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  • Nicole Noles Collins

Suggested safety guidelines for Florida beachgoers who get acupuncture during red tide outbreaks

Several cases of necrotizing fasciitis, also known as flesh-eating bacteria, have been spiking in different areas of Florida for several weeks. One of the most recent cases was a man who had a steroid injection in his back in the days before his beach visit (read more here).

Because of my background as a massage therapist, I had already been telling my patients for years that I prefer them to schedule massages before acupuncture, because it does leave tiny holes in the skin temporarily. Several months ago I had updated my post-acupuncture instructions to also include no swimming. Even though needles used for steroid injections are bigger than acupuncture needles, the same theory still applies. Any piercing of the skin will leave a tiny hole temporarily, so swimming in our Florida waters should be avoided if you have ANY break in the skin. And if you cut or scrape yourself while at the beach, that is a good reason to leave right away and go home to clean it out and apply Neosporin ASAP and continue to monitor the site.

How long should I wait to go back in the water?

Right now, I'm scheduling acupuncture patients two days before planned beach activities so that there is 48 hours to heal the skin. If you are slow to heal, you may want to plan on waiting longer before you go back in the water.

Who should avoid the beach right now?

Because I have an autoimmune disorder, pyoderma faciale (a severe form of rosacea), it's been four years since I went to a beach. Here are my personal recommendations for my acupuncture patients who may want to consider avoiding the beach at this time. As always, consult your acupuncturist and health care team before deciding for yourself what is appropriate for you.

• Diabetics, especially if you use a lancet to check your blood sugar and/or get insulin injections.

• Anyone with neuropathy, lymphedema, cellulitis, cuts, bites, bruises, chronic skin conditions, acne, rash, etc.

• Anyone who has had an injection in the past three days to a week. If you recently got a piercing or tattoo, follow the care guidelines you were given.

• Anyone with autoimmune disorders, even if their skin is intact.

Is this excessively conservative? It's possible. But now that there has been one suspected case of flesh eating bacteria from an injection site, it's better to be a little more careful today to avoid a nasty complication later. Hopefully, these recommendations won't be needed for very long.

What can you do to help?

Our water quality is something that can't be left to chance or someone else to monitor anymore. Please consider helping out by:

• Picking up litter in and around water, if you can do it safely. Ditto for on land.

• Volunteer with or donate to, Keep Charlotte Beautiful, Florida Coastal Conservancy, Greater Charlotte Harbor Sierra Club, or other organizations that advocate for the environment. They're helping protect your water quality!

• Reduce your use of fertilizers.

• Be mindful of what you flush in the toilet or pour down drains! That includes medicines too. Flushing is not the right way to dispose of your medications or other items.

• Educate yourself on water quality issues in your area. Write your elected officials and tell them how important it is for your health and our economic security. We depend on clean beaches and harbors to attract tourists and we depend on clean water for our health.

Clean water is not a luxury, and ignoring water quality issues won't solve it, either. But with teamwork from local grass-root efforts up to local, state and federal government levels, we can help reverse this trend and clean up our waterways and beaches so we can all go back in the water safely.

Be mindful of your health status when deciding to go to the beach during red tide outbreaks, and keep an eye on your skin when you're there as well as after you get home.

Nicole Noles Collins is a licensed acupuncture physician at Vitalichi Acupuncture. Nicole has two bachelor’s degrees – Alternative Medicine and Professional Health Sciences – as well as a master’s degree in Traditional Chinese Medicine. She has a passion for both writing and natural health. Please visit her website at and like her Facebook page at Vitalichi Acupuncture. For more information, call 941-979-9793.

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