Skin Problems and Water Sports

There are some skin problems that are specific to water sports, whether in fresh or saltwater, at home, or on vacation. Dry skin, for instance, is worse for most people in winter when the air is dry and cold, but it is actually also common among swimming pool users as well. The natural layer of protective sebum gets diluted and melts off the skin, resulting in dry, scaly, and itchy skin. As with winter itch, long hot showers can make the problem worse, as can soaking in a Jacuzzi or hot tub. If you swim a lot in a pool, and shower soon afterward it’s best to use your own moisturizing cleanser and avoid the possibly drying cleanser provided in the shower room. Apply a moisturizer immediately. If you still have eczema, you may need a prescription topical steroid cream.

Some other common skin problems associated with water exposure are:

Bikini Bottom

This is a type of bacterial folliculitis that happens after a full day of wearing a damp, close-fitting bathing suit (or hot-yoga pants!). The follicles affected show firm, inflamed deep nodules over the bottom part of the buttocks. It needs to be treated with antibiotics. Frequent warm soaks of the affected areas can also speed recovery.

Hot Tub Folliculitis

This is caused by different bacteria specific to hot tubs and whirlpools. The parts of the body that were underwater developed red papules and pustules. Anti-itch medicines are generally prescribed, but vinegar compresses for 20 minutes twice a day can also help with the symptoms. If you have a fever, chills, or swollen glands, Ciprofloxacin antibiotic may be needed.

Jellyfish Stings

Jellyfish stings are not uncommon in saltwater swimmers. There are more than 100 kinds of toxic jellyfish. Sting symptoms can range from mild burning and itching to death. The most common reaction is immediate stinging, followed by hive-like lesions in lines like whip marks. The areas should be immediately rinsed with seawater. For box jellyfish stings, dressings soaked in vinegar and applied for 20 minutes twice a day are often helpful. Tentacles should be removed with tweezers and a topical steroid can reduce inflammation. If you know you swim where there are jellyfish, a meat tenderizer that contains proteolytic enzymes can be helpful in neutralizing toxins when applied promptly after being stung.

Sea Bather’s Eruption

Sea bather’s eruption affects salt-water swimmers. It is due to the larva of the Thimble jellyfish. Swimmers feel a stinging sensation and in about 24 hours there is an intensely itchy rash on areas covered by a bathing suit, where larvae have become trapped. It can last for 3-7 days or up to 6 weeks. Treatment includes the application of cool compresses, antihistamine pills, and a topical steroid. Showering with the bathing suit off immediately after coming out of the water can get rid of the larva trapped under the bathing suit and prevent it from happening.

Swimmers Itch

This is easily confused with Seabather’s Eruption, but it occurs in areas not covered by a bathing suit and in fresh, not salt, water. It is an allergic reaction to the schistosome (flatworm) larva and results in an itchy, transient eruption. It resolves itself in a few days but symptoms can be treated with cold packs and oral antihistamines. A topical corticosteroid can help with extensive lesions.

By Melissa Raue, PA-C

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