Skin diseases are a common problem of travelers. One in 10 people are affected during travel; others may not notice symptoms until after they return--days, weeks, or even months later. Most skin problems are caused by insect bites, bacterial and fungal infections, allergic reactions, or too much exposure to sunshine and ultraviolet light.
Heat and Humidity
The body sweats to stay cool. If the sweat ducts become blocked because of heat and humidity, they can cause prickly heat or become infected. Hot moist skin encourages bacterial and fungal growth.
Bites are common from insects such as mosquitoes, gnats, sandflies, ticks, and mites. These bites can cause allergic reactions and often become infected. Some insect bites can transmit infections. Other Some insects can transmit worms or larvae that can penetrate the skin.
Sunlight and Ultraviolet Radiation
The ultraviolet (UV) radiation in sunlight can cause sunburn, rashes, and eye irritation that could lead to blindness. Sunlight can cause allergic reactions when taking certain drugs, such as oral contraceptives or antibiotics; it can also cause a rash when it comes into contact with chemicals found in some sun lotions (such as lemon oil). Long-term exposure to sunlight can lead to skin cancer, premature aging, and chronic itching. Young children, blue-eyed blondes, and especially green-eyed red heads are at greater risk of sunburn and UV damage. UV radiation is greatest near the equator, at high altitudes, near reflecting surfaces such a snow, sand, or water, and when the sun is directly overhead. In addition, UV radiation can penetrate clear water to a depth of 3 feet, so it is possible to get a sunburn underwater.
Preexisting Medical Conditions
Eczema can get worse in hot climates, and people who have a tendency toward eczema or asthma might experience their first episode since infancy. Psoriasis, by contrast, sometimes improves in sunlight. Persons with HIV infection are at risk of allergic skin reactions to medications such as those containing sulfa and some antibiotics.
Specific Activities or Places
If traveling "rough," one can come into contact with lice and scabies. Rural travelers, persons on safari, and especially campers are at greatest risk of insect, tick, and mite bites. The seas also contain animals that can cause irritated skin or painful skin lesions (see Marine Hazards). Some diseases are more common in certain areas of the world. Filarial infections (worms) are a risk if traveling to or living in tropical western or central Africa (see Filarial Infections). Sandflies that can transmit a skin form of a disease called leishmaniasis are common in the forests of South and Central America and the semi-desert areas of North Africa and the Middle East (see Leishmaniasis).
Symptoms and First Aid Measures
|Problem||Common Symptoms||What to do|
(See Sun and Heat.)
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|Drugs and sunlight reactions|| || |
|Prickly heat|| || |
|Insect bites and stings |
(See "Insect Precautions.")
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|Lice and scabies |
(See Infestations in Travelers.)
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Fly larvae penetrate skin from un-ironed clothes (Africa) or are injected into skin by biting mosquito (Central and South America).
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|Bacterial infections of the skin|| || |
|Fungal infections of the skin|| || |
Systemic infection (affects whole body) with skin lesions
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Parasitic infections occurring later
(See Leishmaniasis and Filarial Infections.)
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Care of the skin: Try to adapt slowly to a tropical climate and stay as cool as possible. Keep skin cool and clean through frequent showering. In a humid climate, dry off thoroughly. In a dry climate, use a moisturizer. Clean cuts and scratches with an antiseptic wipe and cover until healed.
Protect against UV radiation: Children and persons who do not tan easily should stay out of the sun as much as possible, especially in the middle of the day, wear long-sleeved clothes, and use a wide-brimmed hat or umbrella and wraparound UV protective sunglasses. Use sunscreens with a sun protection factor (SPF) of 15 or more and lip protection screen. Apply sunscreen before exposure to the sun and reapply after swimming or heavy perspiration. Wear a shirt while swimming.
Avoid insect bites: There are 3 main ways to avoid insect bites:
- Avoid risky areas at risky times.
- Use repellents on skin and garments. (See Insect Precautions.)
- Use insecticides on garments, mosquito nets, and inside camping tents.
Discuss the itinerary with a travel health care provider to learn about possible areas of risk. Use an effective repellent in the daytime (especially early morning and late afternoon to dusk) and in the evening hours (dusk to dawn) to protect against species of insects that bite at different times of day. (Do not apply repellent to sunburnt or inflamed skin.) Do not use more than the manufacturer's recommended dosage when applying insect repellent on children. Use permethrin (an insecticide) on bed nets and curtains. Burning coils and knockdown insecticide sprays may also help prevent bites. In a hot climate, wash clothes frequently and iron to kill myiasis larvae.
Medications and first aid kit: Those with a preexisting medical problem, should consult a doctor before travel and be sure to take an adequate supply of necessary medications, especially if those with severe allergies. Travelers should carry a first aid kit, which at minimum should contain: sunscreen of an appropriate SPF, DEET or other suitable insect repellent, 1% hydrocortisone ointment, antiseptic cream, antiseptic wipes, adhesive bandages, antifungal cream, and aspirin or acetaminophen tablets. If going on a long trip or to places with poor medical facilities, ask a doctor for an antibiotic suitable for cellulitis. (See Packing Personal Medications and Supplies.)
When to Seek Medical Help
Most common skin conditions of travelers can be prevented or can be treated from a first aid kit. Seek medical help for skin conditions that do not respond to simple first aid measures and for severe sunburn, cellulitis (infection of tissues that has spread beyond a localized area), and any condition accompanied by fever. Seek medical help for allergic reactions; they can worsen quickly. See a doctor if nodules or ulcers occur that persist for more than 2 weeks or if rashes and swellings occur later.