Portuguese Man of War Sting First Aid

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Don't touch! But if you do...

Where I live there are two main types of jellyfish. There is a jellyfish we call a jellyball or cabbagehead jellyfish, which can't sting, so you could actually play catch with it. Then there is the Portuguese Man of War, which isn't really a jellyfish at all, but an animal that looks a lot like a jellyfish. The sting of the Man of War is painful and could even kill you, so I've had a vested interested in learning Man of War sting first aid.

Man of War Photo: NOAA

About the Portuguese Man of War 

The Portuguese Man of War is also called a Blue Bottle, Blue Bubble, or Man o War. The Portuguese Man of War (Physalia) can be found in any ocean when the water becomes warm. They are most often seen when strong winds have blown them near or onto the shore. These creatures are characterized by their blue, violet, or pink balloon-like float, which trails clusters of tentacles and polyps. The tentacles, which may extend 165 feet (~50 meters) in length, house the stinging nematocysts. The nematocysts sting upon contact. The man-of-war sting can cause a life-threatening reaction, although this is rare. More commonly, inappropriate first aid worsens the sting from what it would normally be. Many properly-treated stings resolve on their own, sometimes as quickly as 15-20 minutes. That's why it is important to take prompt and proper action in the event of a man-of-war sting. Here's what to do (and not to do):

The Most Important Thing

The Man of War does not have to be alive to sting you. Tentacles can sting and release venom literally for weeks. Don't touch these animals! Tentacles can trail out for 20 feet beyond the blue float, so stay far away.

Symptoms of Man-of-War and Jellyfish Stings 

First, know your jellyfish! A man-of-war is different from a true jellyfish and both are different from a box jellyfish. If you don't know what caused the sting, carefully lift off any remaining tentacles and rinse with seawater. Don't scrub the area and don't apply any chemical (e.g., vinegar, fresh water, commercial product), as inappropriate use can cause injury or death. Don't make the sting worse. Unless the person has a reaction to the venom, stings heal well on their own. Here are the symptoms of a man-of-war or jellyfish sting:

Painful raised red lesions running along the site of tentacle contact (most common symptom)

The lesions may become filled with fluid. Sometimes these will heal with pigmentation.

Muscle spasms in the affected area

Systemic reactions: nausea, vomiting, headaches, dizziness, muscle weakness, runny nose, difficulty breathing, and irregular heart rate (these symptoms are more likely to occur in sensitive individuals or those with extensive stings)

First Aid for Man-of-War Stings 

Prevent further stings. Carefully lift off tentacle remnants, using a stick or gloved fingers. Do not rub the tentacles off, as this will cause more nematocysts to sting.

Next, rinse the affected area with seawater. Do NOT use fresh water or vinegar, as these may cause the stinging cells to discharge all at once and may greatly worsen the sting! Do not scrub the affected area. [vinegar, papain (as in meat tenderizer), baking soda, urine, or aluminum sulfate all may deactivate the toxin, but they may also cause the stinging cells to discharge all at once, possibly intensifying the injury]

Ice may be applied to reduce pain and swelling.

Pain can be countered with topical treatment of products containing lidocaine or benzocaine (as in those products used for sunburn).

Diphenhydramine (benadryl) cream may be applied for persistent itching.

Seek immediate medical attention if the person stung is having any difficulty breathing or maintaining consciousness.

Seek medical attention for muscle spasms.

Infection is possible, so seek medical attention if the pain persists, the rash worsens, a feeling of overall illness develops, lymph nodes become swollen, a red streak develops between lymph nodes and the sting, or the area becomes hot, red, and tender.

It is not uncommon for the sites of man-of-war stings to 'flare up' with irritation periodically for up to 6-8 weeks following the sting. Unless the signs of infection are seen, these symptoms tend to resolve on their own.

Try a Wetsuit 

Protection Against Man of War Stings

A swimsuit will protect your skin from a man of war or a jellyfish, but it doesn't provide total coverage. You could wear pantyhose to protect your legs or you could try a wetsuit.

O'Neill Women's Reactor 3/2 Full Wetsuit (Black, 12)

Amazon Price: $115.44 (as of 11/26/2009)Buy Now

First Aid for Animal Stings 

Man of War and More

All Stings Considered: First Aid and Medical Treatment of Hawaii's Marine Injuries (Latitude 20 Books)

Amazon Price: $20.51 (as of 11/26/2009) Buy Now

Nox-a-sting Swabs, 1/2 Cc, 10-BOX BUNDLE

Amazon Price: $23.99 (as of 11/26/2009) Buy Now

Blue Bottles Aren't Always Blue

Guess what! The float of a Blue Bottle or Portuguese Man of War isn't always blue. Sometimes the float can appear pink or purple.

Look but Don't Touch! (Frank Krämer)

Nature's Balloon

The Man of War can't steer itself. The float is at the mercy of the wind and waves. You could touch the float, but it's best not to, just in case there is a tentacle sitting on it.

Man-o-War Questions or Comments? 

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  • Reply
    kailuakim kailuakim Oct 1, 2009 @ 8:20 pm
    i just got stung by man of wars this afternoon on my regular ocean swim... It was windy, but that is normal for Kailua beach, so did not think much about it.
    On my way swimming back in, i felt like I swam into an electirc fence and could feel "strings" all over my arms... needless to say it freaked me out so I swam really fast to get back in. When I got back to shore, I talked to some folks on the beach, and I told them i think I got stung, they saw my arms and agreed.
    I immediately went to the drug store, rubbed some gel on the wounded areas, then when I got home I read online that vinegar pulls the sting out. My arms felt as though they were on fire, I asked my neighbor to rub the vinegar on my arms, (that was about 20 mins ago) and it helped, but i still feel tremendous stingy on my arms...
    This is the first time EVER I have been stung... I do feel muscle weakness and like I am going to vomit, along with a quickened pulse (my heart is racing) strange.
  • Reply
    Andrea Andrea Sep 19, 2009 @ 12:41 pm
    Carrie, I am so sorry you are going through this awful experience.

    I was stung while on vacation in Italy swimming in the Meditteranean a week ago. I believe it was a Portuguese Man o War. (I hear they are now present in that area) The pain was so severe upon contact, I had trouble walking immediately after. In fact, my leg swelled terribly within two days and my flight home to the U.S. was delayed two days. I was seen for potential blood clots. The sting left three long finger-type welts on the inner part of my right knee/shin area and a huge - what I call - palm print on the back of my knee. I was given ten days of strong anitbiotics and advised to keep my leg elevated to help the swelling. Now, after a week, I am starting to develop new raised welts as well as severe itching, some swelling and pain in my leg. After reading your article, I am worried this will go on for 6-8 weeks. It is awful. Thanks for the information, however.
  • Reply
    x xCarrie x xCarrie Sep 10, 2009 @ 7:53 pm
    I believe I was stung by a man o' war while floating in the surf at Ocean Isle Beach, NC. My symptoms are very similar to what is described in this article. The 1st symptoms were severe burning of both lower legs. I did not see what stung me. A week later , I had a flare up of intense itching along with pain and raised welts (again). I went to the dr. who prescribed a cortisone injection and methylprednisolone pills for 6 days. I now have the welts back and I am just taking antihistamines in the form of zyrtec during the day and benadryl at night. I also use benadryl gel on the afffected areas. I have 3 -5 more weeks, supposedly!!!
  • Reply
    Billie, 12 Billie, 12 Aug 16, 2009 @ 8:54 am
    My local beach is full of them at the moment. I thought I should check them out, and this website gave me alot of information. As I go swimming/body boarding weekly with mt life saving club, I thought I should know. ;) Thanks.
  • Reply
    LowThyroidCures LowThyroidCures Aug 14, 2009 @ 10:42 am
    Great lens, I really enjoyed it. Although I don't get the opportunity to go to the beach often, jellyfish has always been my biggest fear of getting in the ocean.

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