How to treat a lionfish sting
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The bottom line
Lionfish have spines on their bodies that can cause painful stings. Symptoms following lionfish stings can include swelling, tenderness, redness, sweating, and muscle weakness.
Prevention Tips
Avoid touching or handling lionfish. Even a dead lionfish can sting!
For those who keep lionfish as pets, be aware of their location while cleaning the tank, wear gloves, and keep your hands well away from their spines.
Wear protective clothing if you plan to swim or dive in infested areas.
Never return a live lionfish to the ocean.
This Really Happened
Case 1. A 62-year-old woman was stung on her finger by her lionfish while she was cleaning its aquarium. The finger immediately developed a bruise and became swollen, and the woman experienced pain at the sting site. She was instructed to soak her finger in tolerably hot water and to use over-the-counter pain medications. She was encouraged to see a medical provider to ensure that no spines were stuck in her finger and to get an updated tetanus vaccination. By the next day, all of her symptoms had resolved.
Case 2. A 57-year-old man put too much fish food into an aquarium at his workplace. He was stung by a lionfish when he reached into the tank to remove the excess food. The finger was red and swollen, and there was some bleeding at the sting site. He was instructed to soak his hand in tolerably hot water. In an emergency room, he was given opioid medication to control his pain. He was started on antibiotics and allowed to go home; his tetanus vaccination was already up-to-date. Four days later, his symptoms had resolved.
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What to know about lionfish
Lionfish (Pterois sp.) look delicate as they use their fan-like fins to gently move through the ocean. But don't be fooled by this flamboyant fish.
Lionfish are an invasive, meat-eating species covered with venomous spines. A female lionfish can release up to 2 million eggs per year. While they are native to the South Pacific and Indian Oceans, they have spread rapidly into the western Atlantic Ocean, including the Caribbean Sea, and are now appearing in the Mediterranean Sea.
Lionfish have big appetites and have no natural predators in these waters. When they arrive at a coral reef, they can eat so much that they reduce the local fish population by as much as 70%. Lionfish are popular aquarium fish, and it is thought that owners releasing their lionfish into the ocean have contributed to their spread to non-native waters.
Symptoms of a lionfish sting
Symptoms following lionfish stings develop within minutes to a few hours and can include swelling, tenderness, warm skin directly surrounding the sting site, redness, sweating, muscle weakness, and a tingling sensation. A lionfish sting involving multiple spines increases the risk of infection and body-wide symptoms such as changes in heart rate, abdominal pain, sweating, and fainting. Symptoms can last anywhere from 8 hours to 30 days depending on the severity of the sting.
Can you treat a lionfish sting at home?
Although lionfish stings are very painful, most can be managed at home if pain is controlled and tetanus immunization is up to date.
If you are stung by a lionfish, here are some first-aid steps:
Wearing gloves and using tweezers, carefully remove spines from the wound, trying not to squeeze the spines.
Wash the area with soap and water.
Soak the affected limb in water hot enough to tolerate but not to burn for 60–90 minutes. An adult should test the water to make sure it is not scalding hot for children.
Use over-the-counter medication to treat pain.
Call your doctor or pharmacist to make sure your tetanus immunization is up to date.
An x-ray might be needed to ensure that there are no broken spines left in the sting site.
When should you go to the ER for a lionfish sting?
Visit an urgent care center or emergency room if you experience any of the following:
Spines are still visible in the wound after attempts to remove them.
Severe muscle aches or cramps.
Severe or persistent pain at the sting site.
Feeling faint.
Evidence of infection such as fever, expanding redness, swelling, or pus.
Paralysis.
Are lionfish safe to eat?
The National Oceanic and Atmospheric Administration (NOAA) has launched a campaign urging people to eat lionfish to help reduce their numbers. However, the Food and Drug Administration warns that lionfish can contain a toxin known as ciguatera. Ciguatera toxin is heat stable, and cooking does not remove the toxin from the meat.
There is no specific prevention recommendation when it comes to ciguatera exposure; however, eating fish smaller than about 4–6 pounds reduces the risk. The average lionfish weighs approximately 1–2 pounds. Properly prepared lionfish is supposed to be pretty tasty!
What to do if you or someone else is stung by a lionfish?
If you suspect someone has been stung by a lionfish, start the home treatment instructions listed above and then use the webPOISONCONTROL® online tool to get additional help or call your poison center at 1-800-222-1222. Whether online or by phone, expert guidance is always free, confidential, and available 24 hours a day.
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