Author Topic: Skin Lesion in the saddle contact area  (Read 2129 times)

Skin Lesion in the saddle contact area
« on: December 14, 2014, 10:29:23 pm »
I have a skin lesion that will not heal properly, it is a weepy little hole where I got chafed in June.
Now even short  rides open it up again.
Any suggestions (Apart from not riding a bike) for creams and lotions that may help cure.

Kim

  • 2nd in the world
Re: Skin Lesion in the saddle contact area
« Reply #1 on: December 14, 2014, 10:46:57 pm »
I had something like this a few years ago due to chafing from cycling in normal clothes.  It eventually healed after I went many weeks without riding a bike with a saddle (recumbents didn't aggravate it, fortunately, so I was still able to cycle).  I've still got a patch of scar tissue, which has re-opened at least once.  I now only cycle in cycling shorts or cycle-specific underwear (basically, something without a seam in the problem area).  Changing clothes for even short rides is much less inconvenient than trying to persuade something like that to heal.   :-\

In general I think this sort of thing is a matter of keeping the area clean and dry and allowing it to heal, rather than applying potions.
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Gus

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Re: Skin Lesion in the saddle contact area
« Reply #2 on: December 14, 2014, 10:56:17 pm »
I've used "Duoderm" extra thin dressing in the past for chafing and saddle sores, with a good result.

Re: Skin Lesion in the saddle contact area
« Reply #3 on: December 15, 2014, 09:06:39 am »
witch hazel in alcohol (rather than a cream) can help.
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hellymedic

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Re: Skin Lesion in the saddle contact area
« Reply #4 on: December 15, 2014, 11:56:39 am »
I have no direct experience of this problem.
My thoughts:
You need to prevent further trauma to the area (obv)
Such trauma can come from:
Compression
Traction/friction
Infection

The first is from sitting on the saddle but riding over bumps might bruise the skin unnecessarily so raise you bum approaching any bump. Stick to short rides etc.

A dressing could reduce friction but removing anything sticky might damage the skin.

Scrupulous hygiene will reduce infection; nappy rash remedies may help.
AVOID STEROIDS as they thin the skin and reduce ability to fight infection.

Antifungals help some people.

mattc

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Re: Skin Lesion in the saddle contact area
« Reply #5 on: December 15, 2014, 01:34:26 pm »
I have a skin lesion that will not heal properly, it is a weepy little hole where I got chafed in June.
Now even short  rides open it up again.
I think you should use some sort of dressing - ask your GP if not sure - before riding, so as to protect it at all costs. Allow it to heal up properly. May still take months, but a good investment in the long run.

( Clearly if even short rides are reopening it, no amount of creams, or "better shorts", or bump-avoidance will help get you through a long ride! )
Has never ridden RAAM
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Mrs Pingu

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Re: Skin Lesion in the saddle contact area
« Reply #6 on: December 15, 2014, 01:39:59 pm »
I was going to suggest hydrocolloid blister/burn dressings, but I seen that Gus has that covered already now that I've looked up Duoderm. I had a very successful use of these on a scald (which I managed to remove the blister from with over-vigorous application of cold water) and it healed very nicely indeed without going scabby and hard and horrible.
Do not clench. It only makes it worse.

Re: Skin Lesion in the saddle contact area
« Reply #7 on: December 15, 2014, 02:00:56 pm »
I will watch this tread with keen interest :(

This is really hard to get rid of once started.  I've tried a couple of doctors but they don't seem to understand or have a magic single treatment.

My current prefered options:

1. ZeroAQS cream as an emmolient and skin wish
2. Assos chamois cream (ouch! for the price)

Also the type of chamois seems quite important.  Anything from Elastic Interfaces/Cytech http://www.elasticinterface.com/brands-2/ seems to help me - I've tried IceBreaker and DHB Aeron Pro, I'm saving up for Assos and Rapha.

This problem has curtailed any long rides for me for the last couple of years.

I thought I had overcome this recently, but it's back.

Re: Skin Lesion in the saddle contact area
« Reply #8 on: December 15, 2014, 03:01:38 pm »
I was going to suggest hydrocolloid blister/burn dressings, but I seen that Gus has that covered already now that I've looked up Duoderm. I had a very successful use of these on a scald (which I managed to remove the blister from with over-vigorous application of cold water) and it healed very nicely indeed without going scabby and hard and horrible.

I had a grade 2 pressure sore on my left sit bone from LEL that healed up lovely using hydrocolloid dressing.

Mrs Pingu

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Re: Skin Lesion in the saddle contact area
« Reply #9 on: December 15, 2014, 03:56:02 pm »
Yay! I think they are magic :)
Do not clench. It only makes it worse.

Ruthie

  • Her Majester
Re: Skin Lesion in the saddle contact area
« Reply #10 on: December 15, 2014, 04:21:39 pm »
Colloid dressings are fabulous.

Mepilex teflon dressings are even better.

Could you not even consider a couple of weeks off the bike, then extra measures to protect it once it's healed?
Milk please, no sugar.

Kim

  • 2nd in the world
Re: Skin Lesion in the saddle contact area
« Reply #11 on: December 15, 2014, 04:24:27 pm »
Indeed.  It's surely the best time of year for an enforced absence from cycling, anyway.  Better it heals now than lingers...
To ride the Windcheetah, first, you must embrace the cantilever...

Ruthie

  • Her Majester
Re: Skin Lesion in the saddle contact area
« Reply #12 on: December 15, 2014, 04:36:03 pm »
http://www.molnlycke.co.uk/advanced-wound-care-products/foam-dressings/mepilex-border/

Forgive me if this sounds preachy, but I know a bit professionally about wound healing.

Nothing external will cure your lesion.  If it heals, it will do so because your body heals itself.  Think yourself as creating the optimum environment for your body to heal this.  So you need to eat right, stay hydrated, remove the cause of the injury, keep the area clean, and give your skin time to heal. 

The thing about bums is the bacteria, and if it's an open lesion you need to keep bacteria out of it.  This is where an adhesive dressing to cover it comes in.  Padding to keep the area comfortable would be a good idea, too.

You could try making an appointment with your district nurse to see if she can help.  I would need to see a wound to do a proper assessment and a plan to heal it.  You can't beat hands-on eyes-on experience!
Milk please, no sugar.

Re: Skin Lesion in the saddle contact area
« Reply #13 on: December 15, 2014, 04:51:35 pm »
BE. VERY. CAREFUL.
As you probably already are.
Back in the heady heatwave of the summer of 2011 I developed an agonising, extensive weepy rash in the same area.
I put it down to heat rash from a long bike ride on a particularly hot day - I think it was the Essex Country Bumpkins Come to London ride.
The hot weather continued unabated and I was in agony.
Luckily, I wasn't working at the time so was able to spend a lot of time sitting around with one leg here <--, the other leg there -->, but no amount of application of Assos cream was making things better.
Needless to say, I pretty much stopped riding as the experience was akin to riding with 80grit production paper against my undercarriage. And fire.

Eventually, I went to see my GP.
She, being both young and good looking, was fascinated as she had just finished a course on sexually transmitted diseases - so nothing I was about to show her was going to shock her.
The STD route was swiftly dismissed. I showed her the Assos cream I'd been using to treat the lesons with. She checked the ingredients and declared there was nothing dodgy in there
A cream was prescribed. I think it was a steroid based one. After a few weeks use it made no difference.

I paid the GP another visit, she took another look, prescribed a military-grade cream saying that if this didn't work she'd arrange for an appointment with a consultant dermatologist, and I could carry on using the Assos cream if I felt it was helping when I (infrequently, now) went cycling (can you see a pattern developing here?).

And lo, six weeks later saw me in front of the Dermatologist at Lewisham Teaching Hospital. She QC'd the Assos cream and passed it as safe. Another cream was prescribed. This one had a special applicator  :o
This one proved equally useless. I didn't know whether I would be able to cycle again. Someone on here who shall remain nameless used the word recumbent to me, and generally I was feeling like the world was falling out of my bottom. Whilst it burned.
On my second visit to the Dermatologist she washed her hands of me (can you see what I did there?) and referred me to the cutaneous allergies clinic at St. Thomas'.

Another  month or so's wait for three appointments in short succession.
The first was a background / history one.
The second was on the Thursday before Good Friday to apply every know chemical under the sun to various parts of my body, but mostly my back (Trust me when I tell you that is not the most icky image I can produce in relation to this story)
The third was on the following Tuesday to assess the results.
'Ohhhhhhhh!!!!'  the doctor hissed excitedly, 'Is that painful?' prodding at an area of my back that had clearly been inflamed by the chemical.
No, not compared to what is going on downstairs -I replied - not having noticed any discomfort on my back.
Turns out I have an allergy to Methylisothiazolinone (yes, really) or MO as it is more commonly known and, according to Doc, on the verge of being banned by the EU on account of the epidemic like spread of people developing allergies to it.
It is put into water based products to arrest the development of bacteria.

Guess what? Assos cream has shedloads of it in it. :thumbsup: >:(
Doctor pointed me at a website where you type in the chemical's name and hit 'Return' and it tells you all the products this is found it (in the US only) It yielded hundreds of thousands of products, mostly cosmetics. But it's use is widespread.
I stopped using Assos cream immediately.
Bought another cream called Nature's Kiss which doesn't have MO - but in the end (ha-ha) decided that going creamless was the way forward.
I checked every single liquid chemical in my house.
No more Fairy washing up liquid for me, thank you.
I also realised the importance of keeping chemistuffs in their original containers / wrappers ::-)

So this is maybe a long and windy way of saying check out what is causing the leisions before treating them.
I'm not knocking the NHS, far from it, but two professionals saw me twice, over a period of around six months, before the third was able to pinpoint what the cause was - to be fair on the first two, or certainly my GP something like that may've been out side her frame of reference.
Stay off the bike. I suspect you'll find that advice as painful as I did. But riding is going to do nothing to accelerate recovery. You are lucky in as much as this is November - not August, when it happened to me.

Oh, and Ruthie is talking a lot of sense. As is usual.

Re: Skin Lesion in the saddle contact area
« Reply #14 on: December 15, 2014, 04:56:56 pm »

Forgive me if this sounds preachy, but I know a bit professionally about wound healing.

You could try making an appointment with your district nurse to see if she can help.  I would need to see a wound to do a proper assessment and a plan to heal it.  You can't beat hands-on eyes-on experience!

I put in a (sadly rejected) funding application for a trial of tele-would care, comparing sending pictures to a wound specialist who directed care remotely, versus usual care. This thread has me thinking of a new application:

"A trial of a novel, forum based tele-wound care service for cyclists, versus usual care"  :thumbsup:

Re: Skin Lesion in the saddle contact area
« Reply #15 on: December 15, 2014, 07:40:42 pm »
BE. VERY. CAREFUL.
As you probably already are.
.......

Sadly (I don't think there is anything joyous in this subject, unless one is truly masochistic), your experiences reflect my own view that the average GP is challenged deal with this sort of cycling related condition, albeit they are well intentioned.

I suspect that many cyclists, myself included, let an embarrassing condition drag on and deteriorate before seeking help.

Bicycle abstinence is not an option!

In my case, this all started before I was using creams, so I don't thick it is allergic.

mcshroom

  • Mushroom
Re: Skin Lesion in the saddle contact area
« Reply #16 on: December 15, 2014, 07:57:04 pm »

Forgive me if this sounds preachy, but I know a bit professionally about wound healing.

You could try making an appointment with your district nurse to see if she can help.  I would need to see a wound to do a proper assessment and a plan to heal it.  You can't beat hands-on eyes-on experience!

I put in a (sadly rejected) funding application for a trial of tele-would care, comparing sending pictures to a wound specialist who directed care remotely, versus usual care. This thread has me thinking of a new application:

"A trial of a novel, forum based tele-wound care service for cyclists, versus usual care"  :thumbsup:

Are you suggesting cyclists send Ruthie pictures of their sore arses? ???  :-X
Climbs like a sprinter, sprints like a climber!

Ruthie

  • Her Majester
Re: Skin Lesion in the saddle contact area
« Reply #17 on: December 15, 2014, 07:58:26 pm »
Oh, god, no, please don't.
Milk please, no sugar.

Re: Skin Lesion in the saddle contact area
« Reply #18 on: December 15, 2014, 08:50:31 pm »
Thanks for all the advice as 'The problem' is a hole in the epidermis I am trying colloid dresings for a few weeks.
My two lotions of choice,  Conotrane is MO free.

Re: Skin Lesion in the saddle contact area
« Reply #19 on: December 15, 2014, 11:26:56 pm »
A change of shorts and/or saddle might alter the pressure points enough to allow healing.

Re: Skin Lesion in the saddle contact area
« Reply #20 on: December 16, 2014, 09:20:19 am »
http://www.molnlycke.co.uk/advanced-wound-care-products/foam-dressings/mepilex-border/

Forgive me if this sounds preachy, but I know a bit professionally about wound healing.

Nothing external will cure your lesion.  If it heals, it will do so because your body heals itself.  Think yourself as creating the optimum environment for your body to heal this.  So you need to eat right, stay hydrated, remove the cause of the injury, keep the area clean, and give your skin time to heal. 

The thing about bums is the bacteria, and if it's an open lesion you need to keep bacteria out of it.  This is where an adhesive dressing to cover it comes in.  Padding to keep the area comfortable would be a good idea, too.

You could try making an appointment with your district nurse to see if she can help.  I would need to see a wound to do a proper assessment and a plan to heal it.  You can't beat hands-on eyes-on experience!
Excuse me Miss, can you recommend antiseptic to use?

I normally use iodine but the yellow stains can be a bit embarrassing.
<i>Marmite slave</i>

Ruthie

  • Her Majester
Re: Skin Lesion in the saddle contact area
« Reply #21 on: December 16, 2014, 09:32:30 am »
I wouldn't bother with antiseptic. It interferes with your skin flora.

If you have fauna down there start a new thread.
Milk please, no sugar.

Re: Skin Lesion in the saddle contact area
« Reply #22 on: December 16, 2014, 10:13:32 am »
Flora? All I use these days is Benecol or olive oil
<i>Marmite slave</i>

Re: Skin Lesion in the saddle contact area
« Reply #23 on: December 16, 2014, 10:33:40 am »
Are you suggesting cyclists send Ruthie pictures of their sore arses? ???  :-X

Last bid was for ~£1.2million. It could pay for a big server upgrade.

Oh, god, no, please don't.

Amazingly, in the trial, the plan was to have just one wound care specialist looking at all the pictures for a year (in this case, old people in nursing home care). Be like being stuck in the showers on LEL  F O R E V E R!!!