NZ alert on terbinafine-resistant ringworm

A rash that lingers despite doing the right thing can cost an athlete far more than a few sessions. NZ researchers have issued a clinical alert over terbinafine-resistant ringworm, and for BJJ, wrestling, MMA and other contact-sport communities, it is a reason to take mat hygiene, early reporting and proper diagnosis seriously.

Ringworm is already a familiar problem in high-contact training. It spreads through close skin contact and contaminated surfaces, and it is easy to underestimate when it starts as a small, itchy patch. The clinical alert adds another layer: some fungal infections may not respond as expected to terbinafine, a commonly used antifungal medicine.

That does not mean every case of ringworm is resistant. It does mean athletes, parents, coaches and clinicians should pay attention when a suspected fungal rash is spreading, recurring or failing to improve with the treatment plan.

What the NZ alert on terbinafine-resistant ringworm means

Terbinafine-resistant ringworm is associated with dermatophytes - fungi that infect the outer layers of skin, hair and nails. One species attracting international clinical attention is Trichophyton indotineae, which has been linked with extensive, difficult-to-treat tinea infections and resistance to terbinafine in some cases.

For a grappler, the practical message is simple: do not treat a persistent rash as a minor inconvenience or try to train through it. A rash that has not responded as expected needs medical review. The clinician may need to reconsider the diagnosis, take samples for testing, identify the fungus involved or use a different treatment approach.

Resistance is not something an athlete can identify by looking in the mirror. A circular rash is not automatically ringworm, and ringworm does not always look like the neat red circle shown in textbook images. Eczema, psoriasis, bacterial infections and irritation can all be mistaken for fungal infection. That is why guessing, borrowing medication or repeatedly applying random creams can delay the right answer.

Why combat sports need higher hygiene standards

A packed evening class creates ideal opportunities for skin organisms to move. Athletes grip, frame, sprawl and clinch with repeated bare-skin contact. Sweat accumulates under rash guards, gloves and headgear. Feet travel from changing rooms to mats, and shared gear can pass from one person to the next.

The issue is not that combat sports are inherently unclean. It is that high-contact training environments demand higher hygiene standards. Good academies build those standards into the culture, just as they build safe tapping, controlled sparring and correct warm-ups into the session.

The common mistake is thinking a quick shower at some point later will sort everything. Delayed washing gives sweat, friction and prolonged contact with contaminated clothing more time to irritate the skin. It also means gear and clothing may sit damp in a bag, creating an environment nobody wants to put on again the next day.

Skin health is part of training availability. Protecting the skin barrier through sensible washing, drying and moisturising where needed helps skin tolerate the regular friction, shaving, tape, sweat and laundering that come with serious training. It is not about trying to sterilise your skin. It is about reducing avoidable exposure and responding early when something changes.

A persistent rash needs a different response

A fungal rash may be itchy, scaly, raised at the edge or gradually enlarging. It can show up on the trunk, limbs, neck, face, groin or feet. In wrestlers and grapplers, it can hide under the exact areas covered by compression gear, knee sleeves or rash guards.

If an athlete notices a suspicious patch, the disciplined move is to stop close-contact training and get it assessed promptly. Covering it with tape, a patch or a long-sleeve rash guard does not make it suitable for rolling. Neither does applying a cream immediately before class.

Seek medical advice sooner rather than later if the rash is widespread, painful, weeping, crusted, near the eyes or scalp, or accompanied by fever or feeling unwell. The same applies when it keeps returning or does not improve as expected with prescribed care. These details can point to a different diagnosis, another infection alongside the fungal rash, or a need for laboratory testing.

Avoid using steroid creams on an undiagnosed rash unless a clinician has advised it. Steroids can reduce visible redness while allowing some fungal infections to spread and become harder to recognise. This is one reason a rash can appear to settle, then return larger after a few days.

Coaches: make reporting the easy option

Athletes hide skin problems when they expect embarrassment, punishment or a public call-out. That is a coaching problem, not an athlete character flaw. Establish a clear private reporting process, treat exclusions as normal safety management and welcome athletes back when they meet the relevant medical and competition guidance.

A coach does not need to diagnose skin conditions. They do need to set the standard: no athlete should feel pressured to roll with an unexplained rash, and no teammate should be asked to take that risk.

The routine that lowers unnecessary exposure

Prevention is built from repeatable actions, not a single magic product or a once-a-month deep clean. Athletes should shower after training as soon as practical, using clean towels and clean clothing afterwards. Training gear should be removed from the bag, aired and washed after every session. A damp gi, rash guard or pair of spats left in the boot overnight is an avoidable hygiene failure.

Keep nails short and clean. Wear footwear in shared changing areas and showers. Do not share towels, razors, soap bars, compression gear, headgear or gloves that contact bare skin. Clean and disinfect mats between sessions using a product and process suitable for the surface, and do not forget high-touch items such as shared pads, headgear, benches and door handles.

For athletes who cannot shower straight after a lunch-time class, a practical hygiene system matters. Combat Soap’s Ultimate Shield is built as an everyday post-training cleansing bar, while Charcoal Cleanse suits hard, sweaty sessions when athletes want a deeper clean. Combat Spray, made with approximately 300 ppm hypochlorous acid, is a convenient option for skin and equipment hygiene around training when the shower is delayed. Use that time wisely: get out of sweaty kit, keep any rash away from contact and shower properly when you can.

The value is consistency. Tea tree, neem, rosemary, charcoal and hypochlorous acid are useful components of an athlete-focused hygiene routine, but their real benefit comes from being used alongside clean gear, well-maintained mats and early action on suspicious skin changes.

Do not confuse hygiene with harshness

Some athletes respond to skin concerns by scrubbing aggressively, washing repeatedly with harsh products or using disinfectant-style products on already irritated skin. That can backfire. Friction, over-washing and harsh actives can dry and disrupt the skin barrier, leaving skin more prone to cracking and irritation.

Wash thoroughly after training, but do not turn your shower into a punishment. Pay attention to areas that stay warm and damp: feet, groin, underarms, skin folds, behind the knees and beneath taped or covered areas. Dry properly, especially between the toes, then put on clean clothes.

If you are prone to dry or irritated skin, adjust the routine rather than abandoning it. It may mean shorter showers, avoiding very hot water, using a gentler cleansing option and applying a suitable moisturiser after washing. The right balance depends on your skin, your training load and the climate, but skipping hygiene is not the answer.

Parents and academy owners set the culture

For junior athletes, parents should check skin regularly without making it dramatic. Ask about itch, discomfort and new patches after training, especially during busy competition periods or when several teammates have skin issues. Early reporting protects the whole room.

Academy owners should have written cleaning procedures, adequate supplies, clear reporting expectations and a plan for suspected outbreaks. Staff should know who is responsible for mat cleaning, how often it happens and what happens when an athlete presents with a suspicious lesion. Vague responsibility usually becomes no responsibility.

The clinical alert is a reminder that ringworm is not always a quick, simple fix. Preparation matters. A clean body, clean kit, clean mats and the confidence to sit out when something looks wrong are the habits that keep athletes available for the training that matters.