Symptoms and Signs of Starfish (Sea Star) and Crown of Thorns Puncture Wounds

Medical Author:
Medically Reviewed on 9/30/2021

Doctor's Notes on Starfish (Sea Star) and Crown of Thorns Puncture Wounds

Starfish (sea star) and crown of thorns are marine animals that possess sharp spines that contain venom inside a gelatinous covering. They live on the bottom of the seabed, and divers usually get puncture wounds accidentally when they physically contact the animal's spines that puncture the skin. Signs and symptoms are

  •  immediate severe pain,
  • significant bleeding, and
  • swelling at the puncture site.

Symptoms in most divers last about 30 minutes to 3 hours and then begin to resolve. However, severe symptoms and signs can include

The causes of the symptoms and signs are due to the sharpness of the spines (that can cause deep puncture wounds and lacerate the skin) and the toxic substances in the venom. Once the spines are removed and the venom inactivated by hot water (not to exceed 140 F), the symptoms and signs abate. If the spines are not removed, the symptoms will continue. Most of these puncture wounds should be seen by a medical caregiver.

What Are the Treatments for Starfish (Sea Star) and Crown of Thorns Puncture Wounds?

Starfish (sea stars) and crown of thorns puncture wounds can be treated by this protocol:

  • Immerse the sting area (puncture wound) in water as hot as the person can stand it for about 30-90 minutes. Repeat as necessary for pain control.
  • Remove all the spines from the wound with tweezers.
  • Scrub the wound with soap and water, and then rinse it with a lot of water.
  • Leave the wound open.
  • Apply topical hydrocortisone cream to reduce the itching.
  • Take over-the-counter pain medicine.
  • Look for signs of infection such as redness, heat, and exudate (rarely infected). You may need a tetanus shot.
  • Apply topical ointment and/or antibiotics if the wound becomes infected.
  • Observe the patient for severe symptoms and signs like numbness, weakness, joint aches, heavy bleeding, and rarely, paralysis.

All such wounds should be examined by medical caregivers.

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Kasper, D.L., et al., eds. Harrison's Principles of Internal Medicine, 19th Ed. United States: McGraw-Hill Education, 2015.