What works best for jellyfish stings?

Perhaps an exposure suit, rinsed well after climbing out of the sea, prevents them the best :-)

According to UH Manoa professor Angel Yanagihara, vinegar is the best readily available household liquid to pour on the tentacles, to prevent cubozoan jellyfish tentacle sting firing (otherwise, brushing the jellyfish tentacle off causes more stings). Prior folk wisdom to the contrary, alcohol and urine are not nearly as good, and hot water is better than cold.

Guided by the new jellyfish sting assay described in the article below, the group is now marketing a proprietary, copper and magnesium ion-based spray-on formulation that the abstract below says works even better than vinegar. At least a plastic bottle of vinegar, or perhaps Sting-No-More, belongs in the scuba first aid kit, for those occasional jellyfish envenomations.

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Experimental Assays to Assess the Efficacy of Vinegar and Other Topical First-Aid Approaches on Cubozoan (Alatina alata) Tentacle Firing and Venom Toxicity

Angel A. Yanagihara, Christie Wilcox, Rebecca King, Kikiana Hurwitz, and Ann M. Castelfranco

Received: 30 October 2015 / Accepted: 4 January 2016 / Published: 11 January 2016

Abstract: Despite the medical urgency presented by cubozoan envenomations, ineffective and contradictory first-aid management recommendations persist. A critical barrier to progress has been the lack of readily available and reproducible envenomation assays that (1) recapitulate live-tentacle stings; (2) allow quantitation and imaging of cnidae discharge; (3) allow primary quantitation of venom toxicity; and (4) employ rigorous controls. We report the implementation of an integrated array of three experimental approaches designed to meet the above-stated criteria. Mechanistically overlapping, yet distinct, the three approaches comprised (1) direct application of test solutions on live tentacles (termed tentacle solution assay, or TSA) with single image- and video-microscopy; (2) spontaneous stinging assay using freshly excised tentacles overlaid on substrate of live human red blood cells suspended in agarose (tentacle blood agarose assays, or TBAA); and (3) a “skin” covered adaptation of TBAA (tentacle skin blood agarose assay, or TSBAA). We report the use and results of these assays to evaluate the efficacy of topical first-aid approaches to inhibit tentacle firing and venom activity. TSA results included the potent stimulation of massive cnidae discharge by alcohols but only moderate induction by urine, freshwater, and “cola” (carbonated soft drink). Although vinegar, the 40-year field standard of first aid for the removal of adherent tentacles, completely inhibited cnidae firing in TSA and TSBAA ex vivo models, the most striking inhibition of both tentacle firing and subsequent venom-induced hemolysis was observed using newly-developed proprietary formulations (Sting No More™) containing copper gluconate, magnesium sulfate, and urea.