What are the other Names for this Condition? (Also known as/Synonyms)

• Ocean Itch
• Sea Lice
• Sea Poisoning

What is Seabather's Eruption? (Definition/Background Information)

• Seabather’s Eruption is an itchy skin condition (hypersensitivity reaction) that occurs on seawater exposure, due to a particular species of jellyfish
• The jellyfish larvae gets trapped under the bathing garments, wet-suits, and hair, and discharges a type of poison when they are squeezed or rubbed, into the human skin causing allergic reactions, especially in sensitive individuals
• It forms a highly itchy eruption after long hours of exposure to seawater, which occur on the swimsuit contact areas and not on the open exposed parts of the body
• The factors that encourage the larvae to discharge the venom include wearing the swimming garment for a long period of time after swimming, and mechanical stimulation
• The signs and symptoms of Seabather's Eruption include small, red, raised lesions on the skin with itching, accompanied by nausea, fatigue, and even fever in children
• Seabather's Eruption is not a serious medical condition and it has an excellent prognosis. The symptoms usually resolves in 2-3 weeks, with or without treatment

Who gets Seabather's Eruption? (Age and Sex Distribution)

• Any individual who is exposed to seawater may be affected by Seabather’s Eruption. The severity of the symptoms is more in children than in adults
• The condition affects both male and female in equal ratio
• No ethnic or racial predominance has been observed
• However, individuals in certain geographical regions (mainly in the tropics) have a higher exposure incidence

What are the Risk Factors for Seabather's Eruption? (Predisposing Factors)

The risk factors for Seabather’s Eruption include:

• Exposure to the sea or seawater
• Swimmers, divers, and snorkelers
• Wearing the bathing or diving suit for long durations, even after coming out of the seawater
• Season: Seabather’s Eruption occurrence is seasonal and most often occurs in summer (March to August), with an incidence peak in May and June. It is also dependent on the water temperature
• Geographical area: People living in the tropical regions of Bahamas, Bermuda, Philippines, Thailand, Brazil, USA (Florida), New Zealand, Mexico and the Caribbean region have a high risk

It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases ones chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.

Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.

What are the Causes of Seabather's Eruption? (Etiology)

Seabather’s Eruption is an inflammation of the skin accompanied by itching sensation (pruritic dermatitis), which occurs after exposure to seawater containing a certain species of jellyfish, the thimble jellyfish.

• The condition causes a highly pruritic, itchy, papular eruption that tends to occur underneath the swimsuit (rather than on the exposed parts) after long hours of exposure to seawater
• The rashes are caused by the body’s allergic reaction to the poison that enters the human skin released by the nematocysts of the larval jellyfish. These larval forms, which are of the size of a pinhead, get trapped underneath the bathing suit or in the hair of the bather
• Each larva contains a number of stinging cells that is activated through simple mechanical pressure, due to osmotic changes that occur with evaporation, or while rinsing-off with freshwater
• As the swimmer comes out of the sea, the water keeps dripping from the swimsuit, trapping the larva between the suit and the skin
• The pressure exerted on the small jellyfish causes it to release the poison into the skin

The skin condition may sometimes appear, days or weeks after washing and drying the infested clothing or suit.

What are the Signs and Symptoms of Seabather's Eruption?

On exposure to the jellyfish, the itching sensation may begin immediately, but not the eruptions. Once the symptoms appear, they may last from a few days to a maximum period of two weeks. The common signs and symptoms of Seabather’s Eruption include:

• A tingling sensation under the bathing suit, while still in water, is the first symptom of Seabather’s Eruption. Itching sensation starts almost immediately and is the main symptom of this condition; it may last for 1-2 weeks
• Also, the development of rashes may start in a few minutes to even 12 hours after swimming
• Small red papules (a small raised pimple or swelling that forms part of a skin rash) accompanied by severe itching
• Lesions generally occur at sites covered by the bathing suit
• Nausea and vomiting
• Headache
• Sore throat, cough
• Fatigue, malaise (general feeling of illness)
• Diarrhea
• Abdominal pain
• Pinkeye or conjunctivitis
• Fever and chills are common in children
• Swollen lymph nodes in the neck, armpit, and groin region

How is Seabather's Eruption Diagnosed?

A diagnosis of Seabather’s Eruption may entail the following:

• Complete evaluation of medical history along with a thorough physical examination of the skin. History of exposure to seawater and the presence of skin lesions are sufficient to make the diagnosis
• Elevated serum levels of immunoglobulins (antibodies)
• Skin biopsy is unnecessary

Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.

What are the possible Complications of Seabather's Eruption?

There are no long-term complications observed with Seabather's Eruption.

How is Seabather's Eruption Treated?

The treatment of Seabather's Eruption aims at managing the symptoms. The rashes will subside and go away without medical treatment in about 10-14 days.

• Home remedies may include:
  • Scratching the affected area should be avoided, since it may lead to further swelling and secondary infections
  • Clothing should be avoided on the affected area, because it may cause irritation
  • Avoid sunlight and hot showers which tend to increase the itching
  • Applying diluted vinegar and alcohol to the itching area can help neutralize the remaining stinging cells
  •  A lukewarm bath with one cup of cornstarch or colloidal oatmeal added to the water can help in soothe the affected areas            
  • Use of numbing medicines, which contain benzocaine or lidocaine, can help in relieving itching and pain
  • Using an ice pack will help in pain-relief
  • Topical corticosteroids are generally administered in the treatment of Seabather’s Eruption such as clobetasol

  • Antihistamines are also generally used that may include loratadine, cetirizine, and desloratadine

How can Seabather's Eruption be Prevented?

There are no definitive methods to prevent Seabather’s Eruption. However the following measures may be of help:

• The risk of developing Seabather’s Eruption is considerably reduced, when the bather takes a fresh shower after promptly removing the swimming/bathing suit
• Educating individuals about the skin infection caused by the thimble jellyfish larvae during peak seasons and the need to take freshwater shower after a swim or dive in the sea
• Individuals with a history of severe allergic reactions should avoid swimming in water
• Thimble jellyfish thrive well only during the summer season; hence, avoiding swimming during summer seasons in waters known to harbor the jellyfish, can help prevent the condition
• The bathing suit should be rinsed thoroughly with laundry detergent and dried well in the hot sun to kill all the pathogens present in it

What is the Prognosis of Seabather's Eruption? (Outcomes/Resolutions)

• The prognosis is excellent with or without treatment; the eruptions normally clear within 2 weeks
• Generally, Seabather’s Eruption is not a very serious illness that requires hospitalization for its treatment

Additional and Relevant Useful Information for Seabather's Eruption:

An expert opinion of a dermatologist will be required to narrow the differential diagnosis in patients with severe symptoms.