Management of Small, Painful Red Bumps from Rafting
For small, painful red bumps caused by paddling in rafting without fluid, apply a bland emollient such as 50% white soft paraffin and 50% liquid paraffin to support barrier function, reduce water loss, and encourage healing. 1
Initial Assessment and Care
- The small, painful red bumps are likely friction-related lesions from repetitive paddling motion during rafting 2
- Gently cleanse the affected areas with an antimicrobial solution to prevent infection 1
- After cleansing, apply a bland emollient to support barrier function and encourage re-epithelialization 1
- For painful areas, consider covering with a low-adhesion dressing such as Mepitel or Atrauman held in place with soft elasticated viscose 1
Treatment Options
For Non-Infected Lesions:
- Apply a bland emollient (50% white soft paraffin and 50% liquid paraffin) to the affected areas 1-3 times daily 1
- For adults and children over 2 years: apply a small amount (equal to the surface area of a fingertip) to the affected area 1-3 times daily 3
- Consider covering with a sterile bandage if the area is subject to continued friction 3
If Signs of Infection Develop:
- Watch for increased redness, warmth, swelling, or purulent drainage 1
- Daily washing with an antibacterial product can decrease colonization 1
- For infected lesions, bacterial swabs should be taken before starting antimicrobial therapy 1
- Topical antimicrobials may be appropriate for short periods 1
- Systemic antibiotics should be used if there are local or systemic signs of infection 1
Prevention Strategies
- Ensure proper paddling technique to minimize friction 2
- Consider wearing appropriate protective clothing during future rafting activities 4
- Apply emollients before activities to reduce friction 1
- Ensure thorough drying of affected areas after water exposure 1
Special Considerations
If lesions persist or worsen despite treatment, consider alternative diagnoses such as:
For persistent lesions, especially those that develop granulomatous appearance after water exposure, consider atypical infections like Mycobacterium marinum which require specific cultures and prolonged antimicrobial treatment 7
Pain Management
- Pain control is essential for comfort and function 1
- Consider appropriate analgesia prior to any painful procedures like dressing changes 1
- For significant pain, address both acute and background pain with appropriate analgesics 1
Remember that most friction-related skin lesions will heal with proper care and time. If lesions worsen, spread, or don't improve within a week, medical evaluation is recommended to rule out infection or other conditions.