Nothing is much worse than peeling off your wetsuit only to discover that you have developed a mysterious rash. We as humans are designed to live our lives above the surface, with only brief immersions in water. Yet, as divers, our zeal for adventure and our love of aquatic environments brings us into an environment that can be irritating or even hostile to our bodies. Let’s take a look at some common dive related dermatology problems, plus some tactics for preventing and treating them.
Allergic Contact Dermatitis
One of the worst forms of dermatitis, Allergic Contact Dermatitis can be severe and can come from a variety of sources. If you have ever gotten a rash from poison oak or poison ivy, then you know how bad the symptoms can be. They include puffy, hot red skin, weeping blisters, and severe itching and burning. Some people find that they are allergic to wetsuit neoprene, which can cause it, and if you come into contact with hydroids, you are likely to suffer from contact dermatitis. Often, treatment includes injectable or topical steroids, like prednisone.
Fungal Infections
Humid, moist conditions like those that exist inside a wetsuit can cause fungal infections to flare up, especially if you are already prone to athlete’s foot or jock itch. Also known as Tinea Cruris, Tinea Corporis, and Tinea Pedis, these fungal conditions can be avoided by getting dried off as soon as possible, showering frequently, and using topical antifungal powders and creams. If symptoms, which include itching, burning, and scaly red skin persist, then you will need to seek medical attention. Your doctor can prescribe an oral antifungal treatment. Be sure to keep your wetsuit and other equipment clean to help prevent future problems.
Eczemas: Xerotic Eczema, Neurodermatitis, and Atopic Dermatitis
All three of these common eczema types are caused by repeated immersion, followed by drying without moisturizing. The most common symptom is dry, flaking, and very itchy skin, although tropical climates can worsen symptoms leading to red, rashy areas with red bumps. In order to prevent this from happening, be sure to keep your skin moisturized and use only very mild soaps. If problems persist, you may need to see your doctor for topical steroid cream, or even for oral or injectable steroid treatments. Prevention is the key here – sun and salt rob your skin of its surface oils, leading to problems that can happen quickly.
Candidiasis
Also known as Monilia or yeast infection, Candidiasis is a fungal infection that can show up in places that are moist and dark. Although candida, or yeast, are present on and inside our bodies, warm, moist conditions let the organisms grow out of control. If you end up with Candidiasis, which shows up as itchy, red, hot patches, you will need to seek treatment. To prevent it, practice good hygiene, use topical antifungals, and be sure to dry yourself thoroughly after diving.
Coral Dermatitis
Another reason to use good buoyancy control and never touch coral, Coral Dermatitis is caused by even a slight brush up against coral, particularly fire coral, which releases toxic nematocytes. A coral sting can be felt immediately, although sometimes, nematocysts must work their way through a wetsuit to eventually come into contact with your skin. Weeping, reddening, and chronic swelling and inflammation needs to be treated immediately, as delayed treatment can lead to the nematocysts burrowing even deeper beneath the skin and causing worse problems. If you’ve come into contact with coral and problems don’t seem to be abating after 24 to 36 hours, get back to the doctor for further treatment.
Miliaria or Prickly Heat
Caused by constant hot and humid conditions combined with blocked sweat glands, this rash looks almost like built up beads of perspiration, which are in fact tiny blisters beneath the skin. Normally, this condition goes away on its own once you cool off and remove your wetsuit, but when it is combined with other dermatology problems, it can become worse. This is not only uncomfortable, with its pins and needles sensation and its itching, it can also lead to heat exhaustion if large areas are affected and treatment is not provided. In some cases where prickly heat is ignored, it can worsen, sometimes leading to deep rashes and actually damaging your body’s sweat glands. Prevent it by exfoliating regularly, practicing good hygiene, and preventing any kind of chafing.
Sea Bathers Eruption
This is caused by thimble jellyfish larvae, which emit a poison that is similar to the toxin hydroid stings contain. Often, sea bather’s eruption occurs in warm tropical waters, typically in the Caribbean area. Common in areas around Florida and Cozumel as well, these minuscule larvae can get inside your wetsuit and sting you repeatedly, causing a nasty rash. After removing your wetsuit, spritz yourself with vinegar or rubbing alcohol, and wait a short time to shower, since rewetting the area with water can cause the nematocysts to reactivate. Don’t be surprised if you need to see a doctor for treatment; this condition can be severe. Be sure to wash your wetsuit thoroughly after an encounter with thimble jellyfish larvae, since they can accumulate and be reactivated even after drying.
Swimmer’s Itch
Properly known as Cercarial Dermatitis or Schistosomiasis, and caused by Microbilharzia Variglandis or Schistosoma parasites, which are carried by aquatic birds and snails, Swimmer’s itch is associated with freshwater diving in most cases. These creatures are a form of parasitic worm that can burrow into your skin, causing a nasty rash with huge red spots at first. If not treated immediately, the parasites associated with swimmers itch burrow further into your flesh, eventually making their way to your lungs and liver, where they mature fully. After developing into adults, the parasites can migrate into any of your major organs, normally following major arteries and blood vessels. Not normally associated with bodies of water in the United States, these parasites are commonly found in bodies of fresh water located in tropical climates and in developing nations. If you suspect contact with Schistosoma, get to the doctor for treatment immediately.
Creeping Eruption
Caused by the larvae of hookworms that are commonly found in dog and cat feces or traces of those feces, Creeping Eruption shows up as blisters and itching, along with raised, almost snake-like tracks on your skin that can spread up to about 1 centimeter per day. It is endemic in certain parts of Florida and in other tropical areas, and if you end up with an infection, you will need to see a doctor immediately for treatment. Prevention is simple – wear sandals in areas where animals have been, particularly in areas where people do not treat their animals for parasites on a regular basis.
These dermatology problems can happen to anyone, particularly if you are diving in warm, tropical waters. Understanding the risks involved with diving in certain areas can help you to take preventative steps to reduce the likelihood of problems. By doing this and practicing good hygiene, you can usually keep problems from getting out of control and ruining a perfectly good vacation.