Your little soccer player comes home after a game, chucks her cleats on the floor and yanks those shin guards off her legs. Then you see it: splayed across her legs is a bright red rash that she’s furiously itching.

Skin reactions to sporting equipment or sports-related situations is common, but sometimes it’s hard for parents to know whether it’s a simple fix or a more serious allergic reaction.

Chicago Blackhawks winger Marian Hossa recently made headlines when he announced that he will not play this season because of a progressive skin disorder that requires aggressive medication. He is presumed to have a severe allergy to his equipment.

Ewa Schafer, MD, Allergy & Immunology at NorthShore, said it’s important for parents to know whether the reaction their child has is an immunological response or not. Here she answers questions about the topic:

Why are athletes more susceptible to reactions?
Athletes are more susceptible to infection because of their frequent exposure to bacteria, fungus and viruses. While they practice, they sweat and their temperature increases, causing small breaks in the skin. This allows these substances to enter, making the person vulnerable to irritation. Symptoms vary depending on the type of infection, but frequently result in a rash and itchiness.

How do you know if the condition is serious?
It is important to understand whether the symptom is the result of an allergy or an irritation. Irritant Contact Dermatitis (ICD) and Allergy Contact Dermatitis (ACD) present similar symptoms, including rash and itching, however the involvement of the immune system differentiates the conditions. ICD occurs when the skin comes in contact with an irritating material, and after first exposure, the body’s innate immune system becomes activated to fight off the substance. ACD presents symptoms 24-72 hours or more after exposure to the allergen, and activates specific cells to fight off the substance. An allergy differs from an irritant because of the response of the immune system to the allergen. Once exposed to an allergen, the body responds with antibodies targeted to that substance, causing an allergic reaction. It can be helpful to get a Patch test to know whether symptoms are a result of an allergy or an irritation.

What treatments are available?
The condition can get very severe, especially with reapplication and if the cause is not removed from constant contact, you’re just going to make the skin condition worse. Treatments for ICD and ACD typically include topical steroids (oral steroids if more severe) or over the counter allergy medication. Avoidance is the ultimate solution in ACD.

Are there any side effects?
With any steady treatment plan, medication awareness is essential as is communication with your doctor.  With prolonged use of topical steroids or use at high doses, skin atrophy (thinning), telangiectasias, striae (stretch marks) and acne may occur.  Avoidance of any allergens is key to prevent need for medications.  In ICD, finding the trigger and removing it is also essential.

What can I do?
Be aware. Look out for symptoms of ICD and ACD and take initiative. Skin irritations are frequently a result of a lack of equipment maintenance. However, if symptoms recur, you may need to consider seeing an Allergist or Dermatologist and consider a Patch test. Without proper care of equipment, such as soccer shin guards, bacteria and fungus can grow causing a skin irritation. To prevent this, be sure to let the equipment dry after use or create a barrier between the equipment and the skin, such as socks. The warm, wet environment between an athlete’s body and the gear allows for the growth of bacteria and fungus. These substances are highly contagious, so be sure to avoid sharing equipment when possible.  Proper fit of equipment is also necessary to avoid irritation to the skin.