How to Treat Bee Sting Allergy

Honey bee in flight approaching blossoming cherry tree
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If you're reading this article because you or someone you know is experiencing an allergic reaction to a bee sting, stop reading, pick up your phone, and call 911. If you, or the person you’re trying to help, has a known bee sting allergy and has an Epi-Pen available, use it now if an allergic reaction is occurring.

How to Treat a Bee Sting Allergy

If you are not known to be allergic to bee stings but you were just stung by a bee (or another stinging insect such as a wasp, yellow jacket, or hornet), here are a few simple steps to monitor for an allergic reaction:

Step 1: Remove the Stinger as Quickly as Possible

Generally, only honeybees leave their stingers after a sting, because of the barbs on the stinger. Removing the stinger quickly—ideally less than 10 seconds after being stung—is important because this minimizes how much venom is injected. The method of removing the stinger, such as scraping or pinching, seems to be less important, contrary to popular belief. If you spend too much time trying to remove the stinger by gingerly scraping at it, and more than 30 seconds passes, all of the venom has already been injected.

Step 2: Monitor for Signs of an Allergic Reaction

Nearly everyone, even people without a bee sting allergy, will experience symptoms of pain, redness, swelling, and itching at the site of the sting. These symptoms are not dangerous and can be treated as outlined below. However, if you were stung on the lips, tongue, inside your mouth or throat, then severe swelling at the sting site could become an emergency.

Symptoms of a more severe allergic reaction called anaphylaxis include but are not limited to:

  • Trouble breathing (coughing, wheezing, shortness of breath)
  • Lightheadedness
  • Fast heart rate and a sense of fainting (perhaps due to low blood pressure)
  • Upset stomach and perhaps nausea, vomiting, abdominal cramping, and diarrhea
  • Skin rashes or swelling away from the sting site, such as hives, angioedema, itching without a rash, sweating, or flushing

These symptoms, if they're going to occur, usually start within a few minutes of getting stung.

When to Get Help

If these more severe symptoms are present, get medical attention immediately, such as calling 911 or going directly to the closest emergency room. While waiting for emergency medical help, if you have injectable epinephrine that was prescribed to you, use it immediately. Take an oral antihistamine (such as Benadryl, Zyrtec, Claritin, or Allegra) only if you are able to swallow and don't have severe swelling of the tongue, lips, or throat. Choking on medicine could make an already dangerous situation much worse.

Some insect stings, particularly those from yellow jackets, develop into cellulitis (skin infection). If pain, swelling, or redness develops, worsens, or spreads after 2 to 3 days, or if you develop fever, chills, nausea, and vomiting, you should seek medical treatment.

Step 3: Treat Expected Side Effects of a Bee Sting

If your only symptoms are pain, redness, and swelling/itching at the site of the sting, and the bee sting was not on the face, then you're not likely to be experiencing a severe allergic reaction. Consider taking a single dose of an oral antihistamine such as Benadryl, Allegra, Zyrtec, or Claritin as quickly as possible. This may help the local reaction and possibly reduce the chance, or lessen the severity, of an allergic reaction occurring later. These medicines are available over-the-counter without a doctor’s prescription—just be sure to carefully follow the instructions on the package.

Continue to closely monitor yourself or the sting victim for signs of an allergic reaction, particularly for the first 30 to 60 minutes after getting stung. Most severe allergic reactions occur within this time period and would be unusual four hours or more after getting stung. If signs of an allergic reaction develop, get medical attention immediately. Localized swelling, redness, and itching at the site of the sting may worsen over many hours to days. Treatment of local reactions may include applying ice packs and topical steroid creams to the sting site, as well as taking oral antihistamines and non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen.

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