The question for cyclists
is not if you will get a saddle
sore but when you will get
a saddle sore. Ride long
enough and a saddle sore will come.
First, a saddle sore is really a pressure
sore. A sore is basically a breakdown
of skin that may or may not be
infected. A saddle sore arises from
two things: abnormal pressure causing skin breakdown on the perineum
and an environment (warm, moist)
that allows skin to become infected.
When these two things happen
together, a saddle sore is likely. On
the surface, a saddle sore appears as
an infected pimple or an ingrown hair.
At its core, a saddle sore is an
inflamed, bacteria-laden pore. Skin
naturally contains a balance of
bacteria—some are good, while others
are bad. When an imbalance of skin
bacteria arises in proper conditions, for
whatever reason, a saddle sore is likely.
There are different reasons for getting
saddle sores; most of the time it’s a
I’m a long-time cyclist
that’s been riding the same
bike and saddle for two
years, and suddenly I’m
getting saddle sores. What would be
the cause for them to appear? What’s
the best fix?
Q:combination of mechanical and medical. MECHANICAL: Mechanically,
changes in pressure patterns within the
saddle may cause saddle sores. The
inner foam eventually breaks down.
When foam loses its form, the
pressure patterns change on your
perineum, which may help explain new,
unexplained saddle sores. In this case,
consider buying a new saddle of the
same brand and see if this helps. Check
your chamois. A chamois does not last
forever, and when they go bad, saddle
sores can arise. Always use chamois
cream. Other things you might consider
are looking at your pedals and cleats.
Are they worn out or has something
changed? Consider a bike fit. We all
change with age, and sometimes a bike
fit may show an imbalance that could
lead to saddle sores.
MEDICAL: Medically, the list is huge.
In warm, sweaty areas, a fungus called
“candida” can grow in the crotch, mak-
ing a saddle sore more likely. A typical
dermatology problem is laundry soap or
fabric softeners. If you recently changed
soaps and your skin is sensitive, this
may predispose to irritation and saddle
sores. Also, improper washing of cycling
clothes can cause mildew and may be
a source of infection. If you have
diabetes or pre-diabetes, this may lead
to an imbalance of skin bacteria, predis-
posing you to saddle-sore infections, so
you might consider buying a home glu-
cose monitor to check yourself. If your
glucose is high, see your doctor and rid
yourself of processed foods for starters.
Finally, you may be experiencing
perineal numbness due to an enlarged
prostate, for example. By the time you
have realized the numbness, nerve
damage has already occurred.
TREATMENT: Basic tenets of
treating a saddle sore involve calming
the inflammation and infection. Keeping
the infected area clean and dry and
a few days rest will cure most saddle
sores. Epsom salt baths can help. Some
people swear by tea tree essential oil
and Vaseline. If you are going to
continue to ride, stand up—a lot!
More complex saddle sores may
require a doctor’s visit, where you can
be advised to use antibiotic or
cortisone cream to calm the
inflammation. There are cases where
this is necessary. Chronic saddle sores
can also lead to scar tissue. I have
actually seen cases where surgery was
necessary to remove the scar tissue.
If you have a medical or training
question you’d like answered,
please e-mail the doc at letters@
Health tips from
By Dr. Johnathan Edwards