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Lionfish Sting

Last updated Oct. 29, 2018

Approved by: Krish Tangella MD, MBA, FCAP

The lionfish is a venomous fish that may range in size from 30-40 cm. It is a predatory animal that blends well amongst the coral reefs or rocky terrains. The tropical and temperate waters of the Indo-Pacific region are its main habitat.


What are the other Names for this Condition? (Also known as/Synonyms)

  • Sting of the Lionfish

What is Lionfish Sting? (Definition/Background Information)

  • The lionfish is a venomous fish that may range in size from 30-40 cm. It is a predatory animal that blends well amongst the coral reefs or rocky terrains. The tropical and temperate waters of the Indo-Pacific region are its main habitat
  • Lionfish generally reside at the edge of coral reefs or at shallow depths of 50-60 m and feed on other fish. The fish is covered in prickly spines that carry toxic venom. The venom is not generally fatal, but it depends upon the health condition of the individual (young children and elderly adults may have severe signs and symptoms)
  • Lionfish are exotic creatures and sought after as ornamental pets for artificial marine aquariums. However, their venom is fast-acting and can cause extreme pain and burning sensations
  • Contact with humans occurs mostly during sea diving (accidental contact), while hunting for these fishes, or while cleaning tanks. Lionfish do not generally attack humans, but are territorial creatures and can inflict painful stings with the release of potent venom
  • Some Lionfish Stings may have mild symptoms, while others have severe symptoms. The severity of signs and symptoms depends on the species of lionfish, the amount of toxin injected, and also on the reaction of the human body to the toxin
  • Immediate medical attention has to be sought in case of severe stings. The treatment would involve removal of the spines, washing the affected area, and use of medications (topical antibiotics and painkillers). The prognosis is generally good with treatment in a majority of cases

Who gets Lionfish Sting? (Age and Sex Distribution)

  • Any individual exposed to the lionfish is vulnerable to its sting
  • Both males and females are affected and there is no gender bias observed
  • Lionfish are marine creatures found mostly in the Indo-Pacific oceanic regions

What are the Risk Factors for Lionfish Sting? (Predisposing Factors)

The risk factors identified for Lionfish Stings include:

  • Deep sea divers, hunting for these marine creatures
  • Keeping them as pets in aquariums (exotic collection)
  • Handling dead or live lionfish species

It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases ones chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.

Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.

What are the Causes of Lionfish Sting? (Etiology)

  • Lionfish Stings release a poisonous chemical into the human skin through their spine, which can affect the human body
  • Depending on the amount of poison injected, the severity of the signs and symptoms is dictated

What are the Signs and Symptoms of Lionfish Sting?

The severity of signs and symptoms of Lionfish Sting depends on the following factors:

  • The type or species of lionfish
  • The amount of toxin injected
  • The reaction of the human body to the toxin

The signs and symptoms of Lionfish Sting may be mild or severe and may include:

  • Extremely severe stinging pain
  • Rashes on the skin (red-colored welts), bruising
  • Bleeding and edema, formation of blister
  • Swelling of the wound
  • Sweating
  • Headaches
  • Abnormal heart rate, reduced blood pressure
  • Allergic shock or reaction, in some cases
  • Shortness of breath; breathing difficulties
  • Muscle cramps, abdominal cramps
  • Nausea, vomiting, and diarrhea
  • Severe fatigue
  • Unconsciousness

How is Lionfish Sting Diagnosed?

A Lionfish Sting is diagnosed through the following tools:

  • A physical examination of the affected site by the physician is normally sufficient to diagnose the condition
  • In addition, the symptoms exhibited by the individual may be carefully observed
  • The individual may be asked to provide an account (history) of the events that occurred (what took place and how)
  • Blood tests consisting of complete blood count (CBC) and electrolytes

Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.

What are the possible Complications of Lionfish Sting?

The complications that may arise from a Lionfish Sting may include:

  • Bleeding and skin ulceration can cause secondary bacterial or fungal infections to develop
  • Tissue necrosis at the site of the sting
  • Anaphylaxis type allergic reaction
  • Respiratory distress
  • Reduced heart rate
  • Delirium and shock
  • Convulsions and paralysis

Lionfish Stings are known to result in fatalities in some cases.

How is Lionfish Sting Treated?

The treatment measures for Lionfish Sting may include:

  • The first line of treatment is often to remove the stingers/spines by gently pulling them out with a pair of tweezers; breaking the spines must be avoided
  • The use of very hot water can help reduce the potency of the venom, and hence, the wound is soaked for up to an hour in hot water. This can also help reduce the pain intensity
  • Once the spines are removed, the affected area is washed with soap and fresh water
  • Ice packs may also help mitigate pain
  • The wound is left uncovered to heal
  • Topical antiseptics may help prevent wound infection
  • Pain relieving medications (acetaminophen) as required
  • Tetanus vaccination is usually required, if it is not up to date
  • In case of severe stings, it could be a medical emergency and prompt attention has to be provided. The treatment measures may include:
    • CPR may be provided as necessary, breathing assistance
    • Stabilizing the blood pressure
    • Pain control medications, steroids
  • Proper follow-up care and check-ups may be required, especially to monitor for any signs of infection

Note: It is always important to call the local emergency helpline number (911 in the US) without any delay.

How can Lionfish Sting be Prevented?

The following factors may be considered to reduce the incidence of Lionfish Stings:

  • Do not ignore warnings of lifeguards or health officials at the beach
  • Avoid making an attempt to touch or handle marine animals unnecessarily
  • Wear protective clothing if you plan to swim or dive in infested areas (suitable wet skin or diver’s suit)
  • Generally be aware or watchful of the waters you are in (to the extent possible)
  • Wear protective footwear while walking on beach sand
  • When removing stingers from the body, wear suitable protective cover (such as hand gloves); avoid removing the sting with bare hands
  • Avoid rubbing the stung area with bare (unprotected) hands
  • Ensure safety precautions while cleaning marine animal aquariums; wear gloves
  • Marine life explorers and sea adventurers are required to carry marine first aid kit

Note: Currently, there is no anti-venom available for Lionfish Stings.

What is the Prognosis of Lionfish Sting? (Outcomes/Resolutions)

  • The prognosis of Lionfish Sting is generally good with effective treatment, since a majority of the cases are mild
  • However, severe stings combined with delayed treatment may be life-threatening or can even result in death

Additional and Relevant Useful Information for Lionfish Sting:

The scorpionfish, lionfish, and stonefish are grouped under the same biological family of Scorpaenidae.

What are some Useful Resources for Additional Information?


References and Information Sources used for the Article:


Helpful Peer-Reviewed Medical Articles:


Reviewed and Approved by a member of the DoveMed Editorial Board
First uploaded: Dec. 24, 2015
Last updated: Oct. 29, 2018