Coastal Solutions, Inc.

Coastal Solutions, Inc. of Savannah, Georgia promotes a line of products named "Jellyfish Squish, "Fire Ant Coolant," "Chigger Chaser," and "Bite Blaster," the active ingredient for all of these being the topical anesthetic 4% lidocaine hydrochloride (dissolved in water). The products are provided in Magic Marker-sized (0.24 fluid ounce or 7 milliliters) pump spray containers. Fire Ant Coolant, Chigger Chaser, and Jellyfish Squish also contain, among other compounds, aloe eucalyptus oil, methyl paraben, and propyl paraben. Bite Blaster does not contain eucalyptus oil.

Topical lidocaine is an effective anesthetic, and rarely causes adverse reactions. I asked the company to provide me with any data available to them to indicated the efficacy of lidocaine. I received a paper entitled "Jellyfish Sting Relief," authored by Peter Verity and Dick Lee of the Skidaway Institute of Oceanography, which is affiliated with the University System of Georgia. These investigators compared lidocaine, vinegar (acetic acid), household ammonia, meat tenderizer, and deionized water as topic remedies to treat stings on the arms of volunteers from the jellyfishes Chiropsalmus quadrumanus ("sea wasp") and Chrysaora quinquecirrha ("sea nettle"). Their observations were that lidocaine was helpful (e.g., alleviated the pain), whereas deionized water and papain were without effect, and vinegar and ammonia caused an initial increase in pain. Furthermore, they observed the stinging cells of the sea nettle under the microscope while being "treated" with these same remedies, and found that vinegar stimulated mass firing of nematocysts. The implication of this finding is not entirely clear, because it was not correlated with any particular clinical finding. Lidocaine was not seen to cause nematocysts to fire.

Lidocaine hydrochloride is a well-known and extensively tested topical (skin) anesthetic, which has long been known to be useful abrasions (scrapes), minor burns, small cuts, and insect bites. To this list can now probably be added jellyfish stings. The role of other topical agents, such as vinegar, ammonia, and baking soda, remains empirical, but supported by many experts based upon clinical observations of efficacy. For instance, vinegar is emphatically recommended by experts in Australia for stings from Chironex fleckeri, the dreaded box-jellyfish. I have used vinegar and rubbing alcohol, alone and in combination, to treat all varieties of jellyfish stings with great effect. This makes me continue to believe that all jellyfish are not absolutely identical in terms of their response to therapies, and that the nematocysts of different species may respond differently to different topical agents.

It makes perfect sense to me that topical lidocaine hydrochloride should be effective for jellyfish stings, chigger bites, and insect stings, as it is a non-specific anesthetic agent that is capable of numbing superficial skin no matter what the irritant. However, it should not be relied upon to abort an allergic reaction to a sting, nor to neutralize any venom that has been transferred in the envenomation or stinging process. I intend to carry a spray vial and to utilize it the next time I am bitten or stung, which is inevitable. It may also come in handy the next time I need to prepare (numb) a wound for cleansing, with the notation that this is not a sterile solution. Lidocaine toxicity should not be a concern when using a small amount of this spray.

Join me from January 24 to February 2, 2010 for an exciting dive and wilderness medicine CME adventure aboard the Nautilus Explorer to Socorro Island, Mexico to benefit the Wilderness Medical Society.

Tags: Coastal Solutions, jellyfish, chigger, fire ant, wilderness medicine, healthline

Labels: chigger, Coastal Solutions, fire ant, insect bite, jellyfish

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