first Aid & injuries center

Coral Cuts

What Is Coral? What Are Coral Cuts?

  • Coral is the hard calcareous outer skeleton (exoskeleton) secreted by many types of marine polyps.
  • The exoskeletons can be very sharp and colorful. Coral reefs are composed of a many different types of polyps that have calcified outer skeletons; reefs can extend for miles and are a favorite place for people to snorkel or scuba dive.
  • Coral formations occur in tropical and subtropical waters. Because coral formations are rigid and sharp, injury can occur after accidental contact, leaving a small amount of animal protein and calcareous material in the wound.
  • The small, harmless-appearing cut may quickly develop into an infected wound.
  • Some corals contain nematocysts (an organ in some marine animals consisting of a minute capsule containing an ejectable thread that causes a sting), which can produce a more significant injury.
  • Occasionally, a cut or abrasion from the coral will expose the open skin to other pathogens that may be floating in the water (for example, Vibrio ssp).

What Are Signs and Symptoms of Coral Cuts?

  • The inflamed, swollen, red, tender and sometimes itchy wound may develop into a festering sore or ulcer with a pustular (infectious) drainage.
  • Spreading redness of the skin around the wounded area suggests expanding infection (cellulitis) and requires immediate medical attention.
  • Red streaks moving up an extremity, especially with pus draining, or a blister more than 3/16 of an inch (5mm) in diameter (bullae) forms requires immediate medical attention.

What Are Treatments for Coral Cuts?

  • Scrub with soap and water and then flush with fresh water as soon as possible after contact with the coral.
  • If the wound stings, rinse it with acetic acid (vinegar) or isopropyl alcohol (this action may reduce the effect of any irritating toxins such as those produced by fire coral).
  • Flush the wound or abrasion with a mixture of 1/2 water and 1/2 hydrogen peroxide to remove coral dust and then flush with fresh water for most non-stinging coral cuts or abrasions.
  • Rinse daily and apply an antibiotic such as bacitracin (Baci-IM) or similar topical ointment three to four times per day.
  • Oral antibiotics are usually recommended to prevent infection. If an infection develops, continue taking the antibiotic for at least 5 days after all signs of the infection have resolved. Notify the doctor of any medication allergies the patient has prior to starting an antibiotic. Some antibiotics (for example, tetracyclines) can cause increased sensitivity to the sun (photosensitivity), thus it is recommended to use a sunscreen of at least SPF 15 if the area is going to be exposed to sunlight. If a wound develops pus, seek medical treatment.
  • If no evidence of infection or open wound is present, an over-the-counter steroid ointment may be used to relieve itching for a short period of time (a few days).
  • Pain may be relieved with one to two acetaminophen (Tylenol) every 4 hours and/or one to two ibuprofen (Motrin, Advil) every 6-8 hours. Do not exceed 3 grams of acetaminophen over a 24-hour time period. Some health care professionals prefer to use naproxen (Aleve) for pain relief.
  • Patients that are alcoholics have a tendency to develop bacterial infections by Vibrio spp that can be very aggressive and dangerous (life-threatening) in a short time span. Any redness of skin that progresses rapidly with blisters moving up an extremity (arms or legs) toward the body should be considered a medical emergency, and will require IV antibiotics.

When to Seek Medical Care for Coral Cuts

  • Seek medical treatment in cases of severe cuts or infection, or if a wound is not healing or is not healing and becoming larger.
  • A doctor should be consulted about treatment with available medications. Occasionally, long-term infections may develop (for example, fish handler's disease).
  • Rapid progression of a red blister-producing infection, especially if a person is an alcoholic, is a medical emergency.

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References
DiversAlertNetwork.org. Coral Cuts, Scrapes, and Rashes.

Trizna, Z., et al. "Cutaneous Manifestations Following Exposures to Marine Life." Medscape. Jan. 12, 2018. <https://emedicine.medscape.com/article/1089144-overview>.