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How to treat jellyfish stings. Dr. Emily Altman, dermatologist NJ

Jellyfish (also known as jellies or sea jellies or Medusozoa, phylum Cnidaria) are free-swimming, non-aggressive, gelatinous marine animals surrounded by trailing tentacles. These tentacles are covered with thousands of tiny barbed stingers. These stingers contain sacs (nematocysts) that are filled with poison (venom) that can cause a painful to sometimes life-threatening sting. The marine animals included in the “family” are jellyfish, box jellyfish (sea wasps), Portuguese man-of-war, hydroids, anemones, and fire coral. Jellyfish are found throughout the world. But, the most deadly are found in the Indo-Pacific and Australian waters.

Jellyfish image

Jellyfish

Box jellyfish

Box Jellyfish

Jellyfish are usually found near the surface of the water during times of diminished light or after washing up on the beach. Jellyfish stings range from mild to severe. Some types of jellyfish are harmless to humans, while others are very poisonous and can cause severe pain and irritation. Most jellyfish stings get better with home treatment, but some types of jellyfish stings can be more severe and require medical treatment. In rare cases, jellyfish stings that are widespread or from certain species of jellyfish can be life-threatening.

Jellyfish sting from emedicinehealth.com

Jellyfish sting from emedicinehealth.com

Jellyfish sting image

Jellyfish sting from WebMD

Seabather’s eruption is an acute dermatitis, caused by cnidarian larvae, that begins a few hours after bathing in the waters along the coast of the Atlantic. It affects covered areas of the body as the larvae become trapped under the bathing suit and the nematocyst releases its toxin because of external pressure. Thus, the buttocks and waist are affected primarily, with the breast also involved in women. The rash is composed of extremely itchy, small red macules and papules that may develop pustules or vesicles. Hive-like (urticarial) lesions may also be present.

Jellyfish sting symptoms:

  • Immediate intense stinging or burning pain, itching, rash, blisters and raised welts.
  • Painful red marks or lines that develop after several minutes to several hours.
  • Throbbing pain that may radiate up a leg or arm to the torso
  • The progressive effects of a jellyfish sting may include nausea, vomiting, headache, diarrhea, lymph node swelling, abdominal pain, numbness/tingling, muscle spasms, weakness, trouble controlling muscle movement, dizziness and fever.
  • Severe reactions can also cause hives (urticaria), swelling of the lips of the lips, mouth and other soft tissues (angioedema)difficulty breathing, coma and death.
  • Severe symptoms can occur with widespread stings and are most common in children and older adults.
  • A sting from a box jellyfish or other venomous types of jellyfish can cause death in minutes.
  • Delayed and persistent lesions also rarely occur.
  • An infection of the soft tissues (cellulitis) and scarring may occur either from the wounds themselves or from scratching.

Treatment of jellyfish stings:
Most jellyfish stings can be treated with home remedies. Steps include:

  • Deactivating stingers. Wash off the sting area immediately with seawater to remove any remaining tentacles. Be sure to use seawater; using fresh water can discharge more of the nematocysts and cause more stings. Do not rub the area when washing. Pour the sea water over the area for 10-15 minutes.
  • Rinse the area with vinegar to inactivate stingers on the skin unless you suspect the sting was caused by a Chesapeake sea nettle or Pacific Physalia (bluebottle). Vinegar may release more stingers in this type of jellyfish.
  • Remove as many tentacles or stingers as possible by forceps, gloved fingers or by gentle scraping with a plastic object such as a credit card.
  • Make a paste of baking soda and seawater or use shaving cream to apply to the area, let dry and gently scrape with credit card to remove any more nematocysts. The shaving cream or paste prevents nematocysts that have not been activated from releasing their toxin during removal with the credit card.
  • Do not apply pressure dressings or bandages to the area as they may release more venom.
  • Eye stings should be rinsed with a commercial saline solution like artificial tears. Do not use vinegar or baking soda in the eyes.
  • Apply a topical steroid cream after all the stingers have been removed. Oral steroids, like prednisone may be necessary for more extensive or uncomfortable stings.
  • Take diphenhydramine (Benadryl) for itching or if there are hives present.
  • Take acetaminophen or ibuprofen for pain.
  • If the person continues to have itching, redness, pain, swelling of the
    skin around the sting, see a doctor.
  • If there is any swelling of the lips or mouth, if the area of the sting is large or if there is any difficulty breathing, go to the emergency room immediately. This is particularly true of children and the elderly.
  • If it has been longer than 10 years since the patient’s last tetanus vaccination, get a tetanus shot.
  • If you were stung by a box jellyfish, seek emergency care immediately. Their venom may be lethal.

Prevention of jellyfish stings:

  • Do not swim in jellyfish-infested waters. Jellyfish are usually found near the surface of the water during times of diminished light, floating in the water column, or after washing up on the beach. Jellyfish stings are generally
    accidental – from swimming or wading into a jellyfish or carelessly handling them. Some types of jellyfish have reproductive jelly gatherings 8 to 10 days after a full moon, thus there is an increase in the number of jellyfish found at that time.
  • Do not touch or pick up dead jellyfish, as they may still have live nematocysts that may release venom even after they have dried up.
  • Wear protective clothing (gloves, wet suits, dive skins) when you do swim in waters with jellyfish present.
  • Be prepared to treat a jellyfish sting, including a first aid kit (with diphenhydramine) and vinegar.
  • Learn what types of jellyfish are likely to be in the area where you are swimming.

References:

  1. http://www.emedicinehealth.com/j…
  2. http://www.mayoclinic.com/health…
  3. http://en.wikipedia.org/wiki/Box…
  4. http://en.wikipedia.org/wiki/Jel…
  5. James, William D et al. Andrews’ Diseases of Skin. Saunders 2011
  6. http://www.webmd.com/skin-proble…

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