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Over-the-counter topical Novocaine (The strongest level you can find) Topical Lidocaine (It’s a version of what dentists use to numb your mouth) An 11-blade scalpel set Some steri-strips, which are taped, make-shift sutures (An adhesive to hold together a wound after an incision) A pair of tweezers One or two oral antibiotics you can pick up at the pharmacy. I would recommend Ciprofloxacin or Doxycycline, which are two good, broad-spectrum antibiotics, and are specifically good for aquatic-related infections. Over-the-counter Benadryl Over-the-counter cortisone cream. I’d get the highest-level prescription you can. I would apply those topically like a lotion to all the areas that are chafed, injured or irritated. A Medrol Dosepack, or a short course of steroids 800-mg of Motrin or Tylenol
Reef rash and Dermatitis in the chest, the armpits, and the inner thighs bother a lot of travelers when they’re on a trip. The volume of surfing goes up 500% from what they’re used to back home, then they’re down and out on day three because the chafing is too painful.
Apply any kind of body glide, like a topical cream. Be resourceful: Cyrus Sutton spoke about using coconut oil on his face when it was really cold. That’s a great idea as an easy-access body glide that you put on high-friction areas of your body. The over-the-counter stuff, like the cortisone cream and Benadryl, can be helpful for the itching and the inflammation. On a recent trip to Nicaragua, when the chafing got bad, I would give some of the guys short courses of steroids, and that seemed to help them in about a day. You could go to your primary care doctor before your trip and get a medrol dosepack, if you need it.
While surfing in Sri Lanka a while ago, I washed up onto a reef and got a small piece stuck in my hand. Back on the beach, I made the mistake of attempting to remove the reef with a dull safety pin. I started myself on strong antibiotics, but I still developed a serious hand infection. Eventually, I had to see a physician in Sri Lanka and convince him to slice my hand open to remove the piece of reef and irrigate it. I was close to losing my fingers.
Reef injuries are a big deal, especially as we start going out further into the wilderness and seeking out places where there is not immediate medical care or access, and we’re out in the jungle for long periods of time. If you get an organic foreign body like a piece of coral stuck in your hand or foot, the likelihood of it getting infected and it progressing quickly is quite high.
The most important thing to prevent severe infections is to remove the foreign body. While it’s challenging for many people to inject a local anesthetic (lidocaine) into the skin via a needle, topical lidocaine ointment is an alternative. Take a strong formulation of lidocaine cream and apply to the area. Allow 20 minutes to numb the area. Once the area is numb, carefully open the skin with small incisions using an over-the-counter scalpel, a clean razor blade, or another sharp, sterile instrument (like removing a splinter). Make sure the instrument is clean.
Once the incision is made and the foreign body is removed, the area should be very heavily irrigated with water, or the ocean. As we say, the enemy of pollution is dilution. Finally, apply some kind of antiseptic: alcohol, hydrogen peroxide, or soap and water. Leave the wound open to allow ongoing draining, which will help to prevent infection. Try to keep the wound open and irrigate it or clean it twice daily. If you are surfing all day, this frequency is good enough.
