Diving-Related Skin Changes: When to Seek Medical Advice

Is it decompression sickness?

Hello, I have been recreational diving for about three years, with approximately 110 dives.
I dive throughout the year, mostly from the shore, and during a few boat dives, I have had 1 or 2 instances where I surfaced before completing the required decompression stops.
This year, I noticed brown spots with a diameter of 0.2 to 0.5 cm appearing on both sides of my lower back.
They are not painful or itchy.
Initially, there were only 1 or 2 spots, but from June to October, the spots gradually increased, spreading from my lower back up to my armpits.
When resting on land, I usually wear sun-protective clothing, and the areas exposed to the sun are mainly my palms and below my thighs, so I can rule out sun exposure as the cause of these spots.
I would like to ask the doctor if this phenomenon could be caused by diving.
Will it resolve on its own? Is there a need for a medical examination? If so, which department should I consult?

Jīngtàn hào, 20~29 year old female. Ask Date: 2009/10/13

Dr. Lin Zhengyan reply Diving Medicine

Hello! This phenomenon should not be related to diving.
Since no skin spots were observed, it is impossible to determine whether it will resolve on its own.
Please seek medical attention and visit a dermatologist.

Reply Date: 2009/10/13

More Info

Hello! Thank you for reaching out with your concerns regarding the skin changes you've experienced while diving. Based on your description, it sounds like you have developed brown spots on your skin, which have increased in number over the summer months. Given your history of recreational diving and the specific nature of these spots, it’s important to consider several factors that could be contributing to this condition.

Firstly, the appearance of brown spots on the skin, particularly after engaging in activities like diving, could be related to a few different causes. One possibility is that these spots are a form of hyperpigmentation, which can occur due to various factors including sun exposure, skin irritation, or even changes in the skin due to pressure changes while diving. Although you mentioned that you wear sun protection clothing, it’s still possible for some areas of your skin to be exposed to UV rays, especially if there are any gaps in coverage or if the clothing is not rated for high UV protection.

Another consideration is the potential impact of diving itself. Repeated exposure to water, especially in varying temperatures and salinity, can affect the skin barrier. This might lead to conditions such as xerosis (dry skin) or dermatitis, which could manifest as discoloration or spots. Additionally, if you have experienced any decompression issues during your dives, it’s essential to monitor your health closely, as diving-related injuries can sometimes have delayed effects on the skin and other systems.

Regarding whether these spots will resolve on their own, it can vary. Some forms of hyperpigmentation may fade over time, especially if the underlying cause is addressed (such as improving skin hydration or reducing sun exposure). However, if the spots persist or increase in number, it would be wise to seek medical advice.

In terms of when to seek medical attention, you should consider consulting a dermatologist, especially since the spots have increased in number and spread over a significant area of your body. A dermatologist can perform a thorough examination and may suggest a biopsy if there’s any concern about the nature of the spots. They can also provide guidance on treatment options, which may include topical treatments to reduce pigmentation or other interventions based on the diagnosis.

In summary, while the brown spots you are experiencing may be benign, it is crucial to monitor them closely. If they continue to spread or change in appearance, please consult a dermatologist for a professional evaluation. Additionally, maintaining good skin care practices, such as moisturizing regularly and using sunscreen, can help protect your skin while diving and in daily life. Always prioritize your health and safety, especially when engaging in activities like diving that can have various effects on your body.

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