Marina del Rey Hospital

A day at the beach ends more often than you would think with someone hopping on one foot back to the towel. Buried in that soft, warm sand is an assortment of things you would rather not step on. Broken glass, a lost fish hook, a sharp shell, a bit of rusty metal, even a sea urchin spine near the rocks. Most of these leave nothing more than a startled yelp and a tiny mark. The trouble is that the tiny mark is exactly what makes a puncture wound worth respecting.

Here is the part most people have backwards. A puncture wound looks less serious than a scrape, but it often is not. A cut bleeds freely, which helps flush bacteria out. A puncture makes a small deep hole that seals over within an hour or two, trapping whatever came in with it in a warm space where bacteria are happy to grow. That is why a pinprick from a rusty hook can cause more trouble than a dramatic looking graze.

So what do you do if you step on something? Let it bleed for a moment, since that natural rinse works in your favor. Wash your hands, then run clean water over the wound for several minutes. Use a little mild soap around the opening, and lift away any surface debris with tweezers cleaned in alcohol. Skip the hydrogen peroxide, which does more to harm healing than help. Pat it dry, add a thin layer of antibiotic ointment, and cover it.

One firm rule: if something is deeply embedded, a piece of glass, a hook past the barb, a spine you cannot easily slide out, leave it in place and let a professional remove it. Digging around only pushes it deeper and does more damage.

It is worth getting checked when a wound was deep or dirty, when you cannot get it fully clean, when you stepped on something through a shoe, or when spreading redness, warmth, swelling or pus shows up over the next day or two. Tetanus matters here too, so if it has been more than five years since your last booster and the wound is dirty, you likely need one within a couple of days. Anyone with diabetes or reduced feeling in their feet should be quicker to seek care, since a small wound can turn serious before it is ever felt.

The easiest fix of all is a pair of water shoes or sandals. A few dollars of foot protection beats an afternoon in the ER, and it keeps the only things you bring home from the beach a good tan and the pleasantly tired kind of sore.

Rip currents are the most common hazard along our coast, and they can move faster than an Olympic swimmer. The hardest part is that your instinct, swimming straight back to shore, is the very thing that wears you out. The safer move is to stay calm and float, then work your way out sideways. Swipe through for the steps from the National Oceanic and Atmospheric Administration (NOAA) and the lifeguards who know these waters best, and remember the safest swim of all is the one near a lifeguard.