Peeling,thickening and acne of skin after diving

[DDSDiveJunkie]

Hello!
I’ve experience thickening of my skin (particularly feet and fingers) after the last several dive trip. I read the previous thread, but I do not experience pain in these areas unles the skin cracks or peels deep. The last trip was the worst and I’m still dealing with the effects.

Symptom History: started noticing about year and a half ago. Started with finger tips and now they always peel off in what I would describe as a thick hood of tissue. Sensation is diminished on the fingertips and lateral borders of the fingers. Lasts for a couple of weeks post trip for the sides of the fingers and until the tips peel off from the fingers. Progressively this has been increasing in thickness depth and length of time affected as well as me noticing the feet and toes as well. (Previously can’t say I really paid attention to my feet). I have also been experiencing significant non typical acne on my face, chest, shoulders and back which usually begins a few days into the trip. It is deep and seemingly cystic type acne. (Coulle weeks in Indonesia...1 week Lembeh, 10 days Raja Ampat all 3-4 dives per day) This last trip left me a complete hot mess. I would describe the acne as severe on face, shoulders, back and chest. Obviously I don’t like how it looks but more importantly I’m concerned about all the lesions leaving me susceptible to infection. Usually I have nice sandal ready feet, so they are not neglected...but now the whole foot is peeling and appears thick and yellowish in some areas. My hands were awful too.

Treatments and gear: i am meticulous with my hygiene, exfoliate consistently, have taken oral antibiotics (for the acne), showered between dives to remove salt water and bacteria, topical antibiotics and antibacterial. Feet and hands I try to let dry thoroughly and moisturize after completely dry. I wear a 3 mm wetsuit, ankle boots with a sock. Let me emphasize that I shower immediately after I get out of the water. I do not and have not ever worn gloves.

Any ideas? Differential diagnosis? Treatment? Anybody else have this?

Thank you in advance!

 

[Geobound]

So this only happens when you dive, and not in a bathtub or a shower or a local swimming hole (no scuba kit)?

Always in salt water and not fresh or chlorinated?

Are you by change allergic to neoprene? This sounds like a common occurrence each time you were your wetsuit and boots?

Just an idea, no experience whatsoever?

I just went and looked this up quickly.........does it sound like you?

Neoprene splinting: dermatological issues. - PubMed - NCBI

Here is another link worth checking out, and a possible solution if you do have an allergy to Thiuram.

Neoprene Allergy: What if You Are a Surfer and Can Not Wear a Wetsuit? - 360Guide

 

[Streydog]

A few years ago my hands and fingers started to peel a light layer of skin a few days after getting back from saltwater fishing trips. I had never had this issue prior. I do not experience this after dive trips. After surfing the web it seems this happens to others and there is speculation that it is caused by handling squid or from fish slime. Are you handling bait or fish on your trips?

 

[DDSDiveJunkie]

Thank you for the feedback.

So this only happens when you dive, and not in a bathtub or a shower or a local swimming hole (no scuba kit)?

Always in salt water and not fresh or chlorinated?

Are you by change allergic to neoprene? This sounds like a common occurrence each time you were your wetsuit and boots?

Just an idea, no experience whatsoever?

I just went and looked this up quickly.........does it sound like you?

Neoprene splinting: dermatological issues. - PubMed - NCBI

Here is another link worth checking out, and a possible solution if you do have an allergy to Thiuram.

Neoprene Allergy: What if You Are a Surfer and Can Not Wear a Wetsuit? - 360Guide

I suppose there is a possibility that I’m sensitive to neoprene. I take Benadryl, Zyrtec and singular, so I would expect that would curb any histamine or allergic response. The inside of my wetsuit is wool as well. I only started wearing a hood in the last two trips and prior never used and I have never worn gloves diving (although I do have to pull up my wetsuit which could explain the finger tips). I do wear boots with non neoprene socks. I would expect the areas of contact like my chest, back and shoulders to exhibit more acne than my face and that isn’t the case. It may be two separate issues. I think I’ll try a dive skin under the wetsuit to see if that helps. Thank you for the links!!!

 

[DDSDiveJunkie]

So this only happens when you dive, and not in a bathtub or a shower or a local swimming hole (no scuba kit)?

Always in salt water and not fresh or chlorinated?

Are you by change allergic to neoprene? This sounds like a common occurrence each time you were your wetsuit and boots?

Just an idea, no experience whatsoever?

I just went and looked this up quickly.........does it sound like you?

Neoprene splinting: dermatological issues. - PubMed - NCBI

Here is another link worth checking out, and a possible solution if you do have an allergy to Thiuram.

Neoprene Allergy: What if You Are a Surfer and Can Not Wear a Wetsuit? - 360Guide

Forgot to mention that I was on multiple swim teams for years and never had an issues with chlorinated water. I only spent occasional time in the ocean before diving without issue, but not a good comparison because now I’m in the water 3-4 hours a day when on trips.

 

[DDSDiveJunkie]

A few years ago my hands and fingers started to peel a light layer of skin a few days after getting back from saltwater fishing trips. I had never had this issue prior. I do not experience this after dive trips. After surfing the web it seems this happens to others and there is speculation that it is caused by handling squid or from fish slime. Are you handling bait or fish on your trips?

Good question! thankfully I am not one of those divers. I never wear gloves and do not touch any marine life. I have used a single finger to stabilize on rare occasion, but I’m very conscious of where that finger touches.

 

[Geobound]

Sorry I can't be of anymore help, but good luck in getting it sorted out.

I'd be curious to know what the outcome is, should you find it out.

Best of luck to you.

 

[morecowbells]

I think the skin thickening and peeling of hands and feet are completely separate issues from the cystic acne. Prolonged exposure through immersion in water and high humidity(essentially water logged tissue)and not thoroughly drying out the hands and feet may cause maceration and break down of the skin. It makes me wonder if adding lotion and moisturizer is actually making the problem worse since this may inhibit the tissue from adequately drying off and ventilating. As for the cystic acne, I am not sure if neoprene is the problem since it is also an issue occurring on your face too. There are so many factors to consider; allergy to sunscreen, sun sensitivity, dietary/ dairy issues, hormones etc. Best of luck getting to the bottom of these issues.

 

[Streydog]

I didn't mean to imply that you were touching sea life while diving. I thought it might be a possibility that while you were in that area you might be eating/handling seafood you might not normally handle or fishing using live bait.

 

[James T. Burton]

Hi!

It's no remedy but I thought I'd share.
I am an instructor and have just got back to Indonesia after nearly 2 years out.
By the time I left Indonesia last time I had acne all over my chest and back. Singular spots that seemed quite deep and often popped with blood and fluid (sorry to be graphic). The areas do not itch.
While being away from diving/SE Asia/specific diet -whichever is causing it - they cleared up completely within a few months.
After only 7 days back I have noticed that at least 10 faint red spots on my chest have already started to come out and a handful on my back already have white heads! I'm DREADING another full outbreak.

- Whilst in Indo last time, I changed the material of the rash vest I wore underneath my wetsuit 3 times (Polyamide/Elastine, Neoprene and Nylon/Elastine). This makes me doubt it's the material I'm wearing.
- Since I have been diving this time I have not been in the pool so we can strike that off the list.
- I am aware my diet changes massively while I am here. The main increases in foods I do not usually intake are: rice; noodles; chilli; soy products (tempeh/tofu/soy sauce); certain oils (Palm?) and food ingredients (MSG?); I guess more deep fried products than usual too.. I am not ingesting as much dairy; avocado; brown bread; cereals..
- I have not yet had a clothes wash so I doubt it is washing powder or other cosmetic products.
- Sun exposure and suncream usage is no different to when I am in the summer elsewhere in the world.

If anyone has any input into the situation it would be massively appreciated!
Can you be allergic to Nitrogen intake?? Bacteria in the water..? Pores susceptible to pressure?!

The first thing I'm going to try is to avoid all obviously deepfried foods like tempeh/chicken/tofu and foods heavy with oil like sambals/oily curries etc... Hopefully I don't have to get rid of Indonesian food all together!

Maybe this is a case for a dermatologist as opposed the Scuba Board but I thought I'd mention as it seems like a very similar situation to you DDSDiveJunkie!