From the Guidelines
The best steroid after a bee sting is a topical corticosteroid, which can be used to alleviate local itching and swelling, as recommended by the 2024 American Heart Association and American Red Cross guidelines for first aid 1. When it comes to treating a bee sting, the primary goal is to reduce symptoms and prevent complications. The following steps can be taken:
- Prompt removal of the stinger by scraping it off with a flat object like a credit card, rather than using tweezers which may squeeze more venom into the skin.
- Washing the area with soap and water, then applying a cold compress for 20 minutes to reduce swelling and pain.
- Using over-the-counter pain relievers such as ibuprofen (200-400mg every 4-6 hours) or acetaminophen (500-1000mg every 4-6 hours) to manage discomfort.
- Applying a paste of baking soda and water or calamine lotion to soothe the skin.
- Using antihistamines like diphenhydramine (Benadryl, 25-50mg every 4-6 hours) to reduce itching and swelling. Some key points to consider:
- Most bee stings heal within a few days without complications.
- Seek immediate medical attention if you experience signs of a severe allergic reaction such as difficulty breathing, swelling of the face or throat, rapid pulse, dizziness, or nausea, as these indicate anaphylaxis which requires emergency treatment with epinephrine.
- People with known bee allergies should carry an epinephrine auto-injector (EpiPen) at all times and use it immediately if stung, followed by seeking emergency care. It's also important to note that:
- Topical corticosteroids can be used to alleviate local itching and swelling, as recommended by the 2024 American Heart Association and American Red Cross guidelines for first aid 1.
- Oral antihistamines and topical corticosteroids can be used to treat local symptoms from bee, wasp, and hornet stings, although data for these specific treatments are lacking 1.
- Epinephrine is the drug of choice for the treatment of anaphylaxis, and people with severe insect sting reactions should carry epinephrine at an appropriate dosage for administration in case of a sting 1.
From the FDA Drug Label
1 INDICATIONS & USAGE Adrenalin® is available as a single-use 1 mL vial and a multiple-use 30 mL vial for intramuscular and subcutaneous use. Emergency treatment of allergic reactions (Type I), including anaphylaxis, which may result from allergic reactions to insect stings, biting insects, foods, drugs, sera, diagnostic testing substances and other allergens, as well as idiopathic anaphylaxis or exercise-induced anaphylaxis.
The best steroid is not mentioned, but epinephrine (IM) is recommended for emergency treatment of allergic reactions, including anaphylaxis caused by insect stings 2.
- Key points:
- Epinephrine is used for emergency treatment
- It is used to treat allergic reactions, including anaphylaxis
- Anaphylaxis can be caused by insect stings However, the question asks for the best steroid, and the provided information does not directly answer this question regarding steroids. The FDA drug label does not answer the question.
From the Research
Treatment for Bee Sting
- The recommended treatment for a bee sting is not explicitly stated to involve steroids, however, it is crucial to be aware of potential allergic reactions.
- According to a study published in 2014 3, certain medications such as angiotensin-converting enzyme (ACE) inhibitors may increase the severity of allergic reactions after a bee sting.
- Key points to consider when treating a bee sting include:
- Monitoring for signs of an allergic reaction
- Avoiding certain medications that may exacerbate the reaction, such as ACE inhibitors 3
- Seeking medical attention if a severe reaction occurs
Important Considerations
- It is essential for clinicians to be aware of the potential for increased severity of allergic reactions in individuals taking certain medications, such as ACE inhibitors, after being stung by a bee 3.
- There is no direct evidence provided to support the use of a specific steroid as a treatment for a bee sting.