Skin Bends and Flying After Diving

Cutaneous decompression sickness — also known as skin bends — manifests as bruising or mottled skin, typically on the belly, buttocks, breasts, thighs, or upper arms. In some cases, there are no additional symptoms, but in others, the skin discoloration is accompanied by neurological symptoms. Because of this, it’s important that dive professionals take skin bends seriously and encourage affected divers to seek prompt medical attention. As with other types of decompression sickness, divers who experienced skin bends should not fly until cleared to do so by a doctor familiar with diving medicine. As always, DAN is available to consult with divers, dive professionals, and medical professionals who have questions about symptoms after diving.

Tricia and her buddy had been diving in Cuba twice a day for three days. The dives were between 60 and 104 feet deep, all on air. At the end of the third day of diving she experienced itchy skin and a rash, but she felt well enough to meet friends for dinner. When she got to dinner, however, her condition began to deteriorate, and she headed back to her room to lie down.

Though she was quite uncomfortable she eventually managed to sleep, but only for a few hours. When she awoke the itching was worse, and he skin appeared bruised and mottled. Suspecting skin bends (cutaneous decompression sickness [DCS]), she decided to call DAN.

The DAN medic agreed Tricia might be suffering from DCS and told her to head to the local clinic right away for a thorough neurological evaluation. The medic also offered to coordinate a physician-to-physician consult in Spanish to assist the local physician with the evaluation. She let Tricia know that there were hyperbaric chambers on nearby islands and that she would explore getting an airlift if one was needed. At the clinic Tricia breathed oxygen for around 30-45 minutes. She felt better, and the symptoms subsided somewhat, so the doctor released her. She felt well enough the next day to go sightseeing in Havana, and she even chose to proceed with her scheduled flight home: a 30-minute trip to Miami.

The morning after her flight she was in considerable pain, and her abdomen was swollen and disfigured. She called DAN again, and while the medic had her on the phone she also called Mariners Hospital in Tavernier, Florida, which was the closest hyperbaric chamber facility to Tricia’s home, and arranged for the chamber staff to meet her in the emergency room. Tricia arrived at the ER and was taken back quickly, given oxygen and put through a series of tests to evaluate her condition. Despite being four days postdive, the doctor decided to treat her in the chamber. She felt much better after the six-hour chamber treatment, though some abdominal soreness persisted for about a week.

Reflecting on the incident, she initially found it puzzling that of the 20 divers in the group she was the one who got DCS. “I was one of the youngest, I have always stayed active and in shape, and I did not dive beyond any limits.” But in the aftermath of the event she learned that the vast majority of DCS cases involve no identifiable causes or explanations (beyond time spent at depth). “If I had to go through this all over again,” she said, “next time I’d advocate for myself more forcefully. I probably would have called DAN sooner in the first place and again the day before I flew. I knew it wasn’t a good idea to get on that plane with symptoms, so I would have liked to discuss that with DAN before we departed.”

“I realize how fortunate I am that my DCS was not any worse,” Tricia said, “and I’m so grateful that we’ve always been covered by DAN dive accident insurance since we began diving in 1998. Neither of us ever wanted to have to dial that number, but I’m sure glad DAN was there for us when we did.”

DAN takes the guesswork out of emergency logistics. Once a member calls the 24/7 hotline, DAN arranges care — including evacuations and complex air travel arrangements if necessary. Behind the scenes, DAN specialists coordinate medical care and transportation with local agencies, and in dive emergencies, DAN medical staff can even consult with local physicians who may not be familiar with dive medicine.

With more than 40 years of experience managing emergencies around the globe, DAN helps its members fully enjoy their travels. Learn about DAN World Membership & Coverage HERE.