Skin Bumps After Brazilian Jiu-Jitsu: Treatment Approach
Most Likely Diagnosis and Initial Management
The most common skin conditions from BJJ mat contact are bacterial folliculitis, impetigo, or traumatic skin abrasions—all requiring gentle cleansing and monitoring for infection rather than prophylactic antibiotics. 1
Immediate Wound Care Protocol
Basic Cleansing
- Gently irrigate the affected areas with warmed sterile water, saline, or dilute chlorhexidine (1:5000) to remove mat debris and reduce bacterial load 2, 1
- Avoid aggressive scrubbing that could further damage skin 1
- Pat dry gently with clean towel 2
Topical Application
- Apply a greasy emollient (50% white soft paraffin with 50% liquid paraffin) over the entire affected area to maintain moisture and prevent adherence 2, 1
- Cover with non-adherent dressing (such as Mepitel or Telfa) if there are open abrasions 2, 1
- Apply secondary foam dressing to collect any exudate if needed 2, 1
When to Use Topical Antibiotics
Do NOT use topical antibiotics prophylactically on clean wounds or minor abrasions 3, 4. The evidence is clear:
- Topical antibiotic prophylaxis provides no clinical benefit for preventing infection in clean wounds (RR 0.83,95% CI 0.61-1.16) 3
- The American Academy of Dermatology no longer recommends topical antibiotics for clean post-surgical wounds 5
- Overuse contributes to bacterial resistance without improving outcomes 5, 4
Only Use Topical Antibiotics If:
- Clear signs of superinfection develop: increasing erythema >5cm, purulent discharge with foul odor, or severe pain 2, 6
- Apply topical antimicrobial (such as mupirocin or triple-antibiotic ointment) only to infected areas 2, 7
- Consider silver-containing products for sloughy/infected areas only 2
Systemic Antibiotic Indications
Administer oral antibiotics only if clinical signs of infection are present 1, 6:
- Fever >38.5°C (101.3°F) 6
- Expanding erythema with warmth 6
- Purulent drainage with odor 6
- Systemic symptoms (malaise, lymphadenopathy) 6
For suspected bacterial folliculitis or impetigo from mat contact, consider oral doxycycline or cephalexin if infection is confirmed 2.
Monitoring and Follow-Up
- Reassess within 24-48 hours for signs of infection progression 6
- Change dressings every 5-7 days if no complications arise 1, 6
- Take wound swabs for bacterial culture only if infection develops 1
Critical Pitfalls to Avoid
- Clear to yellowish serous fluid is normal wound exudate—not infection 6
- Do not apply topical antibiotics, antiseptics, or antimicrobial dressings routinely to clean abrasions 1, 5
- Avoid chlorhexidine in alcohol formulations, which can irritate skin 2
- Do not use honey, collagen, or alginate dressings for routine BJJ-related skin trauma 1
Adjunctive Measures
- Keep affected areas clean and dry between training sessions 2
- Avoid further mat contact until skin integrity is restored 2
- Use soap-free shower gel and avoid alcoholic solutions 2
- Apply urea- or glycerin-based moisturizer to surrounding dry skin 2
When to Escalate Care
Consider dermatology referral if: