Skin Bends or Marine Life Injury?
A Diver’s Question
Q: I arrived home from a dive trip five days ago. The palms of my hands are itchy and red, and the right hand is worse than the left. I was careful about where I placed my hands while diving and always used the mooring line to perform my safety stops. During the week I felt some itching on my right hand, but it resolved. Someone suggested skin bends — is that possible?
Expert Answer
Based on your symptoms and their location, a marine life injury is more likely than decompression sickness (skin bends). It’s good practice that you were careful about hand placement, but mooring lines often host hydroids that can sting divers in a way similar to jellyfish or other nematocyst-bearing organisms.
It is not unusual for divers to experience delayed hypersensitivity reactions, where itching or redness resolves and then reappears days later. In these cases, topical hydrocortisone cream is a suitable first treatment. If symptoms don’t improve within 48 hours, or worsen, consult a doctor. In some cases, a short course of oral steroids (e.g., prednisone) may be prescribed.
Diving and Pulmonary Hypertension
A Diver’s Question
Q: Can someone that has been diagnosed with pulmonary hypertension become a diver?
Expert Answer
Pulmonary hypertension is considered a severe medical risk, and diving is not recommended for anyone with this diagnosis. Scuba diving requires high cardiovascular fitness, and the haemodynamic stress of immersion places extra pressure on the lungs and right side of the heart.
In healthy divers, increased fluid shifts to the central circulation during immersion are generally manageable. However, a diver with pulmonary hypertension already has elevated pressure in the pulmonary vessels. This makes it difficult for the right ventricle to keep up, even at rest, and underwater exertion can increase the risk of congestive heart failure or immersion pulmonary oedema.
For these reasons, scuba diving with pulmonary hypertension is unsafe and strongly discouraged.
For an extensive range of diving health and safety information and downloadable resources, research studies, incident summaries, and free e-Learning courses, take the time to explore the DAN website.
Frequently Asked Questions
What is the difference between skin bends and a marine life injury?
Skin bends are a form of decompression sickness, while marine life injuries are usually caused by stings from organisms like hydroids or jellyfish.
Can skin bends cause itchy red hands?
Skin bends usually present as marbling or mottling of the skin, while itchy, red palms are more consistent with marine stings or contact injuries.
How should divers treat suspected marine life injuries?
Initial treatment includes rinsing the affected area, applying topical hydrocortisone cream, and seeking medical care if symptoms worsen.
Why is pulmonary hypertension dangerous for divers?
Diving increases fluid volume shifts and lung workload, which people with pulmonary hypertension may not tolerate, leading to serious complications.
Is there any safe way for someone with pulmonary hypertension to dive?
No. Because of the risks to the heart and lungs, diving with pulmonary hypertension is not recommended under any circumstances.
This article was originally published in Scuba Diver Magazine
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