The Question

Long-time cyclist with same bike and saddle…and suddenly I’m getting saddle sores…what would be the cause for them to appear? What’s the best fix?

The Why

The question for us cyclists is not IF you will get a saddle sore, it is WHEN you will get a saddle sore. Ride long enough, a saddle sore will come. First, a saddle sore is really a pressure sore. A sore is basically an infection. Thus, a saddle sore is an infection that arises from two things: abnormal pressure causing skin breakdown on the perineum (or crotch, taint, etc.) 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 looks like an infected pimple or an ingrown hair. Most appear on the crotch area or the back of the thighs. At its core, a saddle sore is an inflamed, bacteria laden pore. This is a simplistic explanation, but you get the point.

Skin naturally contains a balance of bacteria, some are good, while others are bad. When an imbalance of bacteria arises in proper conditions for whatever reason, a saddle sore infection is likely. There are different reasons for getting saddle sores; most of the time it’s a combination of mechanical and medical.

Mechanical

Mechanically, changes in pressure patterns within the saddle may be the cause. The inners of a seat do not last forever. A saddle’s inners are high-tech foam. 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. Chamois do 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, 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, making 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. Also, if you have diabetes or pre-diabetes, this may lead to an imbalance of skin bacteria, predisposing you to saddle sore infections. If your fasting blood sugar is consistently over 90, this may suggest pre-diabetes or insulin resistance (90 million Americans have this). Consider buying a home glucose monitor and 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. By the time you have realized the numbness, nerve damage has already occurred.

Treatment

Basic tenants of treating a saddle sore involves calming the inflammation. 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 require a doctor’s visit where you may be advised to use antibiotic or cortisone cream to calm the inflammation. There are cases where this is necessary, like long cycling events. Chronic saddle sores lead to scar tissue. I have seen cases where surgery was necessary to remove the scar tissue to alleviate the saddle sores. Finally, if you are really sick with fever, chills, and pus, present yourself to a doctor and get appropriate treatment.

Also see this post about cycling and the prostate