The most familiar sting is from honeybees, but some wasps and other insects can also sting. Yellow jacket wasps are the most common cause of allergic reactions to insect stings in the United States.
The bee's stinging apparatus consists of a sac of venom attached to a barbed stinger. The wasp's is similar, but with a smooth stinger. When a bee or wasp stings, the sac contracts, pumping venom into the tissue.
The information below refers to bee stings, but it applies to stings caused by both bees and wasps. The symptoms, treatments, and dangers are the same.
Here are some key points about insect stings. More detail is in the main article.
- Bees, wasps, and other related insects can sting.
- Pain and swelling are common symptoms, but these usually go away within a few days.
- Bees leave a stinger that injects a toxic venom into the skin.
- If a person develops swelling, hives, and breathing problems, they need immediate medical attention.
Insect bites and stings are common and usually only cause minor irritation.
A bee sting is usually recognized by a sharp pain and a puncture wound or laceration in the skin.
The venom contained in a bee or wasp sting induces a local toxic reaction at the site of attack.
A normal local reaction to a bee or wasp sting produces the following symptoms:
- instant pain at the site of the sting that is sharp, burning, and usually lasts a few seconds
- a swollen red mark that can be itchy and painful
- swollen and red hives or welts that may peak at around 48 hours after the sting and last for up to 1 week
Some stings may produce the following symptoms, referred to as a large local reaction:
- extreme redness and swelling that enlarges up to 12 inches across
- swelling of an entire extremity or limb, which may last a few days
- in the case of multiple stings, there may be a rash, fever, nausea, and headache
- rarely, swelling and pain in joints that appear after several days
Multiple stings can be fatal for children.
In some people, components of the venom can cause an allergic reaction.
Most reactions to a sting are mild to moderate and do not involve a severe allergy.
Severe allergic sting reactions are treated with epinephrine (adrenaline), either self-injected or by a doctor.
However, some symptoms that develop after a bee sting signal a severe allergic reaction and need urgent medical attention.
Without treatment, anaphylactic shock may occur very quickly. This can be fatal.
Symptoms that may signal anaphylaxis include:
- wheezing or difficulty breathing
- severe swelling of the face, throat, or lips
- nausea, vomiting, or diarrhea
- stomach cramps
- itching or hives in places other than the site of the sting
- fast heart rate
- sudden drop in blood pressure or weak pulse
- dizziness or feeling faint
- difficulty swallowing
- confusion, anxiety, or agitation
If any of these symptoms appear following a sting of any kind, emergency medical care is needed.
Individuals who have experienced an allergic reaction to a sting in the past are more likely to have a reaction in the future.
They may carry a "bee sting kit" that contains an Epi-pen, an epinephrine shot. This shot relaxes blood vessels and muscles, helping the body to deal with the response while medical help is called.
Sometimes a sting can become infected. Consult a doctor if the area affected shows a pus discharge, or if there is an increase in the normal pain, swelling, and redness that was produced by the initial sting.
Most bee stings can be treated without medical attention, but some products may help manage the discomfort.
- Aspirin or acetaminophen can relieve pain.
- Sprays or creams that contain anesthetic reduce the risk of infection.
- Antihistamine creams or oral antihistamines can help control swelling.
These are also available over-the-counter (OTC) from a pharmacy, or they may be prescribed by a doctor.
If the local reaction is large, for example, with severe local swelling, oral corticosteroids may be prescribed for 3 to 5 days.
Someone who knows they are allergic to stings may carry an epinephrine injector. A bystander can help the person administer this injection, if needed.
First aid for someone who has been stung by a bee or wasp includes a number of dos and don'ts.
When a honey bee stings a person, the barbed stinger is not pulled back out from the wound.
- Stay with the person to watch out for any severe reaction that could develop.
- Call for urgent medical help if there are signs of an allergic reaction.
- Remove the stinger promptly if it remains. Honey bee stingers usually stay in the skin, continuing to inject venom.
- To remove the stinger, wipe over it with a piece of gauze, or scrape a finger nail, piece of card, or a bank card over it.
- Remain calm and walk away, as wasps and hornets can sting again. They do not usually leave a stinger.
- Wash the site of the sting with plain soap and water.
- Apply a cold compress, for example, ice wrapped in a cloth, frozen peas, or a cold cloth to reduce swelling.
- Squeeze the stinger or use tweezers in an attempt to remove it, as this can cause more venom to be injected.
- Scratch the sting, as this could aggravate the problem and lead to an infection.
- Use calamine lotion, vinegar, or bicarbonate of soda. They will not neutralize the venom because it will be deep within the tissues.
- Burst any blisters that develop, since this can lead to infection.
When to call a doctor
Call a doctor or ambulance at once if a person has signs of wheezing, swelling, or other symptoms of anaphylaxis, or if you know the person is likely to experience an allergic reaction.
See a doctor also if an insect sting leads to blistering, if you are concerned about swelling, if signs of infection develop, such as pus, or if symptoms do not go away within a few days.
Some practical steps can reduce the risk of being stung by a bee.
- wear light-colored, smooth clothing that is not too loose
- keep clothing clean and maintain personal hygiene, as sweat may anger bees
- wear shoes
- remove nests near the home, using a professional service
- keep areas clean, especially where there is food
- cover food containers and trash cans
- use widely brimmed cups when drinking sweet drinks, as it makes insects easier to see
- Use repellent products such as non-harmful traps, available for purchase online.
- take care during activities such as garden trimming, which could provoke a nest
- wear brightly colored and flower-print clothing
- use fragrances, cosmetics, and toiletries that have floral or banana-related scents
- wear loose clothing that can trap bees and insects
- wear open-toed shoes
Where is the most painful place for a bee sting?
One researcher decided to investigate how different sting locations around the body compared on a rating scale for pain.
He selected 25 locations on the body and conducted an experiment on himself to rate the painfulness of a sting at each location caused by a honey bee.
He underwent three stings in each location, leaving 5 minutes between each sting for the pain to subside.
All stings were rated on a scale from 1-10, from low to high pain severity.
The eye-watering results, in order of worst pain first, were:
A sting on the nostril comes out on top as the most painful location for a bee sting.
- nostril (9.0)
- upper lip (8.7)
- penis shaft (7.3)
- scrotum (7.0)
- palm (7.0)
- cheek (7.0)
- armpit (7.0)
- nipple (6.7)
- abdomen (6.7)
- middle finger tip (6.7)
The results were published in a peer-reviewed journal, but it is not known whether they have been replicated by other researchers.