DAKOTA DUNES, S.D.  | Whether you're planning to cruise the Iowa Great Lakes this summer in a powerboat, cast your line in the Missouri River or surf the ocean waters on a beach vacation, there are some health hazards you need to be aware of to protect your skin.

Dermatologist Indy Chabra, of Midlands Clinic in Dakota Dunes, discussed some of these hidden dangers that range from flesh-eating insect bites to lake-dwelling microscopic parasites. Having a prompt and accurate diagnosis from a dermatologist, Chabra said, can ease worries and prevent a potentially serious condition from escalating.


Boaters are at high risk for sunburn due to the sun's reflection off of the water.

Chabra said sunscreen alone, isn't enough. He encourages boaters to don clothing and hats and plan time on the water around peak sunlight hours, 11 a.m. to 4 p.m.

"Protecting your body from the sun is more important than sunscreen," he said. "Sunscreen doesn't work that well because people don't put it on enough."

The American Academy of Dermatology recommends that people use a sunscreen that has an SPF (Sun Protection Factor) or at least 30. Look for sunscreen that contains Zinc, Titanium, Avobenzone, Ecamsole and Mexoryl.

Chabra said you don't have to rub sunscreen into the skin unless it's water resistant. Apply sunscreen every 40 minutes.

Children under six months of age, Chabra said, shouldn't be exposed to direct sunlight.

Mild sunburns can be relieved with cooling gels containing aloe and anti-inflammatory drugs such as Tylenol.

If you have blistering, Chabra said you should see a dermatologist who can prescribe a prescription steroid.


Itchy red bumps spread out on the skin could be swimmer's itch.

The rash is caused by larval forms, or cercariae, of parasitic flat worms that are released from infected snails into lakes, ponds, and lagoons. Swimmer's itch occurs when a film of cercariae-infested water dries on exposed skin.

"These larval forms are released from snails. Normally the host is a duck, but the humans are accidental hosts," Chabra explained.

A couple of years ago, Chabra said swimmers at Lake Okoboji developed the rash at a time when a high number of water fowl were gathering at the lake.

You have free articles remaining.

Become a Member

"Skin under swimwear is often protected," Chabra said.

Topical steroids are prescribed to treat swimmer's itch. Chabra said patients are usually rash-free in a couple of days.


Chabra has treated a few patients who were bit by the brown recluse spider, also called the fiddleback spider for the violin-like pattern on its back.

This venomous spider is found in dark places. Chabra said area fishermen have been bitten while fishing along the rocks. Once the wound starts turning a dusky color, he said that means the tissue isn't getting enough blood supply.

"You need to treat it promptly," he said of the bites that can cause necrosis, or the death, of tissue. "If you don't treat it, you may have to debride it because once the tissue dies you have to cut that tissue out."

Dapsone, an antibiotic, Chabra said is prescribed to treat these bites, which he said are "very painful."


Vibro vulnificus, a flesh-eating bacteria, has claimed two lives in Florida already this year.

The bacteria, which lives in warm water sources, is most often found along the Gulf Coast. Vacationers, Chabra said, will want to be cautious whether swimming or fishing in saltwater, especially if you have an open wound. Eating undercooked shellfish can also lead to blood infections.

"It's extremely aggressive," Chabra said of the bacteria that causes blistering skin lesions that can lead to amputation and ultimately death.


Sea bathers eruption occurs underneath the swimsuit in patients who have been exposed to saltwater and are hypersensitive to the larval form of the thimble jellyfish.

Swimmers develop itchy, red bumps that Chabra said can be painful. He said the rash can be managed with topical steroids, but he said it often heals without medication.

"I think the thing that we add value for is diagnosing it -- basically making sure that's what it is. It's not something else," Chabra said of dermatologists. "We have limited treatments, but we can help you figure out what it is."

Get Breaking News delivered directly to you.

* I understand and agree that registration on or use of this site constitutes agreement to its user agreement and privacy policy.