What is it?
Bee stings are a common outdoor nuisance. In most cases, bee stings are just annoying and pain and swelling go away quickly. Usually home treatment is all that's necessary to ease the pain of bee stings. But if you're allergic to bee stings or you get stung numerous times, you may have a more serious reaction that requires emergency treatment. You can take several steps to avoid bee stings — and find out how to treat them if you do get stung.
Bee sting symptoms include:
- Instant, sharp burning pain at the sting site
- A red welt at the sting area
- A small, white spot where the stinger punctured the skin
- Slight swelling around the sting area
- In most people, swelling and pain go away within a few hours and only cause minor discomfort.
If you're allergic to bee stings, you'll have a more serious reaction. Symptoms can range from mild to severe. Most severe allergic reactions to bee stings develop within minutes of the sting, but in some cases, serious reactions around the bee sting area can take hours or even a few days to develop. Even if you've only had a minor reaction to bee stings in the past, it's possible to have a more serious allergic reaction the next time you get stung.
Signs and symptoms of an allergic reaction to bee stings can include:
- A large area of swelling (edema) at the sting site
- Itching or hives all over your body
- Cough, chest tightness, wheezing or shortness of breath
A severe allergic reaction to bee stings can cause:
- Loss of consciousness
- Upset stomach, diarrhea, nausea, vomiting or other digestive issues
A medical emergency, anaphylaxis is a full-blown allergy attack that can be life-threatening. If you have symptoms of anaphylaxis following a bee sting, seek emergency treatment immediately. Signs and symptoms include:
- Skin reactions in parts of the body other than the sting area, including hives and itching and flushed or pale skin (almost always present with anaphylaxis)
- Difficulty breathing
- Swelling of the throat and tongue or other areas of the body
- A weak and rapid pulse
- Nausea, vomiting or diarrhea
- Dizziness or fainting
- Loss of consciousness
Multiple bee stings
Most honeybees or bumblebees aren't aggressive and only sting in self-defense. In most cases, this results in one or perhaps a few bee stings. However, in some cases a person will disrupt a hive or swarm of bees and get stung multiple times. Some types of bees — such as Africanized honeybees — are more likely than are other bees to swarm, stinging in a group.
Bee stings are rarely fatal, in spite of dramatic movie scenes that might make you believe otherwise. But if you get stung more than a dozen stings, you may feel quite sick. Multiple stings can be a medical emergency in children, older adults, and people who have heart or breathing problems.
Bee sting venom contains proteins that affect skin cells and the immune system, causing pain and swelling around the sting area. In people with a bee sting allergy, bee venom can trigger a more serious immune system reaction.
You're at increased risk of bee stings if:
- You live in an area where bees are especially active
- Your work or hobbies require spending time outside
- You live in an area with beehives nearby
You're more likely to have an allergic reaction to bee stings if:
- You have other allergies, such as hay fever (allergic sinusitis)
- You had an allergic reaction to a bee sting in the past, even if it was minor
Generally, bee stings don't cause any serious problems and symptoms get better within a few hours. However, there are possible complications.
- If you're allergic to bees, stings can cause a more serious reaction. You may be at risk of a life-threatening anaphylactic attack that requires an emergency shot of epinephrine and a trip to the emergency room.
- Multiple bee stings can be dangerous, especially in children. Because children are smaller than adults, fewer stings can create high levels of bee venom in the bloodstream.
- Infection at the site of a sting. As with other cases when the skin is broken, a bee sting site may become infected. Scratching a bee sting site can increase your risk of infection.
If you've had a reaction to bee stings that suggests you might be allergic to bee venom, your doctor may suggest one or both of the following tests:
- Skin prick test. During skin testing, a small amount of purified allergen extract (in this case, bee venom) is pricked into the skin of your arm or upper back. This test is safe and won't cause any serious reactions. If you're allergic to bee stings, you develop a raised bump (hive) at the test location on your skin. Allergy specialists usually are best equipped to perform allergy skin tests.
- Allergy blood test. A blood test (sometimes called the radioallergosorbent, or RAST, test) can measure your immune system's response to bee venom by measuring the amount of allergy-causing antibodies in your bloodstream, known as immunoglobulin E (IgE) antibodies. A blood sample is sent to a medical laboratory, where it can be tested for evidence of sensitivity to possible allergens.
Allergy skin tests are the most accurate tests for insect allergies. But if the allergy skin test is negative — and your doctor still thinks you might have a stinging insect allergy — you may need an allergy blood test to double-check. Your doctor may also want to test you for allergies to yellow jackets, hornets and wasps — which can cause similar allergic reactions to bee stings.
Treatments and drugs
For most bee stings, home treatment is enough. Multiple stings or an allergic reaction, on the other hand, can be a medical emergency that requires immediate treatment.
Treatment for minor reactions
When a bee stings, it jabs a barbed stinger into the skin. Removing the stinger and its attached venom sac right away will keep more venom from being released.
- Remove the stinger as soon as you can, as it takes only seconds for all of the venom to enter your body. Scrape the stinger out with the edge of a credit card or a fingernail, or use a pair of tweezers. Avoid squeezing the attached venom sac, which can release more venom.
- Wash the sting area with soap and water.
- Apply cold compresses to relieve pain and ease swelling.
Treatment for large local reactions
The following steps may help ease the swelling and itching often associated with large local reactions:
- Remove the stinger as soon as possible.
- Wash the area with soap and water.
- Apply cold compresses.
- Apply hydrocortisone cream or calamine lotion to ease redness, itching or swelling.
- If itching or swelling is bothersome, take an oral antihistamine that contains diphenhydramine (Benadryl) or chlorpheniramine.
- Avoid scratching the sting area. This will worsen itching and swelling — and increase your risk of infection.
Emergency treatment for allergic reactions
During an anaphylactic attack, an emergency medical team may perform cardiopulmonary resuscitation (CPR) if you stop breathing or your heart stops beating. You may be given medications including:
- Epinephrine (adrenaline) to reduce your body's allergic response
- Oxygen, to help compensate for restricted breathing
- Intravenous (IV) antihistamines and cortisone to reduce inflammation of your air passages and improve breathing
- A beta agonist (such as salbutamol) to relieve breathing symptoms
If you're allergic to bee stings, your doctor will likely prescribe an emergency epinephrine autoinjector (EpiPen, Twinject). You'll need to carry it with you at all times. An autoinjector is a combined syringe and concealed needle that injects a single dose of medication when pressed against your thigh. Always be sure to replace epinephrine before its expiration date, or it may not work properly.
Be sure you know how to use the autoinjector. Also, make sure the people closest to you know how to administer the drug — if they're with you in an anaphylactic emergency, they could save your life. Medical personnel called in to respond to a severe anaphylactic reaction also may give you an epinephrine injection or another medication.
You might also consider wearing an alert bracelet that identifies your allergy to bee or other insect stings.
Bee and other insect stings are a common cause of anaphylaxis. If you've had a serious reaction to a bee sting or you've been swarmed by bees, your doctor will likely refer you to an allergy specialist (allergist) for allergy shots (immunotherapy). These shots are generally given on a regular basis for a few years and can reduce or completely eliminate your allergic response to bee venom.
Although they haven't been tested by research studies, common home remedies are sometimes used:
- Rub a wet aspirin on the sting area.
- Make a paste with baking soda or meat tenderizer and water. Leave it on the sting area for a few minutes.
A number of prevention strategies can help you minimize your chance of getting stung by bees.
Minimize your exposure:
- Take care when drinking beverages outside. Wide, open cups may be your best option because you can readily see what's in them.
- Avoid eating sweet foods outside.
- Tightly cover food containers and trash cans.
- Clear away garbage, fallen fruit, and dog or other animal feces (flies can attract wasps).
- Wear a long-sleeved shirt, gloves and a hat.
- Wear shoes when walking outside.
- When driving, keep your windows rolled up.
- If you're concerned about being stung, avoid activities that might arouse insects in a beehive or wasp nest, such as mowing the lawn or trimming vegetation. Have hives and nests near your home removed by a professional.
Know what to do when you're exposed to bees:
- If a few bees are flying around you, stay calm and slowly walk away from the area. Swatting at an insect may cause it to sting.
- If a bee or wasp stings you, or many insects start to fly around, cover your mouth and nose and quickly leave the area. When a bee stings, it releases a chemical that attracts other bees. If you can, get into a building or closed vehicle.