How global travel is fueling a rise in skin diseases and what you can do to stay safe

International travel has increased rapidly in recent decades, with millions journeying each year to tropical and subtropical regions. Alongside the excitement of cultural discovery and adventure, however, comes an often-overlooked health challenge: skin diseases acquired abroad. According to medical data, dermatologic disorders rank as the third most common health problem among returning travellers, following gastrointestinal and respiratory illnesses. Many of these skin conditions, whether infectious or inflammatory, can lead to serious complications if misdiagnosed or untreated. Understanding how these disorders develop, the environments that facilitate their spread, and the importance of early clinical recognition is becoming an essential focus in modern travel medicine.









How travel and environment influence skin health



A study published in Author Manuscript highlights that the likelihood of developing dermatologic illness while travelling depends on multiple factors including the destination, duration of stay, underlying health, and activities undertaken. Tropical and subtropical regions, where insect vectors, parasites, and humid conditions thrive, pose particular risks. Travellers staying in rural or coastal areas, engaging in outdoor activities such as hiking, swimming, or walking barefoot, face increased exposure to infectious agents and environmental irritants.



The range of dermatologic processes observed in travellers is broad, encompassing both infectious and non-infectious causes. Infections are frequently linked to bacterial, viral, or parasitic organisms acquired through insect bites, contaminated water, or direct contact with infected surfaces. Non-infectious causes often result from environmental exposure, phototoxic reactions, or allergic responses to unfamiliar flora and fauna. The tropical climate’s combination of heat, humidity, and dense vegetation creates an ideal setting for microorganisms to proliferate, making preventive awareness as crucial as post-travel diagnosis.









Bacterial and viral infections: How pathogens affect the skin



Among bacterial infections, Staphylococcus aureus and Pseudomonas aeruginosa are commonly implicated in folliculitis, an inflammation of hair follicles often contracted through exposure to inadequately chlorinated freshwater sources such as jacuzzis or natural ponds. Travellers with minor wounds or insect bites are also vulnerable to cellulitis and abscesses caused by Aeromonas hydrophila, a bacterium prevalent in freshwater environments. More severe cases may involve Vibrio vulnificus or Mycobacterium marinum, capable of producing necrotising infections if not promptly treated.



Tick-borne bacterial illnesses present another diagnostic challenge. Rickettsia species, responsible for African tick bite fever and Mediterranean spotted fever, can cause distinctive skin lesions known as eschars, accompanied by fever and malaise. Similarly, Borrelia infections, including Lyme disease, produce erythema migrans, an expanding red rash that often signals early infection. Variants such as Borrelia afzelii and Borrelia garinii in Europe may also result in more chronic dermatologic manifestations like lymphocytoma cutis and acrodermatitis chronica atrophicans. Viral pathogens, including those responsible for dengue and Zika fever, commonly produce maculopapular rashes, offering key diagnostic clues for clinicians evaluating returned travellers with febrile illness.








Parasitic infections in tropical destinations: When the skin becomes a host



Cutaneous leishmaniasis is among the most frequently reported parasitic infections in travellers, transmitted by sandflies carrying Leishmania species. The disease typically presents as chronic, non-healing ulcers or nodular lesions that can persist for months. Depending on the species involved, the infection may assume various forms, from simple ulcers to verrucous or impetiginous eruptions. Although not life-threatening, untreated cutaneous leishmaniasis can cause significant scarring and tissue damage.



Equally concerning is cutaneous larva migrans, a parasitic skin disease often acquired by walking barefoot on contaminated beaches in tropical regions. The infection occurs when larvae from dog or cat hookworms penetrate the human epidermis, resulting in serpiginous, itchy tracks visible under the skin. Because humans are incidental hosts, the larvae cannot complete their development, causing prolonged inflammation and irritation along the migratory path. Treatment typically involves antiparasitic medication such as albendazole or ivermectin, which eliminates the larvae within days. However, delayed treatment can lead to secondary bacterial infections or persistent dermatitis.








Infestations and emerging dermatologic conditions: The complexity of myiasis and tungiasis



Myiasis, an infestation of human tissue by fly larvae, accounts for roughly 10 per cent of all travel-related dermatologic infections. It occurs predominantly among travellers returning from sub-Saharan Africa or South America but has been reported across continents where Diptera flies are present. The larvae penetrate healthy or broken skin, developing beneath the surface as they feed on host tissue. Two main types are recognised: furuncular myiasis, which resembles a boil with a central punctum, and migratory myiasis, where larvae move beneath the skin, leaving visible, winding tracks.



Patients often report pain, discharge, or a sensation of movement beneath the skin, which can be distressing but is also diagnostically distinctive. Management focuses on physically removing the larvae by suffocating them with occlusive substances that force emergence or through minor surgical extraction. While rarely fatal, untreated cases can result in secondary infections or prolonged inflammation. Tungiasis, caused by the sand flea Tunga penetrans, produces similar symptoms, particularly in those walking barefoot on sandy soil. The female flea burrows into the skin to lay eggs, often on the feet, causing swelling, ulceration, and potential bacterial superinfection if neglected.







Non-infectious skin reactions: When sunlight and sensitivity collide



Beyond microbial infections, travellers frequently experience non-infectious skin problems that stem from environmental and behavioural factors. Sunburn remains a leading cause of acute skin damage, particularly among those unaccustomed to high ultraviolet exposure near the equator. Conditions such as phytophotodermatitis arise from contact with plant-based photosensitising compounds followed by sun exposure, resulting in blistering or hyperpigmented streaks. Similarly, drug-induced phototoxicity can occur in individuals taking certain antibiotics or anti-inflammatory medications, producing heightened skin sensitivity to sunlight.



Heat rash (miliaria rubra) and prurigo nodularis, both linked to prolonged heat and humidity, also appear commonly in returning travellers. While not infectious, these conditions highlight the importance of acclimatisation and skin protection in tropical climates. Appropriate clothing, hydration, and adherence to preventive guidelines can substantially reduce dermatologic complications during travel, though awareness remains limited among the general public.













Disclaimer: This article is for informational purposes only and should not be considered medical advice. Please consult a healthcare professional before making any changes to your diet, medication, or lifestyle.











Also Read | How an afternoon nap benefits you more than you can ever imagine