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I dread it when someone asks which treatment is best for Hawaii's jellyfish stings, because my answer is a frustrating one. "No one knows," I say. "It hasn't been studied."

This sounds wrong, I'm sure, to most Hawaii residents, who have been taught several ways of easing the pain of jellyfish and Portuguese man-of-war stings.

One such time-honored treatment is to apply urine to the area. This can be hard to carry out in public, but there are ways around that. One woman told me that when she was a youngster, she and her friends urinated into jars at home and then carried the containers to the beach. That way, each girl could treat her own stings without embarrassment.

For those who didn't relish such earthy treatment, and for lifeguards and health care workers who clearly needed another remedy, there was the widely touted vinegar-and-meat-tenderizer paste. You mixed these two substances together and applied the stuff to the sting.

If you didn't like home remedies, you could always buy a fairly expensive spray called Sting Aid available at drugstores and dive shops.

Besides applying liquids, pastes and sprays to stings, there were also some temperature-change treatments. Some of Hawaii's emergency room workers used hot showers to ease the pain of box jellyfish stings. Other medical personnel routinely applied ice packs to the injury.

The theories behind Hawaii's remedies varied widely, but all had one thing in common: None were scientifically tested. This deficiency bothered several Hawaii lifeguards, medical workers and me, so we banded together to study these common sting treatments.

After years of collecting and analyzing data, the results are now in and can be summed up in two words: Nothing worked.

If you've used some of these cures and they seemed to help, there are good reasons for it. One is that Hawaii's jellyfish and Portuguese men-of-war inflict what doctors call self-limited injuries. That means they almost always disappear on their own with no treatment at all. Therefore, anything we put on the sting often appears to help because it's gradually getting better all by itself.

Another factor to remember is the power of our minds to ease pain. If we believe something will help us feel better, we often do, even if the treatment has no proven benefit.

So what do you do when you get a box jellyfish sting that hurts like crazy? First, spray it liberally with vinegar. This doesn't relieve pain but prevents any unfired stinging cells from going off. Then go home and leave it alone.

For pain, try a hot pack (or hot bath) and then an ice pack and go with the one that works best for you. For a persistent rash or itching, try hydrocortisone cream or ointment.

We didn't study Portuguese men-of-war this time, but there's some evidence that vinegar can make those injuries worse. So instead of vinegar on those stings, just rinse them off with salt or fresh water. Fresh water did not make stings worse in our study. (By the way, we didn't spray urine on people. That treatment was studied under a microscope.)

If you would like more details of our box jellyfish study, Part 1 (temperature tests) is published in the April issue of the Hawaii Medical Journal. Part 2, solution tests, will follow soon.

We still don't know what works for reducing pain in jellyfish stings, but at least now we know what doesn't work.