibers. 

Using this method, any saddle sores I get go away within 2-3 days. For anything more serious I have no advice, as I've never experienced it myself. Needless to say, if your sores are not going away, consider seeing a doctor.

As far as prevention, there is of course the common sense advice: Find a saddle and shorts that work for you. Increase distances gradually. Use chamois cream to reduce friction. Be sure to shower before and after every ride. And always, always wear clean shorts. However, this is not always sufficient. Even the cleanest, most hygienic pair of shorts will turn into a bacterial cesspool after 10+ hours of riding. Even the most comfortable saddle can start to chafe eventually. And even if you start a ride squeaky clean, you will soon get filthy. That is to say, I don't think there is a sure prevention method once you start doing long distances. Some riders are more prone to saddle sores than others and some situations (such as hot weather) are more likely to cause them. You just have to deal with it when you get them. Hopefully for most of you saddle sores are just an occasional nuisance and not a serious problem. 

41 comments:

  1. Diaper cream! Zinc-oxide's a charm. However, apply very thinly so the skin can still breathe, and apply as soon as things feel a bit sensitive. Note: if you get a sunscreen with zinc-oxide you get a second use for it - apply hygienically.

    For we men: off the bike only wear boxers. The boys need to breathe.

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    1. I too find zinc oxide is a miracle cure for any kind of rash or irritation down there!

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  2. Lanolin also helps, though it feels stickier than vaseline.

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  3. "that transitional ridge where leg becomes butt..."

    Velouria, you are a poet!

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    1. Agreed! You have transformed my malady into a landscape of hygienic hope.

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    2. I would add that sometimes a buildup of fluid necessitates a bit of extraction best achieved by hot compress and patience.

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    3. Also, some of the more testosterone-laden among us have resorted to trimming said hair, taking care to keep it above the skin surface. The transitional ridge is a treacherous place.

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    4. Sadly it seems the estrogen-laden can get infected follicles even if there is no visible hair in that area at all.

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  4. Or suck it up and keep riding.

    Other spot I'd directly where a seam is on yer skivvies, for you Lycra-less aesthetes.

    The assumptions here, goodness times have changed.

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  5. I've had terrible problems with saddle sores - I started getting them as soon as I got my new road bike last fall. Any time I'd ride over 20 miles, I'd get them. I tried several different saddles, numerous different pairs of shorts, tried shammy cream, but nothing helped.

    I finally shelled out the dough for a professional fitting, and it seems to have done the trick. Since this is my first road bike, the bike fitting not only got everything setup correctly, but also totally changed my position on the bike. I wouldn't say that the pain and friction is all gone, but I haven't actually had a blistering sore since I changed my riding position. Of course, I haven't done anything over 35 miles this year either - I'm trying to build up my "butt calluses" slowly this year instead of jumping in like I did last fall.

    When I did get the sores regularly last fall, the thing that really helped me treat them was zit cream with benzoyl peroxide. Mine were the infected follicle variety, and as soon as I'd get out of the shower I'd put on the zit cream and it helped them to both not get huge and to go away quicker.

    I'm keeping my finger crossed and hoping that I won't get them again as I increase my distances!

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  6. One recommendation: tea tree oil acne pads (Whole Foods carries a brand called Desert Essence, and I've bought other brands, that's just what's sitting in my cupboard now). Basically disposable acne wipes like Stridex, but with tea tree oil instead of acne medication. (They do have some other ingredients -- check for allergens). They make good removers for any lingering chamois cream or sweat.

    They're especially handy for use after transportation-cycling rides where a shower isn't possible but ducking into a bathroom for a second is.

    My routine when prevention fails is similar -- the aforementioned acne pads + bag balm instead of vaseline.

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    1. I've got the tea tree oil pads as well, same brand; they work nicely. Another good option for astringent pads is witch hazel.

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    2. Witch hazel! How do you like it? Commercially available astringents irritate my skin and I would love to switch to a natural product.

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    3. I use Thayer's witch hazel astringent, which also contains rose pedal extract and aloe vera. It is refreshing and mild, not stinging or drying. Works great for me.

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  7. non-petroleum based products is the way to go in my opinion. i also forgo items with parabens..

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    1. I try to forgo petroleum based products and products with parabens, but have not yet found anything that works quite like vaseline.

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  8. I second the diaper cream! Very helpful for saddle sores that have already happened!
    Call it TMI if you will, but I've tended to get minor ones off and on pretty much as long as I can remember from just daily riding around town in regular clothes, etc, even aside from long rides (where I'm usually OK but get minor ones and minor chafing occasionally too). But maybe 15 years ago I tried boxers as a remedy for always getting them on the line where the edge of the briefs goes, and I have not worn briefs since. Girl bits need to breathe too!

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    1. Emily - maybe you and the other ladies (I'm a man, so I'll let you go first) could try taking a leaf out of Tommy Godwin's book…
      http://www.tommygodwin.com/the-challenge/
      You'll so relate to that story - if ever there was a contender for Patron Saint of endurance cyclists...
      Anyway - saddle sores - Seeing as how Tommy was covering such prodigious mileages, "After limited success using ointment to relieve his suffering, on the advice of a female cyclist he donned a pair of ladies' silk undies and greatly improved his discomfort!" Youse can all try it out and let the fellas know how you get on.
      All being well, you being super-skilled with your sewing machine, you could diversify and run off a batch of silk undies - in blue, for men! :)

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  9. Okay. But sunscreen. What about sunscreen?

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    1. Hm. Are you riding a recumbent in a skirt?

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  10. I love tea tree oil, but some people are allergic to it. Make sure you're not allergic to it before you put it on already irritated or sensitive areas!

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  11. Here's a share for you atmo - I have never had a saddle sore that this recipe didn't fix within a day. Get some Vitamin E gel caps, snip them open with a nail clipper, and spread the contents liberally. I will use 4-5 gels in a sitting (no pun intended...). Other forms of Vitamin E may work, but this is how I deal with the issue.

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    1. Plus one on the Vitamin E. Ashamed to say I've never actually had saddle sores, which means I'm not a proper cyclist yet, although I'm getting there, but I once stuck an electric drill into the side of my thigh, three times (don't ask...). Ok ask - I was kneeling down with a washer in the jaws of a pair of self-locking pliers between my knees trying to drill a bigger hole in the washer because I didn't possess a vice and I was too tight-fisted to go to the hardware store and buy a bag of washers with the right sized hole when I only needed one - I'm Scottish. The washer slipped out of the pliers and the drill went into the side of my leg. It was all caught up in my trousers, and the first two times I went to pull it out I pulled the trigger again (well, you do, don't you?). The drill bit was so hot it cauterized the wounds so they didn't bleed much, but I was left with three holes and a big burn. I never went to hospital, or even the doctor, I was too embarrassed about being so stupid, I just went to the health store, bought Vitamin E capsules and used them to dress the wounds myself. They took a long while to heal, the Vitamin E turns the skin really soft but it was powerful medicine - even the scars are just about gone now, although that took years, but I can imagine how well it works for saddle sores.

      I’ll be looking to you and your buddies on VSalon for advice and therapy and counselling and stuff when I build my first frame. :)

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  12. Bag Balm works wonders.

    If you haven't tried it, don't let it's traditional use on udders scare you. ;)

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    1. I second the Bag Balm. I put it on liberally before a long ride, more than 20 miles, and just don't have issues with sores.

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    2. Just to throw some numbers out there... I don't start getting saddle sores till after 100 or so miles. At that stage, any chamois cream, no matter how tenacious, would have lost its magic. I do carry around a mini tube for re-application. But once your crotch is, how shall I put this, not so minty fresh, it is less effective...

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    3. Just imagining the ad now "Keeping your crotch 'Minty Fresh' with 'Minty'" and something like the Colgate ring of confidence.

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  13. Bag Balm, as the fellow above recommended, is a great at soothing post-ride chafed or irritated skin. It was orginally made for dairy cow udders, but don't let that detour you, it works quite well. I think your opinions on a good chamois, chamois cream and saddle are spot on. But I'd also really stress getting out of those used shorts as quickly as possible after the ride. The bacteria that cause the skin infection (By the way, infected hair follicals are a type of boil.)love warm moist places. So once you get out of the shorts, unless you have direct access to a shower, clean up with baby wipes or a similar product. I have a homemade recipe of one part witchhazel to two parts isopropyl alcohol that is very "tingly", but does an excellent job of disinfecting the whole area. Also, if you already have developed a sore and still want to ride there is a product out there called Boil-ease and it does a fantastic job of numbing up the area so that you can continue on in a reasonable amount of comfort.

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  14. Have just been for an awesome ride on my Brompton along Lake Ontario's waterfront trail from Toronto to Hamilton and back (highly recommended...). Unfortunately half way through the ride saddle soreness was an issue, so much so that towards the end of the ride I could hardly bear to sit in the saddle. I see you have a Brooks saddle on your Brompton, how do you find it? I am seriously considering getting one for mine.

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    1. Seriously? There aren't enough blogs and chat rooms filled with people waxing rhapsodic about their Brooks saddles that you have to hi-jack a thread here? Velouria finds her Brooks saddle wonderful, just the other 83,000,000 people who have raved about Brooks saddles on the net. GO GET ONE FOR GOD's SAKE!!!!

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  15. Elm Bark and Pickle Brine!

    Those of you old enough to remember plus-fours and club ties certainly look back with fondness on the days when we all kept a sharp jack knife on our person for the purpose of scraping a double handful of bark for the needful moment when a leisurely 50 turned into an afternoon of misery and torment.

    As your generation doubtlessly still does, we planned our routes to pass convenient stores and taprooms along the way, especially those that by chance or consideration for suffering cyclists, nurtured a stately Elm on the premises. In addition to the usual attraction of Digestive Biscuit and Plug Tobacco, those essential nutriments of dedicated Wheelmen since the dawn of time, every General Store, Tavern and Bawdy House worthy of the name, invariably maintained a sturdy Hogshead of Dill Pickle in a cozy nook.

    Why, it's almost a nostalgic cliche' of the time, a crowd of ruddy Cyclists filing through the front door with a fistful of Elm for themselves and a nod and a wink for the Shopkeeper, Barkeep or Madame. AH, the relief one felt as the dipper was tilted into ones knickers and the carefully arranged cushion of Elm shreds(or "Crotchal Plaster" as I believe the medico's of the time referred to it)absorbed the soothing elixir. Why, it's effectiveness was such that I recall no instance where a rider, no matter the condition of their "Hinders", ever felt the need to resort to a second application. Is the power of today's fizzing embrocations such that a single dose invariably satisfies the need? Apparently not if the comments above can be credited.

    I look forward to reading the many comments and reminiscences of your faithful readers who remember a far off time where relief came not from a tube or phial but Mother Natures endless cornucopia of roadside reliefs.

    Look back, for the future is the past...

    Spindizzy

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  16. Ah ha! So that's what that was! The first two times I got what I will now believe to (possibly) be a saddle sore, I thought that I had just been unfortunate enough to receive a spider bite in the exact same tender place twice. (I'll still check for spiders under the saddle though.) :)

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  17. As a preventative, I buy premoistened pads used by estheticians prior to waxing and hair removal to prevent ingrown hairs and shaving bumps. I use one each night after I shower when I am doing longer rides and they seem to prevent the worst problems. Ingredients are many but include salicylic acid and chamomile extract.

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  18. Pre and post ride wash with daily-use benzoyl peroxide wash does a great job of keeping the bugs down, but rinse well or it'll bleach your kit. I use Clean and Clear continuous control daily formula (10%) as recommended by a dermatologist for avoiding folliculitis.

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  19. I've tried every preventative measure from bike and saddle fitting to pre-ride creams, balms... what have you. I have 3 bikes with 3 different saddles and I ride long distances regularly. On any ride over 2 1/2 to 3 hours I will start to chafe. I now apply two strips of thin moleskin to my butt in those areas. No more issues. I realize that this solution isn't perfect, but it is effective.

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  20. how many comments will this post get...?

    i'm a big fan of lantiseptic for rando riding / bikepacking. medical grade bed sore / skin protectant. you can find it at some hannaford's and a pharmacy can get it for you. get a tub, or the little packets (handy for mid brevet re-application, or on day 2,3, or 4 of a tour....)

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  21. Shower before every ride? That is ridiculous-i don't know anyone who does that.

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    1. I've found old chamois/shorts can get rough, so all else may be well with them, but they end up causing problems. Also, for much longer rides (>100 mi) or wetter/hotter rides, I use body glide and then chamois cream, and then reapply chamois cream every couple hours or so.
      Showering before

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  22. Monostat Chafing Power Gel. If you try this, pre and post ride, you will NEVER go back to vasoline-like products. A good saddle, of course, and NO underwear with riding pants. Friction and fabric seams are the culprit.

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  23. Years of riding in Oklahoma heat taught me to get out of the riding shorts right away, no matter what. I apply the butt cream of choice before a long ride and bring some along to refresh as needed. Action Wipes are even better than baby wipes, and taking one along to use after calls of nature keeps the area clean and fresh on longer rides. I like Neosporin on the area if I get a bump, but I rarely do.

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  24. all i can say is...i'm so glad i don't get saddle sores or need to use chamois cream or have to worry about all this. tmi! i must have strong seat bones and i hardly ever wear padded shorts.

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