Fast Facts: Bee Stings

By Jonathan Badger PharmD, MS

Published: Jun 28, 2024

Cartoon of a young girl getting stung by a bee.
Image generated using Microsoft Bing Image Creator

Bees, wasps, hornets, and fire ants all pack a nasty sting. If you are looking to treat a sting or just want to be prepared this step-by-step guide has you covered.

Adapted from the APhA Handbook of Nonprescription Drugs1

Sections

When to get help

Step-by-step treatment guide for stings

Final thoughts

References

When to get help

Before looking at self treatment options make sure the person isn’t having a more serious allergic reaction. Severe allergic reactions (anaphylaxis) require immediate medical attention. Here are some symptoms to watch out for:

  • hives (red blotchy widespread rash)
  • swelling in the lips, face, eyelids, or throat
  • dizziness, fainting, or unconsciousness
  • weakness
  • trouble breathing
  • nausea and/or vomiting
  • rapid heart rate with a weak pulse

If any of these symptoms are present get medical help right away and call 911 if needed. If you are helping someone else ask them if they are carrying an epinephrine pen (EpiPen, Auvi-Q, etc.) and help them administer the medication if they need it.

Step-by-step treatment guide for stings

  1. If the insect was a honey bee look for a stinger. Unlike wasps, hornets, and most other bees, honeybees have a barbed stinger that they leave behind. If you see a stinger (small black dot with white top) at the site of a bee sting remove it quickly by gently scraping across it with your fingernail, a credit card, or some other flat dull object.

  2. Wash the area with soap and water.

  3. For immediate relief of pain there are a couple of options:

    • (home remedy) Apply a cold compress using an icepack or ice cubes wrapped in a damp rag. Wetting the rag is key. It will cool the site of the sting quickly leading to faster relief. Leave the compress on for about 10 minutes at a time and reapply as needed with 5-10 minute breaks in between.

    • Use a product that contains a local anesthetic. My favorite product at the moment is Sting-Kill. It has a combination of benzocaine, which will numb the area causing pain, and menthol, which will help with any itching. Keep these products handy for camping trips and other activities where encounters with stinging insects are likely.

mortar-and-pestle Pharmacist Favorite

  1. Take acetaminophen (Tylenol) as needed for longer lasting pain relief.2

  2. For itching:

    • (home remedy) Apply a paste of baking soda and water to the sting. Use it between rounds with an ice pack. After-Bite Advanced pens, which contains 5% baking soda, are also an option if you want something pre-mixed and portable.
    • Take oral antihistamine like loratadine (Claritin) or fexofenadine (Allegra)2
    • If you want a topical cream hydrocortisone 1% and diphenhydramine 2% (Benadryl) are also helpful.
mortar-and-pestle Pharmacist Favorite
mortar-and-pestle Pharmacist Favorite

Final thoughts

Stings are painful, but usually resolve within a few days. Symptoms that persist beyond 7 days or signs of infection should be evaluated by a health care professional. In my outpatient practice I would occasionally see insect stings turn into skin infections (cellulitis), which requires prescribed antibiotics. If a day or two after getting stung you notice redness, heat, and swelling quickly spreading outside the immediate area of the sting see a health care provider promptly for an evaluation.

References

  1. Krinsky DL, Ferreri SP, Hemstreet B, et al. Handbook of Nonprescription Drugs: An Interactive Approach to Self-Care. 20th ed. American Pharmacists Association; 2021.

  2. Clinical Resource, How to Manage Bites and Stings. Pharmacist’s Letter/Prescriber’s Letter. July 2021. [370707]