DAN MEDICAL
SKIN DEEP
Skin Conditions and Disorders By Dr Peter B Bennett and Dr Frans J Cronjé
The skin covers 1.8 m2 of our body surface. It is exposed to the elements and is the organ most vulnerable to wounding. It is one of the most important barriers to infection and, with the exception of several openings, it is the only part of us that is accessible for direct visual scrutiny. Loss of integrity of this barrier makes us vulnerable to dehydration and infection. Diving may affect the skin in direct and indirect ways: exposure to moisture and sunlight has consequences. In this article we review three common conditions – athlete’s foot, rashes and skin cancer.
ATHLETE’S FOOT Due to the nature of diving, wet skin is part of scuba diving, but it can aggravate many skin disorders. Athlete’s foot is a fungal infection due to a fungal organism called tinea pedis. The condition results in an itchy skin with burning, peeling, cracking and a red discolouration. It is especially prevalent between the toes and the bottom of the feet. It usually starts between the fourth and fifth toes. Some individuals are more susceptible than others and recurrences may occur after treatment. From a diver’s viewpoint, it may be contagious and treatment should be sought before diving. Treatment, at first, can be administered with over-the-counter anti-fungal creams. The feet need to be kept dry after diving or swimming, especially between the toes. The use of talcum powder and cotton socks may be helpful. It may also be a good idea to help prevent many dermatological diseases by wearing sandals in public showers and pools. Diving booties should not be shared and should be kept as dry as possible. If the condition does not heal after two weeks and blisters form or the infection is spreading and there are signs of a bacterial infection with pain, pus and fever, then you should consult a physician as antibiotics may be required. Scuba divers are not prevented from diving because of athlete’s foot but should take additional care due to the wet environment.
RASHES There are many kinds of rashes and only those likely to be affected in some way by diving are considered here. Due to exposure to moisture from salt or fresh water, sometimes in humid environments, any acute or chronic dermatitis may be exacerbated, including bacterial skin infections like acne. Allergic reactions may also be induced from wetsuits due to the glues and neoprene. Atopic dermatitis is a type of eczema that presents with intense itching and a red raised rash and sometimes fluid-filled blisters, particularly on the hands, neck, face and legs. Common in babies and children, and sometimes called eczema, it can go on in some individuals into adulthood. The condition often occurs in families and may have a genetic link. It can be triggered 26
ALERTDiver
Autumn 2010
