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Old beach concern resurfaces: sea lice

By BRUCE EPSTEIN

© St. Petersburg Times, published June 7, 2001


As the weather warms, residents and tourists alike head for the fun at the beach. Just when you thought it was safe to go into the water, beachgoers are now faced with another a new problem: sea bather's eruption.

Commonly known as sea lice (no relation to the head lice found in many young children), this condition has been known to Florida natives since the early 1900s. After an absence of 20 years, sea bather's eruption seems to have reappeared in the waters off Florida's southeastern and western coasts. It occurs from March to July, with a peak incidence in May (a Bahamian old wives' tale specifically warns against ocean swimming between Mother's Day and Father's Day).

The exact incidence is unknown, since many parents self-treat themselves or their children, but during an outbreak, it is estimated that one of every four people who went swimming had the dermatitis. Children with sea bather's eruption are not contagious.

The exact cause is not known, but current thinking suggests that the culprit is the microscopic form of the thimble jellyfish. Apparently adult jellyfish release millions of these microscopic larvae that float in the upper few feet of the water, appearing as flecks of pepper on the water's surface. When an unsuspecting swimmer comes along, infested water flows through their bathing suits and becomes trapped, with the fabric acting like a fishing net.

The trapped critters produce tiny stings that may not be felt unless they are rubbed or squeezed. It is not unusual to see evidence of 200 or more stings under a child's bathing suit. The organism has been noted to have an affinity for hair as well as fiber, which could explain why children have lesions on their necks. The toxins that are released from these stings cause itching, irritation and welts several hours later.

Parents will notice hives and blotches (elevated red bumps) under the swimsuit and on other parts of the body after swimming in the ocean. Itching and redness usually occur several hours after the swim. Some children experience a slight "prickling" sensation while they are in the water. It has been observed that pressure on the skin, as from a tight bathing suit, may trigger sea bather's eruption. Itching usually lasts two to four days but can last as long as two weeks. Some children may have a more severe reaction that includes headache, high fever, nausea and infected blisters.

Little can be done to prevent sea bather's eruption. Parents should listen to local beach reports and consult with lifeguards when available before swimming in the ocean. Barrier products like Vaseline, zinc oxide and Skin So Soft have been used with some success. There is also some evidence that use of a topical sunscreen or suntan lotion may protect skin from penetration by the offending organism.

Children should change into dry clothes immediately after ocean bathing and gently pat dry the wet areas of the body to minimize itching. Make sure the bathing suit is removed before showering with fresh water. Thoroughly wash the bathing suit with detergent in hot water before its next use.

Treatment of this condition includes giving an antihistamine, such as diphenhydramine (Benadryl) for the itching and the application of hydrocortisone cream to the rash areas. Bathing in a colloidal oatmeal preparation will also help. In severe cases, oral or injected steroids are administered.

Children with sea bather's eruption can develop high fevers, so to make the child more comfortable, treat with either acetaminophen or ibuprofen, depending on your doctor's recommendation. An additional recommendation for children is to clip their fingernails short to avoid scratching of lesions.

Since there are other causes of rashes similar to sea bather's eruption, it is always best to consult with your child's doctor if you are not sure of the diagnosis.

* * *

Bruce A. Epstein practiced pediatrics in St. Petersburg for 26 years. He edits the Web site http://www.kidsgrowth.com.

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