When it comes to treating painful jellyfish stings, it's better to choose hot than cold water simply because the venom of most marine creatures is sensitive to heat.

While some jellyfish stings are mild and don't require first aid, many hurt - a lot. Worse, the pain can last for days and the venom can be very toxic, causing death. In fact, more people are killed by jellyfish stings than shark attacks.

When giving urgent medical attention to jellyfish sting victims, doctors tend to disagree on which treatment is better: cold or hot water? Still, many are leaning toward the former.

However, researchers Christie Wilcox and Angel Yanagihara of the University of Hawaii in Manoa, Honolulu, believe that hot water or hot packs work better because of the nature of the jellyfish venom.

"Research to date has shown that all marine venoms are highly heat sensitive, thus hot water or hot packs should be more effective than cold packs or ice," said Christie Wilcox.

For the study, the researchers performed three systematic reviews on more than 2,000 articles pertaining to the effects of hot or cold treatments for jellyfish stings using the U.S. Agency for Health Care Policy and Research Classification as a guide.

The first systematic review showed support on immersion in hot water to treat the non-life-threatening effects of the venom, alongside other first-aid treatments. The second review, which was conducted six years later, also supported evidence on using heat to inactivate the venom at a temperature of about 40 to 50 degrees Celsius. Although limited, the third evidence using the Cochrane Database lent support to hot-water immersion and none on ice.

The researchers couldn't stress enough the importance of the results of the study, which is to give policymakers evidence-based data in the hopes that they will reconsider existing regulations and make amendments if and when needed, including making first aid more on point.

Immersion in hot water should also not be feared since it "is considered safe and is recommended for the treatment of stonefish stings and other life-threatening marine envenomations with potential cardiovascular complications," said the researchers.

In the meantime, the researchers intend to add more to the growing body of data by conducting a study on the effects of using vinegar as a jellyfish treatment and randomized clinical trials pertaining to the subject.

The study can now be read in Toxins.