Skin microbiome disruption and dermatological risk in athletes

Aim: This review aims to synthesize current evidence on the composition, function, and vulnerability of the skin microbiome in athletes, with a particular focus on the influence of physical activity, sweat, clothing materials, and environmental exposures. It also examines dermatological risks associated with microbial dysbiosis and discusses evidence-based strategies for prevention and clinical management in sports dermatology. Material and Methods: A literature search was conducted in PubMed, Scopus, Web of Science, and Google Scholar for publications from 2013 to 2025 using keywords: “skin microbiome”, “athletes”, “sports dermatology”, “sweat”, “MRSA”, and “cutaneous infections”. Only peer-reviewed English-language studies directly addressing human skin microbiota in the context of physical activity were included. Clinical studies, metagenomic analyses, and reviews were analyzed. Data were extracted regarding taxonomic composition, functional roles, disruptive factors, and disease associations. Results: Athletic activity significantly alters skin microbiota, promoting colonization by opportunistic species such as Staphylococcus aureus and Malassezia spp., while reducing microbial diversity in areas under friction, occlusion, or chemical exposure. Sweat changes pH, increases salinity, and provides substrates for bacteria and fungi, leading to conditions such as acne mechanica, folliculitis, tinea corporis, and MRSA colonization. Synthetic, tight-fitting clothing and inadequate hygiene exacerbate dysbiosis, whereas breathable fabrics reduce risks. Environmental factors—chlorinated water, UV exposure, air pollution, and contact with contaminated surfaces—further disrupt microbial balance. Preventive measures, including microbiome-friendly cleansers, prompt post-exercise hygiene, appropriate sportswear, and regular dermatological screening, are critical in mitigating risk. Conclusions: The skin microbiome in athletes is a dynamic ecosystem shaped by sport-specific exposures and behaviors. Disruption can increase susceptibility to infectious and inflammatory skin diseases, potentially affecting performance and recovery. Targeted interventions that preserve microbial diversity, enhance barrier function, and integrate personalized care protocols offer promising avenues for sports dermatology. Future research should prioritize longitudinal studies and controlled trials assessing microbiome-supportive strategies tailored to athletic populations.