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heat to the surrounding cooler air. Red faces during exercise are more common in women and more obvious in fair skinned people.

Q I have a very red face. I thought it was just from being out in all weathers but someone said I might have rosacea. Could running have caused it?

A Rosacea is a very common skin condition, but we still don’t fully understand it. It affects the face and is characterised by a redness of the skin. This can come and go, but it can also stay for long periods of time or even become permanent. There may be spots, dry skin, skin thickening and broken blood vessels. It usually affects people between the ages of 40 and 60, and it can be pretty miserable for those who have it because of the way it can look. There’s no cure and there are many theories as to what the cause is, including genetics, abnormalities of the blood vessels and a reaction to skin mites. Hope is not lost, though, because there do seem to be certain things which set it off, including some which are particularly relevant to runners. Strenuous exercise, strong winds, and hot and cold weather, for example, can all potentially activate rosacea, as can sun exposure and hot baths. Others on the list are stress, spicy foods, alcohol, caffeine and dairy products. If you suffer from rosacea, over time you’ll probably work out what your triggers are and can avoid them where possible. Runners can shade their face from the sun with a cap or visor and wear sunscreen. In cold or windy weather a light scarf and hat might be useful. Avoiding perfumed products and looking for dietary causes can be beneficial too.

Treatment focuses on avoiding triggers, using creams to minimise redness and tablet antibiotics to reduce inflammation. If these don’t help, then referral to a dermatologist is needed to explore other treatment options.

Did you know?

Sweat doesn’t actually smell. It’s effectively 99 per cent water with a bit of salt. The odour develops when the bacteria that live on your skin start to break the sweat down.

Q I seem to sweat much more than other runners I know. Why is this and what can I do about it?

A It’s estimated that while running an endurance event in the heat, you can lose up to 10 litres of sweat in a day. How much we sweat depends on how many sweat glands we have in our skin. The average is thought to be around 3 million, but it could be as many as 5 million! The number is largely determined by our genetics – we’re all made differently. There are two types of sweat gland: eccrine and apocrine. Eccrine glands are found in the dermis of the skin (see here) and empty their watery, salty sweat onto the skin surface. Apocrine glands are associated with hair follicles and discharge their thicker, oilier sweat into the hair follicles once puberty has commenced. This is the type of sweat you’ll find in hairy areas such as your armpits or groin and this produces body odour when it meets skin bacteria.

Sweating is one of the body’s ways of controlling our temperature. Heat is lost when sweat evaporates from the skin surface. It’s not something we can influence, because it’s controlled by the central nervous system. When you run, your body temperature increases significantly and sweating is an essential mechanism for lowering it. As you get fitter, you may find you sweat more, as your body is simply getting more efficient at thermoregulation. So potentially you could be proud of your sweating! But understandably it can be inconvenient and even embarrassing. Appropriate sportswear and good hygiene with frequent washing are obviously important. You may have tried a range of antiperspirants, but do have a chat with your pharmacist, because there are some more heavy duty ones available over the counter.

Excessive sweating when your body isn’t overheating is called hyperhidrosis. This can happen all over the body or just in certain areas, such as the armpits or palms of the hands. Treatments include antiperspirants, medications, botox injections and even surgery to remove sweat glands.

Top tips for a healthy runner’s skin

• Shower soon after running.

• Don’t leave skin damp. Dry thoroughly, especially between the toes.

• Use a barrier cream to protect sore skin or problem areas while running.

• Experiment with fabrics to find which suits you best.

• Wash running kit, including socks, after one use.

• Consider alternating between two pairs of running shoes.

• Use a sunscreen with an SPF of at least 15 to protect skin from UV rays.

• Check moles regularly and report changes or new skin lesions to your GP.

• Eat a diet that includes a variety of fruit and vegetables to provide the nutrients needed for healthy skin. Top foods include avocados, nuts, seeds and fish.

• Drink plenty of water daily.

FURTHER HELP AND ADVICE

Cancer Research UK: www.cancerresearchuk.org

Melanoma UK: www.melanomauk.org.uk

British Skin Foundation: www.britishskinfoundation.org.uk

National Eczema Society: www.eczema.org

Allergy UK: www.allergyuk.org

DermNet NZ: www.dermnetnz.org

Hyperhidrosis UK: www.hyperhidrosisuk.org

Chapter 9

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Self-Care

Being a runner and keeping well is often a fine balancing act. While we know that running makes us healthy, it can sometimes directly cause injury and illness. Trial and error, along with understanding our own bodies and a good dollop of luck, are all important in helping find the right balance for us. This chapter explores the things in everyday life that can make a difference and ensure we run well.

Our bodies aim for homeostasis, where everything is running smoothly, in equilibrium and perfect balance. So your body is continually monitoring what is going on and using multiple mechanisms to make both small and large adjustments to maintain the steady environment of homeostasis. From our thermoregulatory system, which aims to keep our core temperature constant, to our hormonal systems influencing our energy and metabolism, we are one finely tuned machine! These processes are happening day in, day out, without us being aware of them.

Sometimes the equilibrium is upset and

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