Using the Selfie as a Telemedical Tool

isolated hand holding smartphone or phone


Telemedicine is sometimes the only alternative for injured diver in remote areas. One common diving injury for which the selfie may be particularly useful is cutaneous decompression sickness (skin bends). In most cases, skin rash is not associated with any symptoms that would compel divers to seek medical attention, and skin bends can be confused with allergies, bruising, hazardous marine life injuries and other conditions. If divers call medical assistance, they will most likely be told that a skin rash could not be diagnosed at a distance and that they should visit a medical facility. Sometimes people will visit a doctor; other times their symptoms may spontaneously resolve before they arrive at the medical facility, in which case the diagnosis remains unknown.

Amazingly, while skin bends represent a common manifestation of DCS, we at DAN have a very limited collection of skin DCS photos. We propose that divers use their smartphones and digital cameras to document their skin rashes and send or bring the photos to their doctors for evaluation.

The reason why there are so few photos of skin bends is probably because skin rash is difficult to photograph, so we asked our expert photographer, Stephen Frink, for advice. Here are his suggestions:

“As for photographing skin bends with a smartphone, the best policy is to move the patient into an outdoor shaded area. Harsh sunlight might make contrast difficult, and photos taken inside with flash aren’t so great. The shaded area of a dive deck would be good. Just make sure there is no bright light in the background, as that might fool the camera. Uniform light in the shaded area during the daylight is probably best shooting condition”

If you have any skin change after dive, please take a shot of it, send it to DAN and call our emergency line (+1-919-684-9111) to report it and ask for help.


Post written by: Petar Denoble, MD, D.Sc.


  1. I had skin bends after a dive in Turks and Caicos. It was my 4th day of diving and I exhibited the skin bends about an hour after my 2nd dive after I was off the boat and resting on the beach. Both my dives were within limits that day and I did 5 minute safety stops. I felt fine leaving the boat but within 30-45 minutes I felt generally fatigued, a little warm, and my shoulders ached and it was later that a rash appeared on my torso and back. It looked like giant hives. DCS occurred to me but denial is a strong reaction and until I reviewed my DAN pamphlet did I realize what I was experiencing. I did not seek any medical attention as the symptoms resolved to only a rash for a few hours but if this ever occurs again I certainly will.

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