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    Wilderness: Starfish, Crown of Thorns, and Sea Star Punctures

    Starfish, Crown of Thorns, and Sea Star Punctures Overview

    Starfish, crown of thorns, and sea stars live throughout the subtropics and tropics. They are bottom dwellers, so any contact with a diver is accidental. Injury occurs from the spine and the venom injected from the spine. Crown of thorns have as many as 13-16 short, sharp spines that are up to 6 cm (over 2 inches) long.

    Starfish, Crown of Thorns, and Sea Star Punctures Symptoms

    Puncture symptoms include:

    • Severe pain
    • Itching
    • Swelling
    • Heat
    • Redness

    More severe reactions include:

    Starfish, Crown of Thorns, and Sea Star Punctures Treatment

    If medical attention is not readily available, use the following guidelines for treating a puncture wound:

    • Immerse the affected area in water as hot as the person can tolerate for 30-90 minutes. Repeat as necessary to control pain.
    • Use tweezers to remove any spines in the wound because symptoms may not go away until all spines have been removed.
    • Scrub the wound with soap and water followed by extensive rinsing with fresh water.
    • Do not cover the wound with tape.
    • Apply hydrocortisone cream 2-3 times daily as needed for itching. Discontinue immediately if any signs of infection appear.
    • Apply topical antibiotic ointment (Bacitracin) 3 times per day if signs of infection, such as pus, redness, or heat, are present.

    Oral antibiotics are usually recommended for infection.

    • Continue antibiotics for at least 5 days after all signs of infection have cleared.
    • Check for drug allergy prior to starting any antibiotic.
    • When outside, use sunscreen and wear protective clothing, such as a long-sleeved shirt, pants, and a wide-brimmed hat, while taking these antibiotics because certain antibiotics may cause sensitivity to the sun.

    Pain may be relieved with 1-2 acetaminophen (Tylenol) tablets every 4 hours or 1-2 ibuprofen (Advil, Motrin) tablets every 6-8 hours.

    When to Seek Medical Care

    Seek medical treatment as soon as possible. Consult a doctor about treatment with available medications.

    Synonyms and Keywords

    wilderness: starfish, crown of thorns, and sea star punctures, starfish punctures, crown of thorns punctures, sea star punctures, scuba diving, snorkeling

    WebMD Medical Reference from eMedicineHealth

    Reviewed by Varnada Karriem-Norwood, MD on May 10, 2014

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