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Marine Stings and Scrapes

Overview

Walking on a beach or swimming in the ocean can be fun and relaxing. But just like with any other activities, accidents can happen. This topic gives an overview of jellyfish and Portuguese man-of-war stings, seabather's eruption, and coral scrapes.

Stings

Jellyfish and Portuguese man-of-wars are members of a large group of venomous marine animals that also includes fire coral and sea anemones. They can be found all over the world. They cause injury and illness through the release of venom when their tentacles come in contact with skin (stinging). Tentacles are long, slender, flexible growths found on jellyfish, Portuguese man-of-wars, squid, and octopuses. Tentacles are used for grasping, feeling, moving, and killing prey by stinging. While the sting of a jellyfish or Portuguese man-of-war can cause severe illness and extreme pain, documented deaths are rare.

Jellyfish are often found in coastal waters, having been brought ashore by winds or ocean currents. They are most common in warm ocean waters, especially along the Atlantic coast of the United States. Stings result from contact with the tentacles, which trail from the jellyfish's see-through body. It's often hard to see jellyfish swimming in the water. Beached jellyfish, which may look like a clear plastic wrapper, can sting if touched.

Jellyfish stings cause intense pain and burning right away. The pain can last for several hours. Raised, red welts form along the site of the sting. It may look like you've been hit with a whip. The welts may last for 1 to 2 weeks, and itchy skin rashes may appear 1 to 4 weeks after the sting.

Most jellyfish stings aren't severe. Extensive stings, allergic reactions, and severe reactions aren't common, but they do occur. To avoid the risk of drowning, swimmers should get out of the water as soon as they realize they've been stung.

The box jellyfish, which is found in the Indian Ocean and South Pacific, can cause a fatal reaction. It is the only jellyfish for which a specific antidote (antivenom) exists. If you get this antivenom, it may save your life.

Seabather's eruption is a rash from the stings of jellyfish or sea anemone larvae. The rash can be quite itchy and annoying. But it usually goes away without medical treatment in 10 to 14 days.

Portuguese man-of-wars (hydrozoans) live in warm seas throughout the world but are most common in the tropical and subtropical regions of the Pacific and Indian oceans and in the Gulf Stream of the North Atlantic Ocean. They float on the surface of the water with their long, stinging tentacles trailing in the water below. Detached tentacles that wash up on the beach may remain dangerous for months.

Portuguese man-of-war stings produce immediate burning pain and redness where the tentacles touched the skin. The affected area develops a red line with small white lesions. In severe cases, blisters and welts that look like a string of beads may appear. Stings that involve the eye may cause pain, swelling, excessive tears, blurred vision, or increased sensitivity to light. Severe reactions are most likely to occur in children and small adults. Severe toxic reactions to the venom can also occur.

Stingrays are members of the shark family. They have sharp spines in their tails that can cause cuts or puncture wounds. The spines also have venom. Stingrays don't bite, but they can suck with their mouths and leave a bruise.

Coral scrapes

Coral scrapes and cuts are common injuries that may occur when you walk on a beach or swim, snorkel, or dive in warm water. Coral polyps, the soft living material that covers the surface of coral, can be easily torn away from the rigid and abrasive structure underneath if you touch, bump, or fall on coral. You may get a skin infection if small pieces of coral, other debris, and bacteria get inside the wound. Scrapes and cuts from sharp-edged coral may take weeks or even months to heal.

Check Your Symptoms

Did you get a sting or scrape while swimming in the ocean or walking on the beach?
This could include a sting from a marine creature, such as a jellyfish or Portuguese man-of-war, or a coral scrape.
Yes
Marine sting or scrape
No
Marine sting or scrape
How old are you?
Less than 12 years
Less than 12 years
12 years or older
12 years or older
Are you male or female?
Male
Male
Female
Female

The medical assessment of symptoms is based on the body parts you have.

  • If you are transgender or nonbinary, choose the sex that matches the body parts (such as ovaries, testes, prostate, breasts, penis, or vagina) you now have in the area where you are having symptoms.
  • If your symptoms aren’t related to those organs, you can choose the gender you identify with.
  • If you have some organs of both sexes, you may need to go through this triage tool twice (once as "male" and once as "female"). This will make sure that the tool asks the right questions for you.
Could you be having a severe allergic reaction?
This is more likely if you have had a bad reaction to something in the past.
Yes
Possible severe allergic reaction (anaphylaxis)
No
Possible severe allergic reaction (anaphylaxis)
Do you have symptoms of shock?
Yes
Symptoms of shock
No
Symptoms of shock
Are you having trouble breathing (more than a stuffy nose)?
Yes
Difficulty breathing more than a stuffy nose
No
Difficulty breathing more than a stuffy nose
Have you had a seizure?
Yes
Seizure
No
Seizure
Have you lost the ability to move part of your body?
Yes
Loss of movement in part of body
No
Loss of movement in part of body
Have you been stung in the eye?
Yes
Stung in eye
No
Stung in eye
Are you having eye or vision problems?
Yes
Eye or vision problems
No
Eye or vision problems
Is there any pain?
Yes
Pain
No
Pain
How bad is the pain on a scale of 0 to 10, if 0 is no pain and 10 is the worst pain you can imagine?
8 to 10: Severe pain
Severe pain
5 to 7: Moderate pain
Moderate pain
1 to 4: Mild pain
Mild pain
Has the pain lasted for more than 8 hours?
Yes
Pain for more than 8 hours
No
Pain for more than 8 hours
Is the pain getting worse?
Yes
Pain is getting worse
No
Pain is getting worse
Do you feel very sleepy or weak all over, or are you having trouble standing or walking?
Yes
Very sleepy or weak all over or having trouble standing or walking
No
Very sleepy or weak all over or having trouble standing or walking
Do you have severe, rapid swelling near the wound?
Yes
Severe, rapid swelling near the wound
No
Severe, rapid swelling near the wound
Do you think you may have a fever?
Yes
Possible fever
No
Possible fever
Are you having other symptoms of a serious reaction to a sting?
These could include symptoms such as nausea, vomiting, headache, dizziness, body aches, or muscle spasms.
Yes
Symptoms of serious reaction to jellyfish or Portuguese man-of-war sting
No
Symptoms of serious reaction to jellyfish or Portuguese man-of-war sting
Are there any symptoms of infection?
Yes
Symptoms of infection
No
Symptoms of infection
Are there red streaks leading away from the area or pus draining from it?
Yes
Red streaks or pus
No
Red streaks or pus
Do you have diabetes, a weakened immune system, peripheral arterial disease, or any surgical hardware in the area?
"Hardware" includes things like artificial joints, plates or screws, catheters, and medicine pumps.
Yes
Diabetes, immune problems, peripheral arterial disease, or surgical hardware in affected area
No
Diabetes, immune problems, peripheral arterial disease, or surgical hardware in affected area
Do you have an itchy rash?
Yes
Itchy rash
No
Itchy rash
Is the itching severe?
Severe means that you are scratching so hard that your skin is cut or bleeding.
Yes
Severe itching
No
Severe itching
Has the itching interfered with sleeping or normal activities for more than 2 days?
Yes
Itching has disrupted sleep or normal activities for more than 2 days
No
Itching has disrupted sleep or normal activities for more than 2 days
Do you think you may need a tetanus shot?
Yes
May need tetanus shot
No
May need tetanus shot
Have you had symptoms for more than a week after the sting or scrape?
Yes
Symptoms for more than 1 week after sting or scrape
No
Symptoms for more than 1 week after sting or scrape

Many things can affect how your body responds to a symptom and what kind of care you may need. These include:

  • Your age. Babies and older adults tend to get sicker quicker.
  • Your overall health. If you have a condition such as diabetes, HIV, cancer, or heart disease, you may need to pay closer attention to certain symptoms and seek care sooner.
  • Medicines you take. Certain medicines, such as blood thinners (anticoagulants), medicines that suppress the immune system like steroids or chemotherapy, herbal remedies, or supplements can cause symptoms or make them worse.
  • Recent health events, such as surgery or injury. These kinds of events can cause symptoms afterwards or make them more serious.
  • Your health habits and lifestyle, such as eating and exercise habits, smoking, alcohol or drug use, sexual history, and travel.

Try Home Treatment

You have answered all the questions. Based on your answers, you may be able to take care of this problem at home.

  • Try home treatment to relieve the symptoms.
  • Call your doctor if symptoms get worse or you have any concerns (for example, if symptoms are not getting better as you would expect). You may need care sooner.

Pain in adults and older children

  • Severe pain (8 to 10): The pain is so bad that you can't stand it for more than a few hours, can't sleep, and can't do anything else except focus on the pain.
  • Moderate pain (5 to 7): The pain is bad enough to disrupt your normal activities and your sleep, but you can tolerate it for hours or days. Moderate can also mean pain that comes and goes even if it's severe when it's there.
  • Mild pain (1 to 4): You notice the pain, but it is not bad enough to disrupt your sleep or activities.

Pain in children under 3 years

It can be hard to tell how much pain a baby or toddler is in.

  • Severe pain (8 to 10): The pain is so bad that the baby cannot sleep, cannot get comfortable, and cries constantly no matter what you do. The baby may kick, make fists, or grimace.
  • Moderate pain (5 to 7): The baby is very fussy, clings to you a lot, and may have trouble sleeping but responds when you try to comfort him or her.
  • Mild pain (1 to 4): The baby is a little fussy and clings to you a little but responds when you try to comfort him or her.

Symptoms of infection may include:

  • Increased pain, swelling, warmth, or redness in or around the area.
  • Red streaks leading from the area.
  • Pus draining from the area.
  • A fever.

Symptoms of difficulty breathing can range from mild to severe. For example:

  • You may feel a little out of breath but still be able to talk (mild difficulty breathing), or you may be so out of breath that you cannot talk at all (severe difficulty breathing).
  • It may be getting hard to breathe with activity (mild difficulty breathing), or you may have to work very hard to breathe even when you’re at rest (severe difficulty breathing).

Symptoms of a severe allergic reaction (anaphylaxis) may include:

  • The sudden appearance of raised, red areas (hives) all over the body.
  • Rapid swelling of the throat, mouth, or tongue.
  • Trouble breathing.
  • Passing out (losing consciousness). Or you may feel very lightheaded or suddenly feel weak, confused, or restless.

A severe reaction can be life-threatening. If you have had a bad allergic reaction to a substance before and are exposed to it again, treat any symptoms as an emergency. Even if the symptoms are mild at first, they may quickly become very severe.

Certain health conditions and medicines weaken the immune system's ability to fight off infection and illness. Some examples in adults are:

  • Diseases such as diabetes, cancer, heart disease, and HIV/AIDS.
  • Long-term alcohol and drug problems.
  • Steroid medicines, which may be used to treat a variety of conditions.
  • Chemotherapy and radiation therapy for cancer.
  • Other medicines used to treat autoimmune disease.
  • Medicines taken after organ transplant.
  • Not having a spleen.

Usually found in dirt and soil, tetanus bacteria typically enter the body through a wound. Wounds may include a bite, a cut, a puncture, a burn, a scrape, insect bites, or any injury that may cause broken skin.

You may need a tetanus shot depending on how dirty the wound is and how long it has been since your last shot.

  • For a dirty wound that has things like dirt, saliva, or feces in it, you may need a shot if:
    • You haven't had a tetanus shot in the past 5 years.
    • You don't know when your last shot was.
  • For a clean wound, you may need a shot if:
    • You have not had a tetanus shot in the past 10 years.
    • You don't know when your last shot was.

Shock is a life-threatening condition that may quickly occur after a sudden illness or injury.

Adults and older children often have several symptoms of shock. These include:

  • Passing out (losing consciousness).
  • Feeling very dizzy or lightheaded, like you may pass out.
  • Feeling very weak or having trouble standing.
  • Not feeling alert or able to think clearly. You may be confused, restless, fearful, or unable to respond to questions.

Shock is a life-threatening condition that may occur quickly after a sudden illness or injury.

Babies and young children often have several symptoms of shock. These include:

  • Passing out (losing consciousness).
  • Being very sleepy or hard to wake up.
  • Not responding when being touched or talked to.
  • Breathing much faster than usual.
  • Acting confused. The child may not know where he or she is.

Call 911 Now

Based on your answers, you need emergency care.

Call 911 or other emergency services now.

Sometimes people don't want to call 911. They may think that their symptoms aren't serious or that they can just get someone else to drive them. Or they might be concerned about the cost. But based on your answers, the safest and quickest way for you to get the care you need is to call 911 for medical transport to the hospital.

Seek Care Today

Based on your answers, you may need care soon. The problem probably will not get better without medical care.

  • Call your doctor today to discuss the symptoms and arrange for care.
  • If you cannot reach your doctor or you don't have one, seek care today.
  • If it is evening, watch the symptoms and seek care in the morning.
  • If the symptoms get worse, seek care sooner.

Seek Care Now

Based on your answers, you may need care right away. The problem is likely to get worse without medical care.

  • Call your doctor now to discuss the symptoms and arrange for care.
  • If you cannot reach your doctor or you don't have one, seek care in the next hour.
  • You do not need to call an ambulance unless:
    • You cannot travel safely either by driving yourself or by having someone else drive you.
    • You are in an area where heavy traffic or other problems may slow you down.

Make an Appointment

Based on your answers, the problem may not improve without medical care.

  • Make an appointment to see your doctor in the next 1 to 2 weeks.
  • If appropriate, try home treatment while you are waiting for the appointment.
  • If symptoms get worse or you have any concerns, call your doctor. You may need care sooner.

Self-Care

Caring for a jellyfish or Portuguese man-of-war sting

Try these tips for caring for a sting from a jellyfish or Portuguese man-of-war.

  • Don't rub.
    • Do not rub the tentacles with your hands, a towel, sand, or clothing.
  • Numb the area, and wash.
    • If you have it, apply topical lidocaine to the sting area.
    • Use hot water on the area to help remove the nematocysts, the stinging part of the tentacle.
    • If hot water and lidocaine aren't available, remove the nematocysts and wash the area with salt water.
    • Don't use urine, gasoline, kerosene, or turpentine.
  • Use special care for eye stings.
    • Rinse eye stings with a saline solution, such as Artificial Tears.
    • Don't put vinegar, alcohol, or any other "stinger solution" in the eyes.
    • Dab the skin around the eye with a cloth soaked in vinegar. But be extremely careful to not get any of the solution in the eye.
  • Remove the tentacles carefully.
    • After decontamination, pick off tentacles with a stick or your hand protected by a towel or glove. Be very careful not to rub or press the tentacles.
    • If it's available, apply a lather of shaving cream or soap, or a paste of baking soda, flour, or talc to the skin. The stinging cells will stick to the shaving cream or paste. They can then be easily scraped off with a safety razor, a knife edge, or the edge of a credit card.
  • Use ice.
    • Using an ice pack can help relieve pain.
  • Try medicines to control the itching.
    • Take an antihistamine, such as a nondrowsy one like loratadine (Claritin) or one that might make you sleepy like diphenhydramine (Benadryl).
    • Apply 1% hydrocortisone cream to help control itching. You may need to check with your doctor first if you need to use the cream for a child younger than age 2 or for use in the genital area.

    These medicines may not be safe for young children or for people who have certain health problems. Before you use them, check the label. If you do use these medicines, always follow the directions about how much to use based on age and, in some cases, weight. You may need to check with your doctor about using these medicines.

If a sting leaves open sores, clean them 3 times a day. Apply a thin layer of petroleum jelly (such as Vaseline), and cover with a light bandage.

Caring for coral scrapes and cuts

Try these tips for caring for minor coral scrapes or cuts.

  • Wash the wound.
    • Clean the wound as soon as you can to reduce the risk of infection, scarring, and tattooing of the skin from coral material left in the wound.
    • Wash the wound for 5 minutes with a soft brush or towel and large amounts of warm water and soap (mild dishwashing soap, such as Ivory, works well).
    • After washing, rinse the wound with a large amount of fresh water.
    • After rinsing with fresh water, rinse the wound again with a solution of one-half hydrogen peroxide and one-half water.
    • After rinsing with a solution of one-half hydrogen peroxide and one-half water, rinse again with fresh water.
  • Stop bleeding with direct pressure to the wound.
  • Apply a nonstick bandage.
    • Cover the wound with a thin layer of petroleum jelly, such as Vaseline, and a nonstick bandage.
    • Apply more petroleum jelly and replace the bandage as needed.
    • Apply a clean bandage when it gets wet or soiled to further help prevent infection.
    • If a bandage is stuck to a scab, soak it in warm water to soften the scab and make the bandage easier to remove.
  • Watch for symptoms of a skin infection.

Be patient. Coral scrapes and cuts may take weeks and sometimes even months to heal completely.

Caring for seabather's eruption

Here are some self-care tips for seabather's eruption.

  • Prevent more stings.
    • Don't rub your skin. If larvae are on your skin, rubbing will cause them to sting.
    • Remove your swimsuit as soon as you can. Larvae can get trapped in the fabric of your suit. So it's important to remove a contaminated suit to prevent more stings.
  • Rinse with vinegar or rubbing alcohol.
    • If available, rinse your skin in household vinegar (5% acetic acid solution) or rubbing alcohol (40%–70% isopropyl alcohol).
  • Shower with fresh water.
    • Apply soap, and vigorously scrub your skin.
    • Don't shower with a contaminated suit on. If larvae are trapped in the fabric of a suit, a freshwater shower will cause the larvae to sting.
  • Use ice.
    • Using an ice pack can help relieve pain.
  • Try medicines to control the itching.
    • Take an antihistamine. Don't give antihistamines to your child unless you've checked with the doctor first.
    • Apply 1% hydrocortisone cream to help control itching. You may need to check with your doctor first if you need to use the cream for a child younger than age 2 or for use in the genital area.

    These medicines may not be safe for young children or for people who have certain health problems. Before you use them, check the label. If you do use these medicines, always follow the directions about how much to use based on age and, in some cases, weight. You may need to check with your doctor about using these medicines.

Wash the rash with clean water daily.

When to call for help during self-care

Call a doctor if any of the following occur during self-care at home:

  • New or worse trouble breathing.
  • New or worse swelling of the lips, tongue, or throat.
  • New or worse rash.
  • New or worse signs of infection. This may include redness, warmth, swelling, pus, or a fever.

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Credits

Current as of: March 9, 2022

Author: Healthwise Staff
Medical Review:
William H. Blahd Jr. MD, FACEP - Emergency Medicine
Adam Husney MD - Family Medicine
Kathleen Romito MD - Family Medicine
E. Gregory Thompson MD - Internal Medicine
David Messenger MD - Emergency Medicine, Critical Care Medicine

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