Your Health
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Ocean Stings, Pokes and Cuts...Myths and Facts
Summer is here and as more people spend time at the beach learning the facts about stings and cuts from sea creatures becomes important. Last's weeks article covered what you should know about Portuguese man-of-war and box jellyfish stings. Now learn about sea urchin punctures and coral cuts.

Sea urchin punctures
Each sea urchin spine has many small barbs that release a toxin, causing pain. Carefully remove any spines that are projecting out of the skin. Using heat for pain control is controversial. Some researchers feel it helps to soak the area in water as hot as possible. (Someone else should test the temperature, since the injured person may not be able to evaluate accurately.) Others feel heat is not helpful. Scrub the area thoroughly with fresh water and soap to help avoid infection.

Long-spined sea urchin or wana. Artwork courtesy of the Waikiki Aquarium.

Spines that remain in the wound are very difficult to remove because of the barbs. Alcohol and vinegar are not effective in dissolving these spikes, but they usually don’t need to be removed. There are two common kinds of sea urchin—wana have very thin spines and ‘ina have spikes more like pencil lead. Within 2-3 weeks the spines of wana most often are absorbed or work out through the skin, with the wound healing shortly thereafter. It is unlikely that the thicker ‘ina spines will lodge in the skin. If they do, or if any kind of spine is poking a joint or nerve, a medical provider should be consulted.

For any punctures
Some people are very sensitive or allergic to certain toxins. If someone has any difficulty at all in breathing, or has weakness, dizziness, confusion, muscle cramps, nausea or vomiting, palpitations, an overall feeling of illness or unbearable pain, medical care should be sought immediately. After the immediate reaction, if the wound becomes hot or more tender, a rash worsens, red streaks develop or pus forms, a medical provider should be consulted.

Coral cuts
Contrary to popular belief, coral left in a wound doesn’t continue to grow. If there are any live animals in the coral, they die shortly after leaving the ocean. However, their calcium coverings remain; the body coats this material and tries to get rid of it. This may feel as if the coral itself is growing.

The main problem with coral cuts is the chance of infection. Bacteria in sea water can easily enter through a coral cut and quickly multiply to cause infection within the first 24 hours. To minimize the risk of infection, the wound should be treated within the first hour. Any pieces of coral should be removed and the cut thoroughly scrubbed (not just rinsed) with fresh water and soap. If soap isn’t available, try at least to use fresh water to clean the wound. Don’t wash with sea water, as more bacteria may be introduced.

If the wound is deep, jagged or continues to bleed, or pieces of coral cannot be removed, a medical provider should be consulted. (Even if one can close the wound with a bandage, sometimes a few stitches can reduce scaring.) Otherwise, a clean covering should be applied and changed daily for five to seven days. If there are early signs of infection or more than a few hours delay before cleaning the cut, antibiotic ointment can be applied. (Be aware that neomycin may produce irritation, so it is safest to use another type of antibiotic.) As with all injuries, if redness, pain, pus, or warmth at the site develop, one should get medical care.

The above information and further discussion of venomous sea creatures and other water dangers can be found at the O‘ahu Lifeguards Web site. For more information on sea urchin check out the Waikiki Aquarium Web site.

University Health Services Manoa serves UH Manoa students, faculty and staff. The health service provides walk-in medical services and referrals for specialty care to in-house or community physicians.

This article is for educational purposes only. Do not rely on this information for diagnosis or treatment and/or in place of personal medical attention. If you feel you have a medical problem, you should consult with a health care professional as soon as possible.