Charleston-area lifeguards have stopped using vinegar to treat jellyfish stings, an age-old remedy that one researcher says remains the best option to stop the release of more venom.
Representatives for Charleston County Parks and Recreation told The Post and Courier this is the first year they've stopped using it.
Instead, they advise victims to remove any remaining tentacles from the bite site and then rinse it with saltwater.
Angel Yanagihara, who has extensively researched jellyfish stings at the University of Hawaii at Manoa, said that's not the best method: Vinegar should be the first line of defense, because it deactivates the stinging cells on jellyfish tentacles for all species.
The two species that beach-goers are most likely to bump into in the summer in South Carolina are the Atlantic Sea Nettle and Lion's Mane.
The key, she said, is neutralizing the cells because they don't disappear, even if visible tentacles are removed.
"A good number of them remain stuck on the skin like a ticking time bomb," Yanagihara said.
Charleston County lifeguards take their first-aid guidance from the U.S. Lifesaving Association, a national nonprofit association of beach lifeguards that develops best practices for ocean rescuers.
Chris Brewster, a spokesperson for the USLA, said for the most part on U.S. beaches, lifeguards aren't treating life-threatening stings, so their main goal is to reduce pain and discomfort. He argued that vinegar may have a placebo effect for pain, and that recent work showed it may even be harmful to use for some species' stings.
The local chapter of the Red Cross doesn't suggest using vinegar either, said Cuthbert Langley, a spokesman.
But Yanagihara said studies that suggest vinegar worsens the situation haven't been replicated. She said the spread of advice downplaying vinegar is an "echo chamber" that's not based in rigorous, peer-reviewed science.
By contrast, she said case studies measuring treatment outcomes in places with potentially fatal species nearby, like Thailand, have shown the best outcomes and survival rates occur when vinegar is used.
"There’s over 40 years of literature as well as traditional knowledge around the world. ... We’ve done this in every different class of cnidaria, and in no case did the vinegar increase the venom load," Yanagihara said, referring to the part of the animal kingdom that jellyfish belong to.
She suggested after rinsing with vinegar to apply heat, whether with a heat pack or by soaking the affected area in very hot water. Cooling the affected site can reduce pain in the short run but exacerbates the effects of the venom over the long term, she said.
There is one thing that first responders who have turned against vinegar and Yanagihara agree on, however: urinating on a sting, an old wives' tale, is not the way to go.