Taking Care of Saddle Sores

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File under “I’m going to stand the whole ride because it hurts”

While they aren’t generally discussed in polite company, saddle sores are simply an uncomfortable fact of life for many cyclists. No matter what, almost every cyclist is guaranteed to have at least one in their lifetime. They can be painful, uncomfortable, and embarrassing. And worst of all, they can take away your motivation to ride.

But don’t worry—its not doom and gloom. Taking care of a saddle sore is pretty easy. There are a few simple things you can do to prevent them from happening in the first place, and shorten the misery if you do get one.

 What Is A Saddle Sore

A saddle sore is a localized skin infection in your pelvic or buttocks area. Think of it as a pimple that forms where the sun don’t shine. Most are very minor and will clear up on their own, but sometimes if you don’t take care of them, they can get a little out of hand.

Always remember: saddle sores are infections, and should be treated with respect. While extremely, extremely rare, saddle sores can develop into dangerous systemic infections.

If the saddle sore is very painful, feels warm to the touch, is very red, you see red streaks coming from it, or you’re running a fever, seek immediate medical care. You may also want to visit a doctor if the saddle sore hasn’t cleared in two weeks, or is getting larger.

 

What Causes Them

This is still debated, not just among cyclists, but also in the medical community. The general consensus seems to be though that saddle sores happen when friction irritates hair follicles, allowing them to become infected by bacteria. This can lead to either a pimple-like spot, or a deeper boil-like infection.

 

Prevention

This is truly a case where an ounce of prevention is worth a pound of cure. To prevent saddle sores from happening in the first place, follow these tips:

1. Proper bike fit

Having your saddle too high can cause you to rock from side to side on the saddle, building up friction along the perinea and where the thighs join to the buttocks. Having your saddle too far back can also cause your pelvis to rotate forward off the sit bones, placing more pressure and friction on delicate soft tissue.

2. Use The Right Saddle (for you)

Not all saddles suite all body types. Find the one that’s right for you—which could mean trying a few different models and brands. Also, if you’ll be riding more than a few miles, stay away from very padded saddles, add on gel cushions, etc… These only increase friction and make things worse. It seems counter-intuitive, but trust us.

3. Wear Bike Shorts

Bike shorts come with a pad sewn into them to help keep you comfortable on minimally padded saddles. By moving the padding to the shorts instead of the saddle, the padding moves with your body, reducing friction and helping prevent saddle sores. Your shorts should be comfortable and fit properly– a sagging chamois is as bad as no chamois. Also, don’t wear underwear underneath them—that just defeats the purpose and causes more friction.

4. Use chamois cream

Chamois cream is an anti-chafing lotion that can be applied to the chamois pad itself, or directly to the skin. It helps form a protective barrier between you and the fabric to prevent chaffing and irritation. If you’re prone to saddle sores or already have one, then don’t be shy. Slather that stuff on there and worry about it getting on your nice saddle later. You may also want to try cleaning your saddle-interface area with soap and water or an antibacterial wipe before you apply chamois cream.

5. Wash Your Shorts

Never wear dirty shorts. Not even the ones you “only wore for a couple of miles yesterday”. Last time you rode in them, you created a hot, moist environment loaded up with dead skin cells and sweat. They’re basically a petri dish for bacteria and fungi. Now you want to put those dirty shorts on and ride again? Sure, if you think that sounds like a good idea.

6. Change and Shower

As soon as you finish your ride, take your shorts off and bathe as quickly as possible. Even if that means wrapping a towel around yourself in the parking lot and changing out of your shorts, go for it. Using some shower wipes to clean up can make a big difference. The longer they stay on after the ride, the greater the chances of a saddle sore. No matter how short your ride, try to grab a shower and wash up. Staying clean is key to prevention.

 

Treatment

Already have a saddle sore? Don’t worry. It probably hurts makes riding uncomfortable, but there’s plenty you can do to help yourself get better.  **Always seek medical advice before trying any new medication, over the counter product, or self-care steps**

1. Cleaning

By far the best thing you can do to help speed along recovery is keep the area clean. Wash 2-3 times a day with regular soap and warm water. Thoroughly dry the area. Warm, soapy compresses can also help to alleviate pressure and pain.

2. Rest

Nobody likes taking time off the bike, but  riding can make saddle sores worse. If the sore is so painful you can’t sit on the bike, you’re better off taking a few days to let things heal. Yes, we hear about the pro’s riding through them all the time. They are paid to do that and are looked after accordingly with a full medical support team. You are not.

3. Chamois Cream

Our old friend is back again. Some chamois creams have mild antiseptic and moisturizing properties. If your saddle interface area is feeling a little irritated or chaffed after your ride, it can help to put a small amount of chamois cream on the affected area after you shower. This helps to soothe the skin, prevent infection, and speed the healing process.

4. Triple Paste

Triple Paste is a lanolin-based diaper rash ointment that can be found at most local drug stores. Usually found in the baby aisle, you’ll recognize it by it’s Carolina Blue packaging and because it’ll be about 3-times more expensive than anything else around it on the shelf. This extremely effective paste is used to treat severe diaper rash, in hospitals for bed sores, and other uses when skin needs to be calmed, soothed, and healed. It can be very effective to help heal existing sores, and can be used in place of chamois cream to prevent chafing in the first place.

5. Ichthammol ointment

Ichthammol is available at your local pharmacy (CVS and Walgreens both sell a private label version), and there are two things you should know about it:

1. It looks and smells like something no animal– let alone a human being– should ever put on their body

2. It can be very effective

Ichthammol is a byproduct of petroleum distillation, and it looks and smells like tar. It is traditionally known as “drawing salve” or “black salve”, and has been used for generations to help treat boils, abscesses and ingrown hairs. During the pre-antibiotic age and World War II, it was widely used to treat skin infections. Exactly how it works is still unknown, but it has been determined to have powerful antibacterial, anti-fungal, and anti-inflammatory properties, and is considered safe and well tolerated by the FDA. Basically, you clean the saddle sore area, put some ichthammol ointment on a clean band-aid, and apply it to the area overnight. In theory, it should help things “come to a head” and drain. We can personally attest that it really does help calm things down and heal, sometimes just overnight. Always consult a doctor before trying new medications.

6. Benzoyl Peroxide & Salicylic Acid

If you catch a saddle sore early, you can sometimes treat them easily with over the counter acne treatments.

We’ve had extremely good luck with topical acne medications that contain Benzoyl Peroxide (like OTC Persa-Gel 10) or Salicylic Acid. Both of these agents can be tough on the skin though, and everyone reacts to things differently, so we’d recommend testing it on a less sensitive area of the body first. Since they can irritate the skin, we recommend using them for only a few days at a time. If the saddle sore doesn’t clear up after a few days, got to step Number 7.  Always consult a doctor before trying new medications.

*The medical community advises AGAINST using an antibiotic ointment for minor skin infections like saddle sores. Antibiotic resistance is a serious and growing problem, so if you think it’s bad enough to warrant antibiotics, then you probably need a trip to the doctor to have them check it out.

6. Don’t Squeeze Them

Sorry if this provokes a gag reflex, but don’t try to “pop” a saddle sore. While they are similar to pimples, they aren’t exactly the same. Trying to squeeze it may only drive the infection into a deeper layer of tissue—then you’re really in trouble.

7. Make An Appointment

This can be a tough pill to swallow (forgive the pun), especially if you don’t have insurance. But if a saddle sore hasn’t healed with 2 weeks of self care, it’s time to visit the doc. The last thing you want to do is let a simple irritated hair follicle turn into a boil, Perineal Nodule, or an abscess. It could be that you need to have it lanced or a course of oral antibiotics. Even if not, your doctor may be able to provide valuable care advice that can help things heal and prevent your saddle sore from coming back.

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