Coral Stings

Question:

When I was diving some time ago, I apparently came in contact with a type of stinging coral. As soon as I got out of the water I noticed a few cuts and scrapes on the outside of my left wrist and forearm. Later that evening I left an itching and burning sensation around the affected skin; it became red and tender to touch.

I washed it with soap and hot water, which actually seemed to help. However, the redness, itching and burning lasted for three to four days. The local doctor prescribed a steroid cream twice a day, and everything seemed to heal during the next four to five days.

Since I returned from my dive trip, the redness and itchy sensations have recurred. The area is uncomfortable and unsightly. Do I need special care?

Answer:

It is not uncommon for a diver to have a red raised rash resulting from a coral encounter. A burning sensation, pain and itching may also accompany a rash if the coral is actually a hydroid, such as fire coral, which is not a true coral but a stinging creature. The extent of the reaction to fire coral depends on the amount of exposure to toxins, the extent of the abrasion and victim's pre-existing sensitivity.

You did the correct thing to clean the wound with soap and water: Reactions may be reduced by immediately cleansing the affected area. The most frequent complications from non-stinging coral scrapes are inflammation, which leads to poor healing, and less commonly, a secondary infection. Proper cleansing, therefore, is very important.

If fire coral is the culprit, then treatment with hot water 45C is recommended. This can be applied as a compress or as a soak to reduce the pain. Other substances that have been used with variable effect are rubbing alcohol and baking soda.

It is not uncommon for the rash, itching and burning to recur after these symptoms have resolved initially because tiny, microscopic fragments of living coral can remain in the wound. In addition, a cyclic immune response (redness, inflammation, itching and swelling, itching or burning) can persist for a few weeks after the incident.

Treatment for the inflammatory response is symptomatic. Steroid creams are rarely helpful and they can prolong a skin infection. If the inflammation is severe, systematic steroids in a moderate, tapering dose may be administered under the supervision of a trained medical provider. Oral antihistamines can sometimes help reduce the itching or burning sensation.

When you are under the water avoid contact with coral or any other living creature. Whenever possible wear a wetsuit or diveskin to protect yourself.

Ocean divers should consider a marine animal first aid kit for their travels. For divers who want to learn more about the various marine life injuries, DAN has a course as well as a variety of books on this topic.

DAN's First Aid for Hazardous Marine Life course is designed to provide divers with knowledge regarding specific types of marine creature injuries and the general first aid treatment for those injuries.