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from the AAD
As Floodwaters Rise,
So Do Dematalogic Conditions
From infections to insect bites, board-certified dermatologists can help treat flood-related skin issues
WASHINGTON (March 1, 2019) — When it comes to hurricane-related injuries, skin disease may not be top of mind for most people.  But as more frequent and intense flooding disasters have occurred in conjunction with progressively rising temperatures, both disaster victims and relief workers have experienced significant dermatologic problems.

Justin P. Bandino, MD, FAAD  
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“In 2017, we experienced almost as many flooding events as we did throughout the previous 10 years,” says board-certified dermatologist Justin P. Bandino, MD, FAAD, assistant professor of dermatology and dermatopathology at San Antonio Military Medical Center. “The health implications for people exposed to floodwaters are staggering and include a wide variety of dermatologic issues, such as wound infections, contact dermatitis and even electrical injuries from downed power lines.”

According to Dr. Bandino, skin and soft tissue infections are some of the most common dermatologic complications that people can experience following a disastrous flooding event. These types of infections can occur when injured skin is exposed to contaminated floodwaters containing sewage, chemicals or pollutants.

In particular, Dr. Bandino says, tsunamis and hurricanes can cause major disruptions in the soil, unearthing unusual infectious organisms. “In cases when malnourished patients have not had access to food and clean water, even a small, superficial cut that has been exposed to these infectious organisms can result in a potentially dangerous infection,” he says.

Symptoms of infection include expanding redness, warmth, tenderness and discharge, Dr. Bandino says, as well as wounds that do not heal or seem to reappear a few months after showing initial improvement. “It’s important to carefully monitor all wounds and seek treatment immediately if you see any of these signs, as these infections can be serious or even fatal,” he says.

Animals and insects also pose risks to victims of extreme flooding, Dr. Bandino says. Bites from domesticated and non-domesticated animals and snakes increase as rising floodwaters force them to compete with humans for space, he says, whereas insects like mosquitoes use stagnant floodwaters as breeding grounds, which can lead to outbreaks of disease like Zika or malaria. He also points to floating fire ant colonies that appeared in the streets of Houston following flooding from Hurricane Harvey.

To reduce the risk of a dermatologic disease following a flooding disaster, Dr. Bandino recommends developing a flood response and evacuation plan tailored to the risks in your area. In addition to mapping routes for escape, he suggests putting together a basic first-aid kit that includes supplies for cleaning, covering and treating minor wounds, as well as insect repellant that contains the active ingredients DEET, picaridin or pyrethrin. To help reduce the chance of malnourishment and dehydration, which increase the risk of infection, he also recommends putting together a basic survival kit that includes nonperishable food and water supplies.

“Tsunamis, hurricanes, floods and other emergency situations can aggravate existing dermatologic conditions such as eczema or psoriasis,” Dr. Bandino says. “When possible, take any medications for current skin conditions with you during an evacuation along with other basic first-aid supplies; this can greatly reduce the opportunity for a flare.”
“If you experience skin problems after exposure to floodwaters, see a board-certified dermatologist,” Dr. Bandino adds. “Dermatologists have unique training and expertise to provide an efficient diagnosis and effective treatment for the serious conditions that may arise after a flooding disaster.”


More Information
F069 - Skin-Environmental Interface: Dermatologic Challenges of Our Changing Climate and Environment

About the AAD
Headquartered in Rosemont, Ill., the American Academy of Dermatology, founded in 1938, is the largest, most influential and most representative of all dermatologic associations. With a membership of more than 20,000 physicians worldwide, the AAD is committed to advancing the diagnosis and medical, surgical and cosmetic treatment of the skin, hair and nails; advocating high standards in clinical practice, education and research in dermatology; and supporting and enhancing patient care for a lifetime of healthier skin, hair and nails. For more information, contact the AAD at (888) 462-DERM (3376) or Follow the AAD on Facebook (American Academy of Dermatology), Twitter (@AADskin), Instagram (@AADskin1) and YouTube (AcademyofDermatology).

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