Bluebottle stings can be excruciating, though they're rarely dangerous. Fortunately, bluebottle sting treatment is simple (and no, you don't have to pee on them).
What Happens When a Bluebottle Stings You
Jellyfish stings occur when their tentacles come in contact with skin. This triggers the release of venom from millions of nematocytes (tiny stinging cells that cover the tentacles). Venom is injected by microscopic, barbed stingers resulting in an often painful sting.
- The severity of a sting will depend on how many stinging cells fire off venom, which in turn depends on how many tentacles contact the skin.
- The stinging cells remain potent and can still inject venom after the bluebottle is dead, so avoid touching or popping a beached bluebottle, even if it appears to be dead.
- They can also sting dogs, so be careful not to let your pooch play with bluebottles washed up on the beach.
Bluebottle Sting Symptoms
How do you know you've been stung by a bluebottle? The symptoms of a bluebottle sting include:
- Intense pain in the stung area that usually eases or stops after one to two hours
- Sores that develop on the area of skin that was in contact with the jellyfish tentacles; these may fade after a few days
- Redness or a rash on the stung area
A 2015 article in Australian Family Physician adds that jellyfish stings also occasionally lead to mild systemic symptoms, such as nausea, vomiting, and general malaise. Some people may develop blister-like skin lesions or keloid scarring.
Bluebottle Sting Treatment
Myths abound about how to treat bluebottle stings. If you're sure the person has been stung by a bluebottle jellyfish, here are the best practice guidelines for treating bluebottle stings.
Get Out of the Water
Have the person immediately get out of the water.
Remove any tentacles that remain on the skin, either using tweezers or by hand. You might feel more comfortable using gloves, but Surf Life Saving Australia's Beachsafe website notes that venom can't usually penetrate the thicker skin of your fingers. You should therefore be okay to remove tentacles by hand if you don't have tweezers and/or gloves.
Rinse the area that has been stung with seawater rather than freshwater. Washing with water helps to wash away any stinging cells that you can't see. But using freshwater will cause the stinging cells to sting again, whereas seawater doesn't.
Apply Hot Water
As soon as possible, apply hot water - ideally at a temperature of 42-45 °C - either by immersing the area in hot water, running it under a hot shower or applying a heat pack for 30-90 minutes (or until pain resolves).
Apply Cold Packs
If you can't immerse the area, or local pain isn't relieved after immersion, you can also apply cold packs or wrapped ice to the sting. This could be especially useful for children who might be burned by water over 40 °C.
Peeing on a Bluebottle Sting and Other Things Not to Do
Peeing on a bluebottle sting is sometimes suggested as a treatment, but that's not only gross, it also doesn't work! Other things you should not do if you or someone you know is stung by a bluebottle jellyfish include:
- Rubbing sand across the sting - this can create a rash around it
- Pouring soft drink over the sting - all this does is make the area sticky
- Pouring vinegar on the sting - while this is useful for stings from tropical jellyfish like the box jellyfish, vinegar can actually make bluebottle stings hurt more
When to Seek Medical Attention After a Bluebottle Jellyfish Sting
Bluebottles are responsible for most jellyfish stings in Australia but rarely lead to hospital presentations. However, it is possible, although highly unlikely, for a bluebottle sting to cause an anaphylactic reaction. This is a severe allergic reaction like some people experience after a wasp or bee sting. Anaphylactic shock can be life-threatening. You should call an ambulance immediately on 000 (triple zero) if the person who has been stung shows any signs of a severe reaction, such as breathing difficulties or distressing chest tightness.
- Organise urgent medical attention for anyone with a significant sting to the neck or face (including stings to the eyes) and for stings that cover large areas (for example, more than half of an arm or leg).
- If you're suffering from ongoing pain, itchiness or blistering at the sting site, it's also a good idea to see your doctor. They may prescribe a topical cream, such as cortisone cream, to reduce the local inflammation.
Treating Stings in Tropical Waters
If it's possible that the sting was from a more dangerous type of jellyfish, such as a major box jellyfish (Chironex fleckeri), or Irukandji jellyfish (Carukia barnesi), always call an ambulance. Both types of jellyfish produce very potent venom, have multiple long tentacles, and can induce the dangerous Irukandji syndrome. Irukandji and box jellyfish stings have caused deaths in Northern Australia.
Healthdirect advises that for box jellyfish stings or any sting with Irukandji-like symptoms (such as severe backache, abdominal pain, increased heart rate, sweating, anxiety, nausea and vomiting), you should:
- Call triple zero (000) for an ambulance first.
- Put plenty of vinegar on the jellyfish stings to stop any further firing of stinging cells.
- Remove tentacles from the skin carefully.
- Perform cardiopulmonary resuscitation (CPR) if the person's breathing or pulse begins to slow down.
The common bluebottle, or Portuguese Man o'War (Physalia utriculus), can be found in marine waters in the Indian and Pacific Oceans.
- Around Australia, it's more common to encounter bluebottles after strong north-easterly winds wash them onto exposed ocean beaches.
- Stings tend to happen when bluebottle swarms enter shallow coastal waters or wash up on the shoreline.
- Every year, approximately 10-30,000 Physalia stings are reported along Australia's east coast (they're particularly common at Sydney's beaches), and about 500 are reported in South and Western Australia. They occur more often in the summer months on the east coast and during autumn and winter in southern Western Australia.
- There have been no confirmed fatalities from bluebottle stings in the Southern Hemisphere, although there have been several from related bluebottle species in the Northern Hemisphere.
Look Out for Warning Signs to Help Avoid Bluebottle Stings
If you're heading to the beach, look out for marine stinger warning signs at patrolled sites, or ask a lifeguard whether any stingers have been spotted. And remember that while bluebottle jellyfish stings can be very painful, they are rarely dangerous. Follow the recommended guidelines for bluebottle sting treatment, and always seek advice from your health professional if you have any concerns.