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Lionfish, Scorpionfish & Stonefish Envenomations
by DAN Medical Team on March 4th, 2016

​Last week I got a saltwater aquarium with an anemone and a small lionfish. I saw the lionfish swimming through the anemone and thought it was going to hurt the anemone, so I reached in the tank and pushed the lionfish away. It nailed me on the fingers, and now they're all swollen and blistered. Is there anything I can do?
​Lionfish (as well as scorpionfish and stonefish) possess dorsal, anal, and pelvic spines that transport venom from their venom glands into puncture wounds. Common reactions include redness or blanching, swelling and blistering (lionfish). The injuries can be extraordinarily painful and occasionally life-threatening (in the case of a stonefish).

The Treatment
  • Soaking the wound in non-scalding hot water to tolerance (110 to 113˚ F / 43.3 to 45˚ C) may provide dramatic relief of pain from a lionfish sting;
  • is less likely to be effective for a scorpionfish sting, and
  • may have little or no effect on the pain from a stonefish sting, but it should be done nonetheless, because the heat may inactivate some of the harmful components of the venom.
If the injured person appears intoxicated or is weak, vomiting, short of breath or unconscious, seek immediate advanced medical care.

Wound care is standard, so – for the blistering wound – appropriate therapy would be a topical antiseptic (such as silver sulfadiazene [Silvadene] cream or bacitracin ointment) and daily dressing changes. A scorpionfish sting frequently requires weeks or months to heal, and therefore requires the attention of a physician. There is an antivenin available to physicians to help manage the sting of the dreaded stonefish.


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