Introduction

The skin of athletes undergoes intensive exposure to adverse factors during training and competitions – ultraviolet radiation, mechanical friction, increased perspiration, temperature fluctuations, and contact with chlorinated water or sports equipment. Effective protection of the integumentary system is an integral component of preserving athletes’ health and maintaining their optimal athletic form.

In the context of the increased risk of ultraviolet exposure for athletes training outdoors, an analysis of sun protection habits and the frequency of sunscreen use among student athletes was performed. In the study by Axcell et al. [1], the involvement of higher education institutions in providing sun protection measures was analysed, and the level of athletes’ adherence to recommendations regarding the use of sunscreen, protective clothing, and other measures was examined. Participants involved in outdoor sports had a high level of repeated radiation exposure; however, about half of the respondents demonstrated a low level of sunscreen use even with relevant knowledge. The increased incidence of skin infections among athletes in contact sports necessitated a systematic analysis of common pathologies and prevention pathways. In the work of Nowicka et al. [2], key dermatological infections among wrestlers, rugby players, footballers, and other athletes who frequently have skin contact with opponents and share equipment are described. Common pathogens include staphylococci, herpes simplex virus, and fungal flora such as Trichophyton. Particular attention is paid to preventive strategies, which include personal hygiene, surface disinfection, timely detection of lesions, and isolation of infected athletes.

Among athletes competing in triathlon, the level of knowledge and behaviour regarding sun protection and the detection of skin pathologies associated with UV radiation were investigated. In the work of Buljan et al. [3], skin phototype characteristics, the number of pigmented nevi, history of sunburns, and sunscreen use were assessed. Despite high awareness of the need for photoprotection, only 3% of participants always used protective measures, while 20% never used them. During dermatological examination, a significant proportion of athletes had solar lentigines and atypical nevi, increasing the risk of oncopathology. Physical contact, the use of shared equipment, and increased perspiration create favourable conditions for the development of infectious skin lesions in team sports [4, 5]. In the interdisciplinary review by Kucharczyk et al. [6], the results of data synthesis on the aetiology, prevalence, clinical presentation, and methods of preventing skin infections among athletes in contact disciplines are presented. Leading pathologies were identified: bacterial, viral (herpetic infections, molluscum contagiosum), as well as mycoses. Separate attention is paid to individual prevention measures, including the use of personal equipment and surface disinfection. Research in the field of sports dermatology indicates an increased risk of developing skin diseases among athletes compared to the general population. Gonzalez-Bravo et al. [7] established that sun protection products can modify the function of the skin barrier, demonstrating a reduction in erythema due to an anti-inflammatory effect. The researchers conducted an analysis of the influence of different types of sunscreens on skin homeostasis, finding that all studied products reduced erythema due to anti-inflammatory properties.

In the Ukrainian scientific space, the study by Fomina et al. [8], which focused on the analysis of chronic dermatoses during the period of military operations in Ukraine, should be highlighted. The results of the work demonstrated that the incidence of chronic dermatoses among military personnel in the central region increased more than fourfold compared to the period before 2014, with a significant worsening of the clinical course of these pathologies observed. The work by Solovyov and Koval [9] was dedicated to the investigation of technological features of creating an emulsion cosmetic cream with a peptide composition. The scientists proposed a composition for an emulsion cosmetic cream for facial care based on plant-microbial peptides – hexapeptide-10 and acetyl hexapeptide-8. A systematic literature analysis conducted by Vazhnichaya et al. [10] revealed the functional significance of antioxidants in the therapy of dermatological diseases. The researchers processed 115 of the most relevant sources out of a total of 3,076 identified publications over a 20-year period from 2005 to 2025. It was established that an imbalance between reactive oxygen species and antioxidant defence is characteristic of contact dermatitis, urticaria, atopic dermatitis, psoriasis, and photoaging. Antioxidants of natural origin (ascorbic acid, α-tocopherol, retinoids, coenzyme Q10, resveratrol) show promise in skin care [11–13]. The scientific work by Badyin [14] was oriented towards determining the effectiveness of rehabilitation measures in the context of age-related skin changes. The study lasted from 2016 to 2020, involving 287 middle-aged women. The author proved the effectiveness of comprehensive rehabilitation programmes for patients with involutive-dystrophic skin changes.

Research on thiolated silicone oils as components of protective creams, conducted by Kulawik-Pióro et al. [15], showed their effectiveness in preventing occupational skin diseases. The synthesised silicone oils demonstrate improved mechanical and rheological properties, which are important for barrier function. In the study by Gilaberte et al. [16], the issue of photoprotection for athletes who experience intensive exposure to solar radiation during outdoor training was considered. The authors analysed the literature and systematised risk factors for the development of photodamage, including habits of sunscreen use and the type of sports clothing. As a result, recommendations for reinforcing photoprotection habits at the level of sports organisations were formulated, emphasising the need for collective responsibility between coaches and medical personnel. A contribution to understanding the issue of athlete photoprotection was made by Kliniec et al. [17], who investigated the level of knowledge about skin malignancy risks and sun-protective behaviour among athletes. The study revealed a critically low level of athlete awareness regarding the need to use photoprotective measures, with forgetfulness being the most common reason for not using sunscreen, reported by 63% of respondents.

Despite a significant number of studies in the field of sports dermatology, most works focus on individual aspects of the problem – either exclusively on sun protection, or on the prevention of infectious lesions, or on the specifics of only one sport. Comprehensive studies encompassing the entire spectrum of cosmetic and medical products for skin protection in athletes from various disciplines during training and competitions remain limited. A large number of studies have been dedicated to the development and investigation of the properties of cosmetic and medical products for the skin; however, works aimed at a comprehensive investigation of the use of cosmetic and medical products for skin protection among athletes of different sports during training and competitions have been found to be insufficient, which necessitated the current study.

Aim

The aim of the current work was to identify the features of cosmetic and medical product use for skin protection by athletes during training and competitions. The objectives of the study were to establish the frequency and regularity of application of different categories of protective products (sunscreens, barrier products, antiseptics) by athletes from various sports; to determine the main factors influencing the choice and use of cosmetic and medical skin protection products among athletes.

Material and methods

The present study was performed as a cross-sectional descriptive investigation to examine practices of skin protective agent usage among athletes. Empirical data collection was conducted from May 2023 to May 2025 by surveying athletes training in sports institutions and who are members of sports federations in the city of Kyiv (Ukraine). The study was carried out in compliance with the ethical principles of the Declaration of Helsinki. All participants provided informed consent prior to engagement in the survey.

The sample population was formed using a non-probability convenience sampling method with elements of snowball sampling. The total sample size comprised 386 respondents, of whom 212 (54.9%) were women and 174 (45.1%) were men. The inclusion criteria for the sample were: age from 18 to 40 years (mean age: 26.5 ±5.2 years); having the status of an active professional or semi-professional athlete; a regular training schedule (not less than 10 h per week); and voluntary consent to participate. The exclusion criteria were: history of chronic dermatological conditions not related to athletic activity (e.g., psoriasis, atopic dermatitis); having concluded a sports career at the time of the survey; provision of incomplete or incorrect responses in the questionnaire.

The representativeness of the sample for the target population (high-level athletes in a large city) was ensured by involving athletes from various sports, who were conditionally grouped into three categories: outdoor sports, water sports, as well as contact and strength sports.

It should be noted, however, that the use of non-probability sampling methods and the potential self-selection of participants may limit the generalizability of the results. Athletes who chose to participate may differ in motivation, awareness, or interest in skin care compared to non-participants, which could introduce bias. Future studies are recommended to address these limitations by employing random sampling techniques, stratified sampling to better represent different sport categories, or increasing sample size and diversity to enhance external validity.

Data collection was carried out throughout all seasons of the year, enabling the analysis of potential seasonal variations in the use of skin protection products. Participants were asked to indicate the types of products used (e.g., sunscreen, moisturisers, barrier creams, antiseptic agents, specialised ointments) and their frequency of application in different seasonal conditions (spring, summer, autumn, winter). This approach allowed for consideration of climatic factors that may influence both the choice and effectiveness of skin care strategies among athletes.

The primary instrument for data collection was a structured questionnaire developed by the author, the distribution of which was carried out online through the administration of sports organizations. The questionnaire was anonymous and consisted of five logical blocks aimed at obtaining information regarding:

A comprehensive approach was applied for processing and analysing the obtained empirical data. At the first stage, methods of descriptive statistics were used to systematise and summarise the primary data, in particular for calculating frequency distributions and percentage ratios, which allowed for the characterisation of general trends within the sample, including differences in product usage across seasons. At the second stage, the chi-square (χ²) test was applied to verify hypotheses regarding the existence of statistically significant differences in distributions between independent groups (men/women; sport type groups; seasonal groups). The critical level of significance for hypothesis testing was set at p < 0.05. All statistical data processing was performed using the SPSS Statistics software package (version 26.0).

The sequential execution of the described methodological steps – from forming a representative sample and collecting data using a validated questionnaire to their subsequent statistical processing – ensured the acquisition of objective and reliable empirical results. The interpretation of these results allowed for the resolution of the set research tasks: to establish the frequency and regularity of application of different categories of protective agents, to assess the seasonal influence on their use, as well as to determine the main factors influencing the selection and use of cosmetic and medical skin protection agents among athletes.

Results

Discussion

The conducted study found that dermatological problems, particularly mechanical skin damage (abrasions, chafing, calluses), as well as physiological disorders, such as skin dryness, acne and fungal infections, are widespread among athletes. The obtained data confirmed that these problems are systemic in nature and are a direct consequence of the specific training environment. At the same time, not all groups of athletes are equally provided with effective means of prevention.

It should be emphasised that the mere frequency of product application, such as sunscreen, does not guarantee adequate protection. Despite 87.3% of athletes reporting sunscreen use, 64% experienced sunburns. This discrepancy likely results from insufficient regularity of reapplication, use of products with inadequate SPF, sweat or water wash-off, or inappropriate amounts applied. Therefore, evaluations of photoprotection must include not only frequency, but also SPF level, water/sweat resistance, and reapplication practices, which are critical for effectiveness.

The study initially failed to consider seasonal fluctuations in training circumstances and the application of skin protection creams. Seasonal variations may affect the nature of dermatological conditions experienced and the selection or efficacy of protective medicines [18, 19]. For instance, in summer, outdoor athletes may augment sunscreen application due to elevated UV exposure, while in winter, systematic use of moisturisers and barrier creams becomes more essential due to lower humidity, cold air, and enhanced transepidermal water loss (TEWL).

A limitation of the current study is the use of a non-probability convenience sampling method with elements of snowball sampling, which may limit the generalizability of the results to the broader population of athletes. Additionally, the reliance on self-reported data, without assessing actual product application techniques, SPF, or water resistance, may overestimate the protective effect. Future studies could address these limitations by employing random sampling, including objective skin assessments, and collecting detailed data on product type, SPF, water resistance, application quantity, and reapplication frequency.

The results of the study partially agree with the findings of the work by Szot et al. [20], dedicated to the prevalence of dermatoses among athletes, which recorded that the most typical diseases in this group are infectious lesions – bacterial, fungal, and viral, as well as contact dermatitis. Particular attention in that study was paid to prevention, hygiene strategies and regular examinations, which were considered key factors in controlling the skin health of athletes. Compared to the data of the current study, where dermatological assistance figures only as a source of recommendations in one third of cases (62.9%), insufficient involvement of dermatology specialists is one of the factors contributing to the persistence of a high frequency of skin problems. It is recommended to analyse why athletes do not consult doctors or dermatologists and to propose ways to enhance their role in selecting protective products and preventing skin problems. The integration of educational programs or cooperation between specialists and coaches could be considered.

Another trend highlighted in the study by Ayvaz et al. [21], dedicated to analysing the level of awareness of the necessity of photoprotection among adolescent athletes. The authors found that over 60% of respondents are at the “pre-contemplation” stage, i.e., they do not think about the need for photoprotection at all, even during outdoor activities. In the current study, on the contrary, sunscreen products were found to be the most widespread among athletes (87.3%), which indicates a higher level of awareness or greater availability of relevant information in the older age group. However, high use does not necessarily ensure efficacy if reapplication, SPF, or water resistance are inadequate.

A limitation of the current study is the absence of objective skin condition indicators, such as hydration level measurements, erythema index, or TEWL. Reliance solely on self-reported data may reduce the accuracy of estimating the true severity of dermatological problems. Inclusion of objective assessments in future studies could increase the reliability and practical value of the findings.

The assessment of the dermatological status of highly qualified athletes, the results of which were characterised by a certain degree of atypical nature of the obtained data, deserves close research attention. The study by Liebich et al. [22] showed that the frequency of dermatological problems in professionals is lower, despite the intensity of loads and the duration of the training process. This result, at first glance, contradicts the conclusions of the current study, where even with the widespread use of protective products, a high prevalence of sunburns (64%), abrasions (85%) and calluses (72%) persists. However, a possible reason for this discrepancy is greater access of elite athletes to specialised agents, such as antifungal creams, warming and cooling ointments, and barrier sprays, individual specialist recommendations, and the presence of systematic monitoring of the skin condition by the medical staff of teams. The absence of such conditions for mass-sport athletes or athletes of lower levels may explain the higher morbidity under similar load conditions.

The issue of adequate photoprotection gains particular relevance in the context of a study dedicated to Olympic athletes. The work of Sesi [23] emphasises that even among representatives of this cohort, who a priori have unrestricted access to qualified medical care, photoprotective measures are not always characterised by sufficient efficacy. The author stresses the fundamental importance of a personalised approach to the stratification of dermatological pathology risks and the necessity for active participation of medical professionals in developing individualised photoprotection protocols, taking into account the specific conditions of the training process. The current study extends this view by highlighting that seasonal climatic factors, such as high summer UV exposure or winter dryness, may necessitate adjustments in the type, frequency, and application method of photoprotective, moisturising, barrier, and specialised agents, depending on the sport type.

Gender analysis clearly established that male athletes predominantly demonstrate a reactive approach, applying moisturisers systematically more than twice as rarely (25.9% “always/almost always”) than females (59.0%) (χ² = 38.14; p < 0.001). This indicates that men activate skincare only to address existing problems, not for prevention. The review by Palm et al. [24], dedicated to male skincare, provides a physiological rationale for why this reactive approach is suboptimal. It was established that male skin, while thicker and more sebaceous, is also characterised by higher TEWL. This biological predisposition to dehydration, intensified by rigorous training, means that preventative moisturising is particularly critical for men. Therefore, the identified reactive approach is biologically irrational and can lead to faster impairment of the barrier function, accelerating premature ageing and increasing susceptibility to dermatoses. Seasonal changes in temperature and humidity may exacerbate this issue, as lower winter humidity can increase TEWL, and outdoor summer training can enhance sweat-related dehydration.

Mechanical damage, such as chafing and abrasions, was the most commonly reported problem by 85.0% of all respondents. However, barrier products, which have a direct preventative purpose, rank only fourth in terms of frequency of use (58.3%). This gap indicates a lack of proactive care despite clear clinical evidence for barrier products’ effectiveness. Seasonal adjustments (e.g., friction from winter clothing, summer sweating) should be considered. Management of mild to moderate uncomplicated intertrigo, a form of inflammation caused by friction and maceration in skin folds, requires the use of topical barrier products and specialised agents with anti-inflammatory or antifungal components [25, 26]. The clinical study by Verzì et al. [27] demonstrated the efficacy of a specialised barrier spray containing zinc oxide and restorative components for significantly reducing the severity of intertrigo symptoms in athletes. Thus, the low frequency of barrier product use in the current study (58.3%) contradicts the medical necessity confirmed by clinical trials establishing these products as a primary means of treating inflammatory conditions caused by friction. Seasonal variations, such as increased friction from winter clothing layers or summer sweating, should be considered when developing recommendations for barrier and specialised agent use.

The current study established that, despite the high frequency of sunscreen use among athletes, the problem of sunburns remains widespread. This discrepancy between the fact of photoprotection application and its effectiveness led to the hypothesis of insufficient regularity of reapplication, inadequate SPF level for training conditions, or mechanical washing off of the product by sweat or water. Seasonal monitoring of sunscreen reapplication, especially during peak UV months, could improve outcomes.

The results of the study by De Castro-Maqueda et al. [28], which covered elite athletes in water sports, found that over 80% of respondents neglect sunscreen reapplication, especially during prolonged water training. This aligns with the hypothesis that behavioural factors, rather than the absence of the product, are the primary cause of photoprotection ineffectiveness. Compared with the data from the current study, where sunscreens are used frequently but without efficacy, the study by De Castro-Maqueda et al. emphasises the low quality of application even among well-informed athletes. The reason for such results may be the lack of clear instructions for reapplication or underestimation of sunscreen performance conditions in a wet environment.

The study by Rachmani et al. [29] demonstrated that the type of sunscreen critically influences the duration of its effectiveness in an aquatic environment. In a randomised clinical trial with swimmers, it was found that organic filters have significantly lower water resistance compared to inorganic ones, even with the same SPF-30. This study confirms that the appearance or stated parameters of a product may not correspond to its real conditions of use, which, in turn, explains the high incidence of burns despite nominal product application. Compared to the current study, which analysed only the fact of product use, the work by Rachmani et al. introduces a qualitative differentiation between types of photoprotection, allowing for better interpretation of the causes of ineffectiveness.

The results of the study by Keshavarzi et al. [30] add a technological dimension to the discussion, showing that standard sunscreens lose their effectiveness under intense sweating. The authors experimentally proved that with increased physical exertion and elevated temperature, conventional cream formulations rapidly lose photoprotective properties, which may be associated with the dissolution of active components in sweat or their mechanical removal. This fully correlates with the data from Keshavarzi et al. study, which indicate insufficient efficacy of products under real training conditions. Thus, the work by Keshavarzi et al. confirms that the problem lies not so much in athlete behaviour, but in the functional unsuitability of products for extreme sports conditions, specifically for prolonged outdoor training or under conditions of increased perspiration.

Drewitz et al. [31] conducted a cross-sectional study regarding dermatological problems associated with training activity among student-athletes at two German universities. The study sample included 296 individuals (102 men, 194 women; age 23.0 ±3.1 years), with a weekly volume of physical activity exceeding 150 min per week. It was found that 47.5% of subjects systematically experience irritation, dryness, blisters, and erythema of the skin, leading to a reduction in the frequency and intensity of the training process and negatively affecting physical conditioning. Only about half of the students apply cosmetic or pharmaceutical products, mostly moisturisers and creams. Modification of sports equipment or consultations with medical professionals had a low frequency. Respondents with pronounced dermatological problems (47.5%) demonstrated a greater training volume (7.6 h per week, 95% CI: 6.8–8.3 h), compared to individuals without complaints (5.1 h per week, 95% CI: 5.5–6.7 h; p = 0.003). The subjects indicated a reduction in the intensity (34.7%) and frequency (22.7%) of training sessions due to dermatological problems. Deterioration in athletic performance was observed in 32.0% of participants. Among 46.1% of individuals who used dermatological pharmaceutical products, 76.6% reported positive dynamics of skin manifestations. Additionally, 41.2% of respondents modified their athletic clothing to reduce dermatological complaints. This measure proved effective in 71.4% of cases. Replacement of previously used care products was carried out by 24.5% of participants, which provided improvement in 56.0% of cases. An alternative strategy for alleviating dermatological problems was the replacement of sports equipment in 21.6% of cases, with 45.5% obtaining a positive result regarding skin condition.

In the conducted study, it was found that acne and folliculitis were observed in half of the respondents (50.0%), with no significant differences found between groups of sports types. The prevalence of these problems was consistently high in all three categories (outdoor sports, aquatic, contact strength, indicating their universal nature, conditioned by common factors: increased sweating, use of shared equipment and changing rooms. Islam and Islam [32] in a systematic review emphasise that frequent use of sanitisers, chlorinated water, aggressive cleansers, and typical equipment disrupts the skin microbiome balance, provoking the growth of Staphylococcus aureus, Malassezia, and a reduction in commensals (Staphylococcus epidermidis), which contributes to dermatitis, eczema, acne mechanica, and infections. Dysbiosis correlates with the exacerbation of atopic dermatitis, outbreaks of impetigo, and tinea. The authors propose abandoning excessive hygiene in combination with targeted restoration of the microbial barrier (pH-balanced cleansers, emollients, probiotics), which is not a dominant practice in the current study. The discussion arises around the idea that not only the frequency of product use, but the adequate selection of type and regularity of care considering the microbiome is of critical importance. The reasons for the differences lie in the lack of modern media practices of “microbiome-friendly” hygiene in the sports environment.

In the group of contact and strength sports, the absolutely dominant problem was chafing and abrasions, reported by 99.2% of respondents. This was an expected result, given the specific nature of these disciplines, which involves intensive physical contact with an opponent’s skin, sports equipment, and surfaces. At the same time, the use of barrier agents in this group was insufficient (58.3% overall), creating a gap between the actual need and preventive measures. Martínez et al. [33] conducted a study during an extreme-distance race (101 km) and established that 11 participants received a mean erythema effective dose of 2959.2 ±404.2 J/m² (29.6 SED), which was 29.6 times higher than the recommended maximum dose by the International Commission on Non-Ionizing Radiation Protection (ICNIRP) (1.0–1.3 SED/8 h). A survey of 1145 athletes revealed that 58% had experienced sunburns, 62.9% usually did not use photoprotection, and 67.2% did not perform skin self-examinations. These data are consistent with the results of the current study (64.0% sunburn incidence with 87.3% photoprotection use) and demonstrate a critical gap between awareness and actual practice among extreme athletes. Reasons include underestimation of the risks of prolonged exposure, lack of systematic reapplication protocols, and the psychological factor of prioritising athletic performance over skin health.

In the conducted study, acne and folliculitis were identified in 50.0% of athletes, indicating a significant prevalence of pore occlusion-related issues. Although specific causes of acne in the current study were not demonstrated, general risk factors include excessive sweating, the use of occlusive agents or cosmetics during physical exertion, and insufficient post-exercise hygiene. Yoon et al. [34] experimentally investigated 20 women (mean age: 22.8 years) and found that the application of foundation makeup during treadmill exercise significantly increased skin temperature (+0.5°C) and decreased stratum corneum hydration compared to a no-makeup control group. The authors recommended avoiding makeup during physical exercise to prevent disruption of thermoregulation and barrier function. This partially explains the results of the current study, where acne and folliculitis were a problem for 50.0% of athletes, as the use of cosmetics (especially occlusive formulas) during training can exacerbate pore occlusion due to increased temperature and humidity. Reasons for discrepancies include insufficient awareness among athletes regarding the impact of cosmetics on the skin during physical activity and a lack of clear guidelines on permissible cosmetic practices.

In the current study, it was established that 64.0% of athletes suffered from sunburns, despite the high frequency of photoprotection use (87.3%). The most pronounced problem for outdoor athletes was sunburns (83.9%). However, the study did not assess the athletes’ level of knowledge regarding long-term risks, in particular the development of skin cancer due to chronic UV exposure. Arslan et al. [35] investigated 200 licensed athletes (mean age: 21.4 years) and established that the mean score on the “Skin Cancer and Sun Knowledge Scale” was only 13.34 ±0.22. Athletes who trained indoors had significantly higher knowledge scores (13.85 vs. 12.72; p = 0.018). Dermoscopic examination of 40 athletes revealed melanocytic changes in 92.5%, inflammatory changes in 55%, and non-inflammatory changes in 40%, with no difference between groups. Compared to the current study, where 76.9% of athletes relied on the coach as a source of information, rather than medical professionals (62.9%), this confirms a critical deficit in dermatological education. Reasons include the absence of systematic educational programs in sports institutions, insufficient integration of dermatologists into multidisciplinary sports medicine teams, and the mistaken belief that sunburns are a “normal” part of the training process.

In the conducted study, the coach was the most authoritative source of information regarding skin care products (76.9% of respondents surveyed), exceeding the influence of medical professionals (62.9%). At the same time, 64.0% of athletes suffered from sunburns, despite the high frequency of photoprotection use. This indicates that coaches, who are key figures in shaping athletes’ behavioural practices, may lack sufficient knowledge or may not pay adequate attention to UV-specific prevention. Leer et al. [36] conducted a nationally representative study of 1,200 German coaches of outdoor sports and identified significant deficits in knowledge regarding UV-specific skin cancer prevention. Only a minority of coaches systematically implemented recommended protective measures: avoiding training during peak UV radiation hours, mandatory use of photoprotection, appropriate athletic clothing. This explains the paradox in the current study, where the coach was the most authoritative source of information (76.9%), yet the effectiveness of photoprotection remained low (64.0% sunburn incidence). Reasons include the lack of mandatory training courses for coaches on skin cancer prevention, the prioritisation of athletic results over athletes’ long-term health, and insufficient collaboration between sports organisations and dermatological associations.

In representatives of aquatic sports, dryness and skin peeling were the most characteristic problem (92.9% of complaints) – the highest indicator among all studied groups. This phenomenon is directly related to the constant contact of the skin with chlorinated water. However, specific mechanisms of skin barrier damage and the potential long-term consequences of chronic chlorine exposure were not considered in the current study. O’Connor et al. [37] in a systematic review of studies on the impact of swimming on atopic dermatitis found that water components (hardness, pH, temperature, antiseptics and other chemicals) can affect skin condition. Potential interventions to reduce damage included the application of emollients before and after swimming, the use of specialised swimming equipment (wetsuits, goggles), and mandatory showering immediately after water immersion. The results of the current study showed that 92.9% of swimmers complained of dryness, yet only 81.1% systematically used moisturisers. This indicates insufficient prevention even with an evidence base for effective interventions. Reasons include the absence of specific care protocols for swimmers, insufficient awareness regarding the importance of barrier protection before swimming, and a deficit of time for additional care procedures under the conditions of an intensive training schedule.

Maitra and Talati [38] in a comprehensive review found that chronic exposure to chlorine and its disinfection by-products (DBPs) in swimming pools poses significant risks to skin health. Chlorine reacts with water to form hypochlorous acid, which can react with other substances, forming over 100 different DBPs (including nitrogenous DBPs from contact with sweat, urine, and skin cells). The impact on the skin barrier leads to increased TEWL, decreased hydration, and increased susceptibility to eczema and acne. Compared to the current study, where swimmers demonstrated the highest level of complaints about dryness (92.9%), the review by Maitra and Talati emphasises the necessity of developing new care strategies aimed at neutralising residual chlorine (shower with vitamin C or sodium thiosulfate) and restoring the microbiome (prebiotic emollients). Reasons for the insufficient effectiveness of standard care lie in the absence of targeted agents capable of neutralising DBPs and restoring the skin’s acidic pH after swimming.

Almost one in 5 (19.9%) athletes was dissatisfied with the effectiveness of their skin care system, indicating the inadequacy of self-selected strategies. At the same time, only 62.9% of athletes relied on the recommendations of medical professionals as a source of information, whereas the coach (76.9%) and peers (71.0%) had greater influence. This indicates a critical gap between the need for professional assistance and actual consultation with dermatologists. Pujalte et al. [39] in a comprehensive review of dermatological conditions in athletes emphasised that skin diseases constitute almost half of all training-related medical conditions. The authors stressed the necessity of systematic education of athletes regarding the prevention of infections, mechanical injuries, and photodamage, as well as the importance of integrating dermatologists into sports medicine teams. This is consistent with the results of the current study, where 19.9% of athletes were dissatisfied with care results, indicating the need for professional medical support instead of self-treatment. Reasons for insufficient engagement of dermatologists include limited availability of specialised sports dermatology services, high consultation costs, and the absence of institutionalised dermatological screening programs in sports organisations. Programs aimed at closer cooperation between dermatologists, coaches, and athletes could enhance preventive practices and improve selection of protective products [40–43].

Thus, the conducted analysis confirms that dermatological problems are a common phenomenon among athletes, regardless of sport. Mechanical damage, skin dryness, acne, and sunburn are most frequently reported, while preventive strategies are often fragmented or ineffective. A significant dependence of care level on awareness, type of agents, training conditions, and access to specialised assistance has been identified. The obtained results indicate the need for systematic dermatological support, adapted to the specific nature of the sporting activity, and highlight the importance of educational initiatives and cooperation between coaches, athletes, and dermatology specialists to improve the prevention and management of skin problems.

Conclusions

The conducted study performed a comprehensive analysis of the use of cosmetic and medical skin protection products among 386 athletes of various disciplines under conditions in Ukraine. A pronounced differentiation in the regularity of protective agent application depending on the sport type and respondent gender was established: photoprotective agents (sunscreens) were used by 87.3% of athletes, moisturisers and restorative creams by 81.1%, antiseptic and anti-inflammatory agents by 74.9%, barrier products such as anti-chafing creams and callus prevention ointments by 58.3%, and specialised agents (warming/cooling ointments, antifungal preparations) by 45.1%. However, the high use of photoprotective agents does not guarantee protection: 64% still reported sunburns, highlighting the need to consider SPF level, water/sweat resistance, and reapplication frequency, as well as adequate product type selection for outdoor, aquatic, or contact sports.

Gender analysis revealed a statistically significant trend towards more disciplined use of all product categories among female athletes compared to males. The study confirmed the high prevalence of dermatological problems: 64% of respondents reported sunburn within the last year, 50% suffered from acne and folliculitis. Aquatic sports were associated with a critically high level of skin dryness (92.9% of complaints), outdoor sports with the highest frequency of sunburn (83.9%), and contact sports with an increase in mechanical skin damage and risk of infections, highlighting the relevance of barrier and specialised agents.

Key factors influencing decision-making regarding the choice of protective agents were determined: the greatest influence was exerted by the coach – 76.9%, peers – 71.0%, with medical professionals only at 62.9%, indicating insufficient integration of dermatologists into the sports medicine system. High photoprotection use alongside high sunburn incidence underscores that correct application, SPF selection, and reapplication practices are critical for efficacy.

A limitation of the study is the use of convenience sampling and voluntary self-selection, which may reduce the generalisability of the results to the broader athlete population. Additionally, the study relied solely on self-reported data without objective measurements of skin condition (hydration, erythema index, TEWL), which may have affected the accuracy of reported prevalence and severity of dermatological issues. Future research incorporating both subjective reports and objective skin assessments, as well as detailed data on the type of products used and their connection with specific dermatological problems, would enhance data reliability and the practical applicability of findings.

The development of differentiated protocols for dermatological support of athletes, taking into account the specific risks of each sport, is recommended, along with the creation of educational programs for coaches and sports physicians regarding the early detection of dermatological problems and the implementation of preventive measures, especially in the context of preventing skin oncological diseases, as well as strengthening the role of dermatologists as primary consultants. A limitation of the study is the use of convenience sampling and its focus solely on the Kyiv athletic community. Prospective directions for further research include conducting longitudinal observations to assess the long-term consequences of various skin protection strategies and the development of innovative or specialised products adapted to the needs of athletes depending on the sport type and dermatological risk.