First off, saddle soreness and saddle sores are two completely different things.
Saddle soreness is normally caused by not having built up enough “defenses” to the highly focused pressure normally felt in the sit-bones area (in other words, you haven’t broken your body in yet) and/or muscle/soft tissue damage from long hours in an ill-fitting saddle.
A saddle sore is a skin irritation in an area that comes into contact with the bicycle saddle, usually caused by chafing, inflammation or infection. A saddle sore is one of the most common and most painful things you will ever experience on a bicycle.
A saddle sore develops in 3 stages
(1) skin abrasion mainly caused by chafing
(2) folliculitis – an infection at the base of a hair follicle, which appears as small, reddish-looking acne, sometimes having a white “head.” Folliculitis occurs when the hair follicle gets damaged. In cycling, this is usually caused by:
- rubbing of clothing – to solve this, get a top quality pair of bibs. More on this below.
- blockage of the hair follicles – be careful what chamois creams or anti-chafing creams you use. More info below.
- shaving – yes, shaving is very irritating to the skin. Since many cyclists shave their legs, shaving too high up the back of the leg (an area that comes in contact with the saddle) makes that area susceptible to saddle sores. So be careful where you shave.
(3) full blown abscess – this is now an infection, i.e., pus deep within the infected hair follicle(s). Sometimes an abscess is caused by sitting on and irritating an ingrown hair.
Prevention of Saddle Sores
Preventing a saddle sore is as easy as giving up cycling. Of course, that’s not an option for us roadies. So you need to keep your skin (a) clean, (b) free of bacteria and (c) free of abrasion or chafing by using a chamois cream. It’s also important to ensure that the hair follicles do not get plugged up, so use a non-clogging chamois cream that will help prevent bacteria and fungus.
Chamois creams that use petrolatum or anything else that can block the hair follicle or skin pores should be avoided. Some riders make their own chamois creams using coconut oil, anti-fungal cream, anti-bacterial cream, tea tree oil, etc. And others who are sensitive to saddle sores use Noxzema or even hemorrhoid cream.
Another preventive measure is to invest in top-quality bib shorts with a top-tier anti-microbial chamois. Most importantly, you are looking for a chamois that has 4-way stretch/3D anatomic, is antimicrobial, moisture-wicking, multi-density and multi-thickness. This is one area of clothing not to skimp on!
Several cyclists wrote in stating that they keep a bottle of hydrogen peroxide and douse their bottoms liberally before as well as after a ride. After a ride, they douse then dry-off immediately. In other words, get out of those damp, bacteria filled cycling shorts as soon as you can.
As a coach, I also recommend changing position on the saddle every so often. Sit, then stand for a minute, then sit, etc. You can also adjust your position on the saddle when seated to shift fore or aft just a bit, which shifts the pressure points on your body.
Treatment of Saddle Sores
Once you get a saddle sore, start treatment immediately. If caught early enough, it can prevent an incipient saddle sore from progressing to folliculitis or a full-blown abscess.
Several studies suggest that Staphylococcus, which lives on the human skin, is what actually infects the (damaged) hair follicles.
If you have a developing saddle sore, an easy treatment can be to just take a day or two off the bike, allowing your skin to heal. Take care of the skin using a doctor-recommended treatment, which will probably be some sort of cream. Some cyclists have reported success using a multi-antibiotic cream + pain reliever. Nearly every drug store, grocery store or big box retailer sells their own brand, so they’re readily available.
Several other cyclists I surveyed say they take a cool bath with Epsom salts then dry off immediately. They use a topical cream or ointment and let the skin breath as much as possible – i.e., no underwear during the day and sleeping in the buff at night.
If you still need to ride, try using a different saddle that changes where the contact points are. For example, if your Fizik saddle has given you a saddle sore, try riding with a ISM Adamo or Cobb saddle for a few days. Another old trick is to buy corn pads (little circular foam pads) and place those around the saddle sore to ameliorate direct pressure.
If you get a saddle sore every once in a while, try one or more of the above recommendations. If you get recurring saddle sores, it may be best to see your doctor and, at the least, get a better grade of chamois in the highest quality bib shorts you can afford.
If your saddle sore gets infected, see your doctor immediately.
You might also want to look into a professional bike fit that will ultimately place you in the right position on the bicycle, and especially on the saddle.
If you have other prevention or treatment tips, please share them in the comments below.