Stung Divers: Skip the Vinegar, Use Hot Water

In the “Sea Lice Season” article from our April issue, we recommended divers feeling the burn of sea lice should immediately apply a mix of alcohol and vinegar, followed by hydrocortisone cream, to reduce the pain. Subscriber and emergency physician Ted Shieh, M.D. (Chicago, IL) wrote in to say medical experts have changed these recommendations and the consensus now is immediate water immersion.

“Treatment of exposure to thimble jellyfish larvae is the same as stings from jellyfish, fire corals, sea urchins, anemones and fish -- soak or rinse the affected areas in a warm-water bath or shower with the temperature as hot as tolerable, usually 112 to 120 degrees Fahrenheit,” says Shieh. “The treatment should continue until painful symptoms subside, up to 90 minutes, although 10 minutes of a warm shower or soak is adequate for most stings. Having been stung by numerous sea jellies and sea lice, I can attest to the effectiveness of a hot shower.”

The rationale: Because most marine animals’ toxins can be destroyed by heat, hot water can destroy the venom both inside and outside the skin. “Vinegar can only neutralize stings that didn’t penetrate the skin, but it can be used only if it’s immediately available and prior to a hot-water dousing. Just in case hot water is not available after a dive, consider packing a heating pad, the squeeze-and-shake kind, to put over the exposed area.”

As for treating allergic skin reactions, Shieh recommends a non-sedating antihistamine like Zyrtec or Claritin (loratadine), and a steroid cream such as hydrocortisone. “And of course, I certainly agree that when stings go beyond mild to moderate symptoms, it’s time to call a physician -- or invite one on your next dive trip.”