Sting-relief research touts vinegar’s effect

Vinegar and hot water really do work on jellyfish stings, according to University of Hawaii-Manoa researchers, while a popular home remedy — urinating on them — is no better than splashing on seawater.

What’s more, neither ice nor cool fresh water alleviate the pain of jellyfish stings — and might even make the problem worse.

Those conclusions come from the researchers who published a study in the journal Toxins this week. The study outlines an array of experiments designed to test the effectiveness of jellyfish sting treatments.

Box jellyfish are among nature’s deadliest creatures and are said to be responsible for more deaths each year than sharks.

Despite the danger posed by these creatures, plenty of confusion still remains about the best way to treat jellyfish stings.

Angel Yana­gihara, lead author of the paper, said Tuesday that the constant bombardment of authoritative — yet inaccurate — Internet articles led to the study. Some credible health websites even recommend a preposterous treatment using an ID card and shaving cream.

“It’s like an echo chamber out there,” she said. “Once it gets out there on the interwebs, they just seem to repeat each other.”

Yanagihara, assistant research professor at UH’s Pacific Biosciences Research Center and John A. Burns School of Medicine, said she fears that emergency responders and public-health decision-makers might rely on these unscientific articles.

In Hawaii, box jellyfish are known to come into leeward and southern shores with the tide at night some eight to 10 days after a full moon.

Yanagihara began studying the problem nearly two decades ago, after she got stung badly by a swarm of box jellyfish during a swim off Waikiki.

At the time, Yanagihara had just finished her UH doctoral degree in biochemistry and was unaware of the jellyfish danger. What followed was three days of bedridden agony.

One thing led to another, and the woman ended up devoting much of her academic career to studying the problem.

“It’s a huge issue,” she said, adding that box jellyfish are known to cause 100 deaths a year around the world.

Yanagihara — with help from Christie Wilcox, a postdoctoral fellow at UH’s school of medicine — devised a unique set of experiments that allowed testing of first-aid measures without putting anyone at risk from the potentially life-threatening box jellyfish venom.

The results from the study show that traditional methods such as vinegar and hot water immersion really are effective against the stings of Hawaiian box jellyfish, or Alatina alata.

“Vinegar, we’ve found, is an absolute, robust and solid, reproducible way to inactivate tentacles and the stinging cells that have been discharged but are left on the skin. So we recommend that as a first course — douse the area with vinegar,” Yanagihara said.

Vinegar has been the top treatment for removing jellyfish tentacles for at least 40 years. Some areas even provide vinegar stations at the beach, Wilcox said.

Hot water works well on jellyfish stings, as well, as it significantly reduces hemolysis, the destruction of red blood cells at the wound. Wilcox advises running the hottest water you can stand for 20 or 30 minutes.

The study also confirmed the effectiveness of Sting No More, a therapeutic ointment and rinse developed by Yanagihara with Department of Defense funding.

Sting No More, which contains vinegar and copper gluconate, inhibits the venom directly and is now being used to treat stings suffered by combat divers with the U.S. Special Operations Command.

Following years of research, the product was released last year to the public in both a rinse solution spray and a treatment cream. It is now is available at the Hanauma Bay gift shop, some dive shops, a few other retailers and online at stingnomore.com.

Ice is not recommended, Wilcox said. It might numb the sting, but you will feel just as bad afterward and maybe worse if the ice scrapes the skin and activates undischarged venom cells.

“People think ice will help because jelly stings burn and ice is cold,” Wilcox said. “But research to date has shown that all marine venoms are highly heat-sensitive. Dozens of studies, including our recent work, have shown that hot water immersion leads to better outcomes than ice.”

A few over-the-counter products were found to be ineffective as well, she added. Lidocaine, ethanol and isopropanol were product ingredients found to be ineffective, according to the study.

While this study tested first-aid measures only against the Hawaiian box jellyfish, the researchers said they would continue experimenting to see how treatments work on stings caused by other common Hawaiian species, including the Portuguese man-of-war, the jellyfish that washes up on windward shores when the wind is strong.

Wilcox said the field has suffered from a lack of standardized, rigorous and reproducible models, and she hopes the new experimental models in the study will lead to better testing of first-aid measures across the globe.