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Clydesdales/Athenas (200+ lb / 91+ kg) Looking to lose that spare tire? Ideal weight 200+? Frustrated being a large cyclist in a sport geared for the ultra-light? Learn about the bikes and parts that can take the abuse of a heavier cyclist, how to keep your body going while losing the weight, and get support from others who've been successful.

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Old 04-12-10, 09:52 AM   #1
gattm99
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Advice with a sensitive issue

OK here is the deal. Since I started riding more frequently in 2004 I have gotten a painful lump right under the skin of my scrotum. It usually shows up in May and hangs around until January. I think it is some kind of cyst. Its fine on shorter rides but as soon as I get up to 40-50 miles it starts hurting and will be swollen and sore for the next several days.

I've gone to 3 different doctors. The first prescribed me an antibiotic and sent me for a ultrasound test which he told me the results were that it was nothing.

A couple years later the second doctor said it was a cyst and sent me to a urologist, after 5 minutes he told me it was a in grown hair and to ignore it.

I've told all these doctors it keeps coming back in the exact same place and that I ride a bike. They all basically tell me to quit riding a bike or to clean my nuts better. I'm like, I've got clean nuts, but they don't listen.

I think I'm going to go to another doctor and try to get it fixed, any advise on what to say.
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Old 04-12-10, 10:19 AM   #2
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I've had cyst issues before. Ever since I started wiping down the area with baby wipes after _every_ ride have they stopped bothering me.
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Old 04-12-10, 10:24 AM   #3
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I've had a similar sounding issue, but different location. Mine was on the inner thigh, up where it contacts the side of the saddle when riding.
I've been doing long rides (200+ miles) for the past 2 years and not had any issues like this, so I went and took stock of what had changed. Turns out that when I switched chamois cremes, it was blocking a pore. Sweat, etc. over the course of a 16 hour day in the saddle and that bugger turned into a sebaceous cyst.

Sebaceous cysts, if uninfected, are just a sac of keratinized oils and skin cells which cannot be released to the surface of the pore. One way to attempt getting rid of them is to treat the area with a heating pad for 10 - 15 minutes twice daily, allowing the oils to liquify and be re-absorbed by the body over the course of 10 - 14 days. That, in conjunction with switching back to a lesser viscous chamois creme, was the solution for me.
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Old 04-12-10, 10:46 AM   #4
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At least three doctors with no clues at all. Wow.
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Old 04-12-10, 11:09 AM   #5
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At least three doctors with no clues at all. Wow.
you sound surprised
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Old 04-12-10, 11:24 AM   #6
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Actually, it was a bit of sarcasm on the side of the OP. My wife is a Pharm. D. so I hear horror stories a lot.

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Old 04-12-10, 01:58 PM   #7
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Sounds like a saddle sore. However, the duration does seem rather long for one.

See if any of this helps:
  • Make sure you're cleaning really well.
  • Don't "hang out" in your riding shorts following rides.
  • Use a chamois creme with anti-bacterial ingredients.
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Old 04-12-10, 02:00 PM   #8
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Chamois cream: I've been using it for years. I think I used it before I started getting this painful lump, but maybe that is causing the problem. The thing is, why would it always be in the same place. I very occasionally get saddle sores and similar painful bumps, but they are in different places and go away after awhile. This is always in the same place.

I really don't want to go to another doctor. The urologist had me so mad I wanted to hit him. He actually kind of laughed, never a good sign when someone is checking out your equipment, and said, "Whats the problem" I explained it and he did a hernia check, then told me I should quit riding until it goes away. I explain that I did and it came back in the exact same place. "Well maybe you should quit riding," I'm thinking maybe you should do your job, but I politely ask about treatment options, and he cracks a smile, "nah, its just an ingrown hair, it'll go away on its own."

The first 2 doctors tried to give me saddle advise, they're like, you could get one of those bike seats with a hole in it. I explain I've tried about 20 different bike seats I have the same problem regardless of saddle.

This is off the subject, but I think if doctors didn't get automatically paid for nothing healthcare would be better.
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Old 04-12-10, 02:06 PM   #9
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Sounds like a saddle sore. However, the duration does seem rather long for one.

See if any of this helps:
  • Make sure you're cleaning really well.
  • Don't "hang out" in your riding shorts following rides.
  • Use a chamois creme with anti-bacterial ingredients.
Thanks for the advise, but I've had saddle sores before, and I don't think this is one, and I've been doing all that stuff for years.
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Old 04-12-10, 02:11 PM   #10
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Thanks for the advise, but I've had saddle sores before, and I don't think this is one, and I've been doing all that stuff for years.
Yeah, figures it wouldn't be something easy... The way you described it sounded just like the ones i get every so often.

To get it taken care of, keep going to Dr's until you find one who will take you seriously.

CyclingNews' used to have a health advisory panel with experts in all sorts of areas. (I can't seem to find it on their website, now.) They might not be able to nail it down, but might give you some ideas.
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Old 04-12-10, 02:12 PM   #11
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Some cysts don't fully "go away". They recede to the point that they're not noticed, but when you re-aggrivate the area they will inflame again. This is (probably) why it's the exact same spot each time.

The two things I did when I started developing my issues earlier this year were to switch back to my old chamois creme, and to start using talc when I finished up in the shower. Since it was a 2-variable change, I can't state which one actually was the reason for things clearing up and staying cleared up, but I've kept up with my routine of Assos creme on long rides, and Gold Bond powder (in the blue bottle) after my shower. Both are mentholated, so they take a bit of getting used to. Just a warning.
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Old 04-12-10, 02:50 PM   #12
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You might want to see a dermatologist, rather than a urologist. If it is an ingrown hair or a cyst in the skin, they should be able to remove it. Regardless of location, sounds like a skin problem.
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Old 04-13-10, 08:42 AM   #13
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You might want to see a dermatologist, rather than a urologist. If it is an ingrown hair or a cyst in the skin, they should be able to remove it. Regardless of location, sounds like a skin problem.
Absolutely agree.

They prescribed me with minocycline and it seems to have helped the issue when I would get it.
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Old 04-13-10, 12:57 PM   #14
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Two words for you my friend, BABY POWDER. Apply liberally after ride and/ or shower and throughout the day when possible. Keeps things dry (very important) and cures most of what will ail you from wearing sweaty lycra for hours on end.
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Old 04-13-10, 02:12 PM   #15
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Two words for you my friend, BABY POWDER. Apply liberally after ride and/ or shower and throughout the day when possible. Keeps things dry (very important) and cures most of what will ail you from wearing sweaty lycra for hours on end.
OK, I'll try that, again I want to emphasize whats going on here. Its not the surface of the skin that is the problem, the lump is under the skin, there is very little evidence of a problem on the surface other then a noticeable lump.

Just as a side note, I've been doing well on eating and activity. I've been in the gym since October and have already put over 500 miles on my bike. My weight is 262, last year at this time it was about 15 pounds higher. I can feel the difference this year, I've got more spring in my step and on the climbs. In the last group ride I did, I dropped back from the leader a few times just to see how much distance I could make up. Riding has been more fun so far this year then ever, but then this lump shows up and now I can't stand to sit on the saddle after 35 miles. Same thing as last year, except last year it happened in late May.

Anyway thanks for all the advise, the dermatologist is going to be my next step.
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Old 04-13-10, 11:09 PM   #16
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That's what minocycline is for. It's pretty much a powerful acne medication (which is what cysts are, pretty much). Plus, it has "cycl[e]" in it.
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Old 04-23-10, 09:09 PM   #17
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I just want to update my situation and discuss saddles. Thank you very much for reading and offering input.

First off I didn't ride last Saturday, I went to St. Louis Zoo and art museum and spent the whole day walking. I felt some soreness and found some new bumps had appeared but they were very small. This was strange becuase last year I pretty much just had one bump all season that never healed up.

Sunday I did a 42 mile ride with my Mom Dad and Uncle, we went pretty hard and kept a 15.7 average on a mildly hilly ride, in which I spent lots of itme in the drops and hoods. I decided to completely forego any kind of chaomois cream as an experiment and at the end of the ride the new bumps were bigger and sore.

I did a short 15 mile ride in the middle of the week and my bumps have bothered me all week while walking, though they seem to be starting to shrink.

I have had the issue on my mind and spent too much time reading and thinking. First off I've decided I really just have saddle sores, I always thought saddle sores were more of a chafing issue but I've learned that there are different kinds, and mine are more of a boil issue.

I have also been honest with myself about my saddle. A little background, I started riding when I was a kid, and did lots of long rides with an older guy who really took me under my wing. Saddle comfort was always a huge problem for me but I never had any kind of issues with bumps or any saddle sores, just general uncomfortableness. I did most of my riding on an old Vetta that was a very basic shaped saddle. Once my friend gave me a B17 to try for awhile, actually he hoped my larger weight would get it broke in faster. I thought it was really comfortable and loved it but eventually he wanted it back.

I really cut back riding in my later high school/college years and didn't take it back up until about 2003, and around that time I bought my very own B17. I found just as before I could ride the B17 all day without any discomfort. My memory isn't too great but I know that in 2005 I was riding many more miles and did my first weeklong tour. I remember on this tour having a big problem with the saddle sores but I don't think they were all together new, I'd just never rode a century then had to get back on my bike the next day. I talked to one of the shop guys on the ride and even asked him about buying a different saddle. He told me the B17 was the best saddle I could have and I needed to, keep clean, adjust it and use chamois cream. Kind of helped but didn't fix the problem.

I bought a new bike later year and rode for a short time with the saddle that it came with, a Selle Italia Trans AM with a big cutout. I eventually decided I didn't like that saddle and went with a Specialized BG2. I was leaving the B17 on my old steel bike. I had reoccuring saddle sore bumps in 2006, 2007, 2008 during which time the only two saddles I used were my original B17 and the Specialized. In Feb 2009 I bought a new B17, I'd conviced myself something was wrong with my old one and it was causing the saddle sores. Guess what, I got saddle sores, and they were pretty bad on the weeklong tour I did in 2009 causing the last few days to be very uncomfortable.

Around July 2009 I bought the B17 Imperial thinking it would help with the bumps. It made it maybe a bit better. This year right after the first 50 mile ride I did in March I got a bump, and you know the story up to now.

I decided Monday this week to go in a totally different direction, I bought the plainest, least gimmicky saddlle I could think of, a San Marco Rolls. It showed up today and I did a short ride after work. Felt like every bit of my weight was on the sitbones, but I couldn't feel my saddle sores at all. I started thinking, both the B17 and the Specialized BG2 stretch. The BG2 has elastomers under the sit bones that you sink into, and the B17 is a giant stretchable hammock. What if my weight is causing me to sink too far into those saddles and create too much pressue/rubbing in places where there shouldn't be pressure?

I'm hoping to be able to get a ride in this weekend and know more.

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Old 04-24-10, 06:04 AM   #18
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You might just need a narrower saddle in general. I've found the B17, for me at lease, only works in quite an upright position.
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Old 04-24-10, 09:32 AM   #19
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Was the area actively swollen when you saw the doctor? I mean, to the point of being palpable?
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Old 04-24-10, 09:45 AM   #20
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A dermatologist might be more help to you if it comes back. They specialize in skin complaints so ingrown hairs and such are right in their line of work.
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Old 04-24-10, 01:04 PM   #21
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Make sure you go in when things are inflamed, so that the doctor can see and evaluate exactly what you are talking about.
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Old 04-24-10, 03:32 PM   #22
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It was inflamed when I went, but not as much as it was when I called.

I tried to make an appointment with a dermatologist on Monday last week, the first one I called didn't have an opening until July, the other one didn't have an opening until June. Decided to try a different saddle.

Did a 20 mile ride today between rainstorms, seems like the new San Marco Rolls saddle may be the answer. During the ride I didn't feel like I was sitting on the bumps, and at the end they weren't inflamed and sore. Keeping my fingers crossed and going to try more miles tommorow.
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