How Do You Recognise Skin Bends?

[jtkyla]

Hi! New here, certified Open Water (completed yesterday!!) and I have a couple of questions on skin bends, as they seem to be a lot more common than we think...
How long after surfacing can they appear?
Can they be confused with mosquito bites?
Do they itch or hurt or both?
If symptoms disappear fairly quickly, how can you make sure it wasn't a skin bend before your next dive?
Should being in the sun affect it?

Thanks a lot!!

 

[bl6394]

Cutaneous DCS would probably not be mistaken for a mosquito bites - unless you were terribly allergic to mosquitoes. Itching and pain are common.

Skin bends would be one of the mildest forms of DCS one can experience - and would be a warning that continuing with such dive profiles may provoke more serious (type 2) DCS hits.

Dan has an article on this here: Divers Alert Network, Cutaneous DCS with Transient Neurological Symptoms after a Hot Shower

On that note - I would suggest you call DAN for any of your medical questions. They are an awesome resource - and it will cost you nothing.

DAN's contact information - including their number for non-emergency medical questions is here: Join or Renew DAN Scuba Diving Membership, Contact DAN — DAN | Divers Alert Network

Dive safe,

 

[lerpy]

Look for rash or bumps. Personally when I saw it start to develop on a guy it looked like a red rash or a sunburn starting to spread across him. It started on his back from what I can recall. It turned out it progressed to beyond just a case of skin DCS, he became quite ill, aching and disoriented, but the rash was the first sign something was wrong.

 

[chillyinCanada]

It looks like mottling, similar in appearance to some bruises. Your skin may itch all over and deep tissue pain will set in.

 

[Jax]

If the markings / symptoms disappear quickly before your next dive, and you haven't been on Oxygen for it to disappear like that, you probably do not have skin bends.
Suit squeeze, maybe.

 

[dmaziuk]

If the markings / symptoms disappear quickly before your next dive, and you haven't been on Oxygen for it to disappear like that, you probably do not have skin bends.
Suit squeeze, maybe.

If diving in a shorty/swimsuit: also sunburn and stinging critters.

 

[chillyinCanada]

If you don't have deep intense tissue pain it's probably not skin bends.

 

[uncfnp]

The is so much info on this, SB and dive medicine internet based. I will try and link a few and will write more of what I know if I have time but basically there are two catagories of "skin bends." One is a fairly benign mild reaction that typically resolves without intervention. Traditionally considered a DCS I. Then there is the more serious version called cutaneous marmorata. This is the rash that is of concern because it can herald a more serious DCS neurological hit, brain and/or spinal cord. This is the rash associated with a PFO. It is the rash that chillyinCanada is describing.

Ask DAN: Skin Bends

Alert Diver | Skin Bends

Divers Alert Network, Cutaneous DCS with Transient Neurological Symptoms after a Hot Shower

Then there is the closely related lymphatic DCS that a SB regular recently experienced.

Dcs & Then Some

 

[Crowley]

I've seen it a couple of times in divers (not myself), but I've had to deal with it and can say the following from my experience, and in response to your questions.

- it looks like a skin rash, but is not as bright in colour. It's not on the surface of the skin and as consequence is darker in colour than an allergic reaction. In both cases, it was spread over the upper torso and if I had to give a location for the cases I witnessed it would be "below the nipples and above the belly button".

- there is no swelling of individual points. It definitely could not be mistaken for insect bites.

- neither case was painful, but one did itch. Both cases displayed other symptoms including headaches and nausea.

- in both cases, the signs were not apparent until at least an hour after diving, and the signs subsequently endured for at least one more hour before oxygen was administered (I was dealing with the aftermath, not on the boat at the time), but in both cases the "mottling/rash" disappeared quite rapidly (within 30 minutes) after the diver was put on oxygen.

- it wasn't "localised" - as in - just on a bit of arm or shoulder - it was quite widespread in the affected area.

But - there are allergic reactions and so on that look similar. It's difficult to judge, but a reasonable guide to differentiating between the two is the colour of the rash - brighter colouration suggests it's closer to the surface of the skin, a darker purple sort of colour suggests that it's subcutaneous (under the skin) . Look for other symptoms (as in the aforementioned headache and nausea etc.) and a dead giveaway is the administration of oxygen. If symptoms persist, it's probably not DCS, if they disappear, there's a significant chance there is. If it's only on one specific location - such as the right shoulder, in one case I dealt with, then it's more likely to be an allergic or stress-related bruise or abrasion. Neural DCS can cause a diver to be "one-sided" due to bubbles in the brain or spinal chord, (similiar to a stroke) but from what I have seen, skin bends do not favour a side (the physiology is different), but are more broadly spread across the body.

That's not meant to be comprehensive, just what I know and what I've had to deal with. Both cases involved the diver being put into the chamber, both were easily resolved, both divers are still diving.

Cheers

C.

 

[chillyinCanada]

cutaneous marmorata likes fatty tissue. Far more likely to be evident in tummy, love handles and such.