Remove the spines that you received from the urchin if possible. It will hurt, but it is necessary in order for it to start the healing process. It is imperative that you take them out fast in order to reduce the pain and get most of the spine out.
Sea urchins release venom through two areas: their spines and pedicellaria, which are small "seizing organs" between the spines. Try removing the spines themselves with your hand or with some tweezers, if you have any. Do this carefully because the spines break easily. Try removing the pedicellaria by applying some shaving cream and gently scraping off with a razor. Another method you can use to remove the pedicellaria is to heat up wax, apply to affected area, and let dry. Then remove the wax once it's dry, removing with it any tiny fragments of the pedicellaria.
Cover the affected area with vinegar once you get out of the water. Soak a lint-free towel in vinegar and hold it on there as long as possible.
Soak it in hot water as hot as you can tolerate for about twenty to forty minutes. It will ease the pain if it doesn't stop it completely and help to relieve soreness on the following day. Put vinegar on it again.
When you go to bed, wrap the area that was stung with a lint-free towel, soaked in vinegar. Wrap the towel in plastic wrap and tape it so it stays on through the night.
Keep an eye on the site of injury for a few days after the incident to make sure no infection sets in. If necrosis, eczema-like skin rash, or secondary bacterial infection sets in, see your doctor to get the wound looked at and treated. If you experience shortness of breath and/or pain breathing, or the urchin's spines are set deep in the skin near a joint, see your doctor for treatment options.
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