Pacific Paddler October 2016 - 42
Got an itch?
Paddlers are confronted with common
dermatology problems which range from minor
annoyances to more potentially serious conditions. How to deal with these problems can be a
little confusing sometimes because of treatments
advocated by word of mouth, social media and
online suggestions without good supporting
clinical evidence. Needless to say, the main goal
is to get back in the boat as soon as possible!
First and foremost besides rashguards, it goes
without saying that sunscreen application using
a good water repellent product is important.
Although an SPF with a minimum of 30 is the
way to go, inadequate applications reduce effectiveness and reapplication when necessary pays
dividends. Also with the amount of exposure on
the water, it is definitely worthwhile, especially
for older paddlers to have a periodic screening
for possible suspicious skin lesions. Without question early detection is critical especially when it
comes to the possibility of melanoma.
Reef rash or dings when getting into or out
of the canoe need early effective treatment. It
is especially important when paddling in areas
where the water is not the cleanest. Media
discussion about the hazards encountered at
places like Keʻehi Lagoon have definitely been
exaggerated and has caused a lot of unneces42
PACiFiC PADDLER OCTOBER 2016
sary concern. For example, bacterial counts
obtained recently at different Oahu locations
indicated higher counts at Waikiki Beach than
a thoroughly cleaned Keʻehi itself. The key, no
matter where the location, is good initial and
subsequent skin care to decrease the chance of
infection and avoid unwanted down time.
What to do? Thereʻs no substitute for good
vigorous cleaning with soap and water.
A dermatologist friend is an advocate of two
small towels : One to bite on for the discomfort
and a second to scrub the area very well to
get rid of debris and contaminants from the
water! Use of an antibacterial concentrate like
Hibiclens, an OTC product, is good. A thorough
flush with a 50% solution of hydrogen peroxide
is helpful in particular for reef encounters.
Application of a 10% solution of povidine or
a betadine solution has its advocates, but there
is some evidence of a relationship to delayed
healing because of its effect on white blood cells
in traumatized tissue. Next comes the application
of a topical antibiotic and subsequent occlusive
dressings with daily changes that should result in
a clean wound with a much reduced chance of
secondary infection. Paddling with a dressing in
place doesnʻt work very well at times and needs
to be avoided for a couple of days depending
on the location and size of the wound. As things
improve, the off the record advice from some
ER physicians is to add a little duct tape to keep
things in place!
How about jellyfish stings from our
Portuguese man-of-war and box jellyfish friends?
There are a lot of first aid remedies out there
so we need to address some of the commonly
heard recommendations (sorry, urinating on
a sting has been shown to have no beneficial
effect!). Two no-noʻs are trying to wash off the
sting with fresh water (just discharges more
nematocysts) and applying cold compresses or
ice (actually makes the pain worse). What to do?
Rinse off with sea water and carefully remove
any residual tentacles. Vinegar compresses help
prevent further discharge and helps the pain. A
paste of meat tenderizer is less effective. Recently
a local researcher has extensively studied the
problem with good data and has developed a
product called Sting No More which appears to
be more helpful than vinegar. After the initial
treatment, hot water immersion or compresses
reduces the pain along with analgesics. Some
individuals can experience allergy symptoms so
benadryl, and lastly, a trip to a physician may be
needed.
PETER CALDWELL
Table of Contents for the Digital Edition of Pacific Paddler October 2016
Pacific Paddler October 2016 - 1
Pacific Paddler October 2016 - 2
Pacific Paddler October 2016 - 3
Pacific Paddler October 2016 - 4
Pacific Paddler October 2016 - 5
Pacific Paddler October 2016 - 6
Pacific Paddler October 2016 - 7
Pacific Paddler October 2016 - 8
Pacific Paddler October 2016 - 9
Pacific Paddler October 2016 - 10
Pacific Paddler October 2016 - 11
Pacific Paddler October 2016 - 12
Pacific Paddler October 2016 - 13
Pacific Paddler October 2016 - 14
Pacific Paddler October 2016 - 15
Pacific Paddler October 2016 - 16
Pacific Paddler October 2016 - 17
Pacific Paddler October 2016 - 18
Pacific Paddler October 2016 - 19
Pacific Paddler October 2016 - 20
Pacific Paddler October 2016 - 21
Pacific Paddler October 2016 - 22
Pacific Paddler October 2016 - 23
Pacific Paddler October 2016 - 24
Pacific Paddler October 2016 - 25
Pacific Paddler October 2016 - 26
Pacific Paddler October 2016 - 27
Pacific Paddler October 2016 - 28
Pacific Paddler October 2016 - 29
Pacific Paddler October 2016 - 30
Pacific Paddler October 2016 - 31
Pacific Paddler October 2016 - 32
Pacific Paddler October 2016 - 33
Pacific Paddler October 2016 - 34
Pacific Paddler October 2016 - 35
Pacific Paddler October 2016 - 36
Pacific Paddler October 2016 - 37
Pacific Paddler October 2016 - 38
Pacific Paddler October 2016 - 39
Pacific Paddler October 2016 - 40
Pacific Paddler October 2016 - 41
Pacific Paddler October 2016 - 42
Pacific Paddler October 2016 - 43
Pacific Paddler October 2016 - 44
Pacific Paddler October 2016 - 45
Pacific Paddler October 2016 - 46
Pacific Paddler October 2016 - 47
Pacific Paddler October 2016 - 48
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