How to Treat Jellyfish Stings

The water is warm and it’s jellyfish season. And while there are lots of creative ideas out there about how to treat jellyfish stings, it’s worth focusing on the basic treatments that are actually proven and effective. And no, before you ask, peeing on a jellyfish sting doesn’t help.

Here is some important information from Dr Gary Payinda, SLSNZ Medical Director and Emergency Medicine Specialist.

Pluck and Heat

The first thing to do is remove any tentacles that remain on the person. If you have gloves, wear them. But if you don’t, do not worry, our jellyfish species are not deadly, and do not have stingers that are deep enough to penetrate the thick skin of the fingertips. Pluck off the tentacles by hand. Don’t scrape the skin with a credit card, as this actually makes the stinging cells discharge, and makes the pain worse. Just ‘pluck’.

And while it’s acceptable to flush the area with seawater, it’s more important to pluck and heat quickly. Don’t waste time. The one thing that the science is most clear about is to not flush or wash the sting with fresh water (or urine for that matter), as this will only cause the remaining stinging cells to discharge, again increasing the pain. The same thing goes for ice, alcohol, bicarbonate of soda, shaving cream, soda, lemon juice, soap, and numerous other things that have been tried through the years. Just ‘pluck and heat’.

Once the tentacles are quickly removed, heat the affected area to as warm as the patient can tolerate. Beware of too-hot water that might scald an infant, an elderly person, or anyone who cannot easily communicate. But if there are no issues, raise the temperature to as hot as the person can tolerate. You don’t need a thermometer, but just for reference, the ideal temperature will be around 40 to 45 degrees Celsius.

This can either come from a hot water tap, a bucket or chilly bin filled with warm water, or a hot shower. If none of these is available, you can use a chemical heat pack applied to the skin. Hot water immersion is the preferred method, though, for fastest pain relief. 

We still don’t know precisely how hot water eliminates jellyfish (and stingray) pain so effectively, but we do know it works, and works quickly. You can expect the pain to subside within minutes.

Once you ‘pluck and heat’, the pain will diminish. Continue hot water immersion for 20 minutes. You can then take a break, allow the skin to cool down, and repeat the hot water soak if needed. 

For most people, this is all the specialised treatment that will be needed. If pain is an issue, take paracetamol or ibuprofen, following the printed directions. 

And finally, keep an eye out for anaphylaxis in anyone who is stung, whether it’s a bee or a jellyfish. Anaphylaxis is a severe allergic reaction where a person develops multiple concerning symptoms often including a skin rash, and/or tightness in the chest, tongue swelling, or in the most severe cases an inability to breathe and collapse. 

If there are any signs of anaphylaxis, however minor, call an ambulance. If the patient has an Epi-pen, help them to use it. Encourage them not to delay, and not to “see if things are going to get better” on their own. If there are even mild airway issues, use that Epi-pen and call 111. Directions for Epi-pen use are printed on the back of the device.

You will probably never see a case this bad, but it’s worth knowing what to do even in a worst-case scenario. And now that you do know, share this info with a friend, so that the beach is a safer, more fun place for everyone. 

Happy swimming. Don’t forget: ‘pluck and heat’.