Hot water immersion for bluebottle stings

Hot water immersion can be used to treat bluebottle (Physalia spp.) stings. Bluebottle stings are most common in non-tropical areas and can be very painful. After initial management, hot water (ideally at 42-45 degrees C) applied to the site of the sting for 30-90 minutes can be used to manage pain. If hot water is unavailable, a heat pack may provide an accessible alternative. Hot water application for bluebottle stings has NHMRC Level 2 evidence of efficacy. The most common adverse effect is that the patient cannot tolerate the heat, and there has been one case of a thermal burn reported. This article forms part of a series on non-drug treatments, which summarise the indications, considerations and the evidence, and where clinicians and patients can find further information.