Common Injuries in Cycling : Skin Chafing and Saddle Sores
Useful tips to keep you in the saddle this season
Camille B. and Hannah C.
The skin is the largest organ of the body, about 20 square feet! It’s our main protection against outside elements and physical trauma, and the first line of defense against bacteria and other infections that can be transmitted through cuts and blood. Our skin helps us regulate our body temperature by telling our brains to release sweat and increase the amount of blood that travels to our skin to dissipate heat.
As amazing as this may sound, heat, moisture, and friction combined with a few hours in the saddle can result in your skin losing its beloved smoothness. Let’s talk about skin chafing, saddle sores, how to prevent and treat them, and when to seek professional help.
Anyone who has dealt with chafing or saddle sores in the past will know exactly what we’re talking about; this burning sensation with every pedal stroke, like you’re sitting on raw skin… yes that’s it!
The skin’s integrity refers to skin health and the capacity of the skin to fulfill its function, and to heal adequately. A well-hydrated, dry, and intact skin is less prone to irritation, pain, and infection. Change this equilibrium and add friction, sweat, and pressure from the saddle in the mix and you might end up with a glowing and painful buttock.
Chafing is essentially a skin rash, or in other words, an irritation of the skin caused by friction. Skin on skin repetitive contact, or, more frequently in cycling, skin on clothing (or skin on HR strap, bra strap, etc) can cause irritation, redness, rawness and tenderness which are all signs of chafed skin. Heat and sweat can make it worse, but chafing also occurs in colder weather and while training indoors.
Saddle sores often start with chafing and can develop when a collection of pus starts to form under the skin.
Fortunately, there are a few things we can do to keep our bums healthy and soft.
How to prevent it
There are a few important steps to take to prevent skin chafing.
Skin care: Good basic skin care is essential. Keeping a well-moisturized and dry skin when off the bike helps avoid irritation
Hydration: Drinking plenty of water before, during and after your ride also contributes to keeping the skin healthy and hydrated.
Clothing: Wearing well-fitting cycling clothing can make a huge difference. You want clothes that comfortably hug the body, almost like a second skin. They shouldn’t be shifting around when pedaling because loose fabrics can cause friction and hence chafing. Beware of bibs and jerseys that are too small. If they’re biting in your skin or if you can “feel them” while riding, it’s probably too small.
Bib: Still regarding clothing, buying a bib with a high-quality chamois should be a priority for every cyclist. More padding doesn’t necessarily equal more comfort and finding one that is comfortable can take a few tries. We should always go with a women-specific bib, that is designed to fit our anatomy, and wearing bibs without underwear reduces the risk of friction from seams. Having multiple pairs of bibs also helps to reduce the risk of saddle sores. If you’ve been wearing one pair of bibs over and over, the accumulation of bacteria coupled with the amount of chafing will result in multiple sores. So be sure to buy a few pairs of shorts!
Our team’s kit sponsor SUGOI has developed a collection of premium and technical chamois with specific characteristics that are suited for all kinds of riders; from everyday cyclists to high-performance racers, you can learn more about it here.
Chamois cream: Using chamois cream is not essential and is a personal choice, but it can provide an additional layer of protection for the skin. For example, I tend to use it only for longer rides, but people who are more prone to saddle sores may want to use it for all types of rides. Check out our favorite brand UNDRBDR, a former sponsor of the team and a huge member of the local bike community.
Hygiene: If possible, getting out of the bib right after finishing a ride and showering with soap and water is ideal. It’s strongly recommended to avoid wearing bibs again if they haven’t been in the laundry. Bacteria love the humidity created by your bibs and can contribute to causing the issues discussed here.
Pubic hair: While understanding that this is a personal choice, experts argue that discontinuing shaving, waxing, and epilation might be the right thing to do in order to avoid skin chafing. This article from The Guardian explains how the British Women’s cycling team tackled the issue of saddle pain by changing the athletes’ hair removal routine. They had women and men stop shaving and keep their pubic hair as it provides friction and protection in keeping the skin dry by helping with transportation and evaporation of sweat. Many hair removal techniques can damage the first layer of the skin, increasing the risk of ingrown hair and folliculitis, which can also contribute to the forming of saddle sores. Plus, it’s one less painful experience!
Saddle: Comfort in the saddle can be a real struggle for women. I personally know of at least two women who decided not to pursue cycling because of how much discomfort they felt. This is because, for a long time, saddles were generic, and lacked diversity in the geometry that was offered. More recently, there has been a shift and bike companies have started designing saddles that are built around the female anatomy: wider sit bones and a presence of soft tissue in the perineal region. A whole post could easily be dedicated to genital discomfort and bicycle saddles ( I recommend reading this excellent blog post) because so many factors impact the type of pain someone may feel. It can be challenging to get started and find a saddle that fits. For example, someone with a more aggressive cycling position on the bike - dropped handlebars, forward lean- will likely feel more anterior discomfort around the genitalia, the labia, and the clitoris region (which can be painful!), while someone who rides more upright might have more posterior or buttocks discomfort.
Generally, what the industry calls “women-specific saddles” tend to have a shorter nose to relieve pressure on the anterior perineal region and are wider to accommodate for wider sit bones. Interestingly enough, cut-outs and relief channels were initially designed for the male anatomy, but women have embraced these shapes and the industry has followed by including them in their models for sale. That being said, finding a saddle shape that is comfortable is a personal experience, and not all women will go for “women-specific saddles”. While we think that products don’t necessarily need to be gendered, we do find that having more choices in saddle geometry is a great thing!
Bike fit: Going to a pro bike fitter is an essential step for anyone dealing with saddle sore issues or saddle discomfort. While it may be intimidating to discuss groin issues with a male fitter, it can be worth giving it a chance, as these issues and these discussions are becoming more mainstream. Having more female bike fitters might encourage cyclists to be more open around these issues as well.
While the best way to manage chafing and saddle sores is prevention, once you develop a saddle sore they can be difficult to treat. The first step is to give your butt a rest. While this can be hard, especially when all your friends are riding, it is essential to avoid encapsulation (the formation of a sac which traps sebum or infection). If you catch the sore before it’s encapsulated, there is a chance it can dissolve and go away on its own. Depending on the type of sore, it may come to the surface and pop like a normal pimple or boil.
For chaffing:
Gently clean and dry the skin
Use topical treatments such as petroleum jelly or moisturizers to help protect the skin as it heals.
For saddle sores, here are a few things you can do to get the cyst to come to a head:
Warm compresses and salt baths
Use of antiseptic-antimicrobial skin cleansers such as chlorexidine gluconate a few times per week
Seeking medical attention
These few days off the bike can save you headache and heartache down the road.
If after a few weeks the saddle sore has not gone away, there is a good chance it is encapsulated. The likelihood of it dissolving and going away on its own is reduced. The next step is to speak to a doctor. In my personal experience, I’ve spoken to a dermatologist, proctologist, and gynecologist. Each situation is unique and your doctor will be best suited to address your particular needs. With that in mind, here are a few management strategies you can speak to your doctor(s) about:
Cortisone Shot - reduces inflammation and therefore the size of the saddle sore. Generally, this does not make the sore go away. If you can change other aspects about your bike position that alleviate pressure on this area, a management strategy like this could work. If your saddle sore is right on your sit bone, the chance of re-irritating the area is high.
Draining the Sac - this is typically a small in-office procedure that removes the fluid (or gunk) inside a saddle sore. As this does not remove the sac wall, there is a chance that it will fill up with fluid again under pressure/friction.
Saddle Sore Removal - this is the most invasive option but is the surest way to eliminate a saddle sore. The procedure may require you to be under anesthesia. Alternatively, your doctor may be able to use a local anesthetic to numb the area. Typically, a small incision is made along the saddle sore, and sac is removed whole. If the wound is neat and the edges can be approximated, stitches will be put in place. If not, the wound may heal by secondary intention (i.e., skin will granulate in to fill in the gap, same way your body heals from regular cuts). Healing with stitches will be quicker and result in less scarring and scar tissue but healing by secondary intention works perfectly fine. Heal time to when you can start riding will vary and your doctor will be best able to comment on this. In my personal experience (as someone that has had two saddle sores removed), my heal time has been 1 - 2 weeks. While your skin is healing, you need to take special care to ensure the wound does not get infected due to its particular location. Your scar may look weird and puckered - don’t freak out, this is normal and not another saddle sore (think back to all of your scars on other parts of your body, they all look a little funky, at least mine do….). Once you are ready to get back in the saddle, your scar will likely be stiff due to scar tissue. This will take a little bit to break up and relax but riding your bike will actually help to ‘massage’ this area.
Being out for the count with a saddle sore is tough. Fortunately, it is an issue you can overcome. If you can keep a positive attitude and work on other aspects of your fitness while healing, you can come back to cycling better than new.
The advice listed here should help with dealing with skin chafing and saddle sores but do not replace medical care. Please consult with a physician or a medical provider as needed.