From the Guidelines
To treat pruritus (itching) after a wasp sting, over-the-counter oral antihistamines and topical corticosteroids can be used to alleviate local itching, as recommended by the 2024 American Heart Association and American Red Cross guidelines for first aid 1. The treatment of itching after a wasp sting involves a combination of measures to reduce inflammation, numb the skin, and block histamine release.
- Apply a cold compress to the affected area for 10-20 minutes to reduce inflammation and numb the skin.
- Take an oral antihistamine such as diphenhydramine (Benadryl) 25-50 mg every 4-6 hours or cetirizine (Zyrtec) 10 mg once daily to block histamine release that causes itching.
- Apply a topical antihistamine cream like diphenhydramine (Benadryl) or a corticosteroid cream such as hydrocortisone 1% to the sting site 2-3 times daily for 1-3 days.
- Calamine lotion can also provide relief. It is also important to avoid scratching the area as this can lead to infection and worsen symptoms, and to wash the area of the sting with soap and water 1. If you experience severe swelling, difficulty breathing, dizziness, or if symptoms worsen after 2-3 days, seek immediate medical attention as these may indicate a more serious allergic reaction. The use of over-the-counter acetaminophen and nonsteroidal anti-inflammatory agents may be considered to alleviate local pain, and the administration of ice or cold packs may be considered for local pain relief 1.
From the FDA Drug Label
Uses temporarily relieves itching associated with minor skin irritations, inflammation, and rashes due to: ... insect bites Directions for itching of skin irritation, inflammation, and rashes: adults and children 2 years of age and older: apply to affected area not more than 3 to 4 times daily
The treatment for pruritus (itching) after a wasp sting is to apply hydrocortisone (TOP) to the affected area, not more than 3 to 4 times daily for adults and children 2 years of age and older. For children under 2 years of age, a doctor should be consulted 2, 2.
From the Research
Treatment for Pruritus after Wasp Sting
- The treatment for pruritus (itching) after a wasp sting can include conservative therapy such as antihistamines, ice or cool compresses, topical lidocaine, or corticosteroid lotions 3.
- Another treatment option is the use of concentrated heat, which has been shown to reduce swelling, pain, and pruritus after insect bites/stings 4.
- In the study by 4, the use of a device called Bite Away(®) that administers concentrated heat to the skin was found to be effective in reducing pruritus, with a significant decrease in VAS pruritus score after 2,5, and 10 minutes of treatment.
- Glucocorticoids and antihistamines are also well established in insect sting treatment and can be used to reduce swelling, pain, and pruritus 4.
- In severe cases, anaphylactic reactions can occur, and prompt recognition and initiation of treatment is critical in successful management of these reactions 5, 3, 6.
Management of Anaphylactic Reactions
- Anaphylactic reactions to wasp stings can be life-threatening and require immediate medical attention 5, 3, 6.
- Treatment of anaphylactic reactions typically involves the administration of epinephrine and other supportive care 5, 6.
- Venom immunotherapy can also be effective in preventing subsequent severe reactions to insect stings 5.