From the Guidelines
For a bee sting, the most effective treatment is to remove the stinger by scraping it off with a flat-edged object, clean the area with soap and water, and apply a cold compress to reduce swelling, as recommended by the 2024 American Heart Association and American Red Cross guidelines for first aid 1. The treatment for a bee sting can be broken down into several steps:
- Remove the stinger as soon as possible by scraping it off with a flat-edged object like a credit card, as squeezing the stinger with tweezers can release more venom 1.
- Clean the area with soap and water to prevent infection.
- Apply a cold compress for 20 minutes to reduce swelling and alleviate pain.
- Take an antihistamine like Benadryl (diphenhydramine) 25-50mg every 4-6 hours to reduce itching and swelling, and use acetaminophen (Tylenol) 325-650mg or ibuprofen (Advil) 200-400mg for pain relief.
- Apply a hydrocortisone cream (0.5-1%) to the sting site 2-3 times daily to reduce inflammation. Some key considerations for bee sting treatment include:
- Most bee stings resolve within hours to days without serious complications.
- Bee venom contains proteins that trigger an immune response, causing pain, redness, and swelling.
- Seek immediate medical attention if you experience difficulty breathing, dizziness, nausea, or swelling beyond the sting site, as these may indicate a severe allergic reaction requiring emergency treatment with epinephrine 1. It's also important to note that individuals with a history of systemic reactions to insect stings should carry epinephrine for emergency self-treatment and be familiar with proper use and indications 1.
From the FDA Drug Label
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 treatment for a bee sting, specifically for anaphylaxis, is epinephrine (IM).
- The signs and symptoms associated with anaphylaxis include:
- Flushing
- Apprehension
- Syncope
- Tachycardia
- Thready or unobtainable pulse associated with hypotension
- Convulsions
- Vomiting
- Diarrhea and abdominal cramps
- Involuntary voiding
- Airway swelling
- Laryngospasm
- Bronchospasm
- Pruritus
- Urticaria or angioedema
- Swelling of the eyelids, lips, and tongue 2
From the Research
Treatment for Bee Stings
- The primary goal of treatment is to alleviate symptoms and prevent further complications.
- Standard treatments for large local reactions include:
- Ice
- Nonsteroidal anti-inflammatory medications
- Antihistamine medications
- Topical or systemic corticosteroids 3
- In some cases, injection of 1% lidocaine with epinephrine into the sting area may be effective in rapidly reversing symptoms of pain and pressure, as well as reducing allergic and inflammatory responses 3
- For oropharyngeal stings, treatment may include parenteral administration of epinephrine, steroids, antihistamines, and inhalational bronchodilators, as well as endotracheal intubation and mechanical ventilation in cases of airway compromise 4
- In cases of corneal bee stings, early surgical intervention and systemic high-dose steroid therapy may be effective in promoting recovery and preventing further damage 5
Removal of the Stinger
- The method of stinger removal is not as important as the speed of removal, with quicker removal resulting in less envenomization 6
- There is no significant difference in response between stings scraped or pinched off after 2 seconds 6