What is the treatment for a bee sting?

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.

Treatment Steps

• Remove the stinger as soon as possible by scraping it off with a flat-edged object like a credit card, as suggested by the guidelines 1.
• Clean the area with soap and water to prevent infection.
• Apply a cold compress for 20 minutes to reduce swelling.
• 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 every 4-6 hours for pain, as mentioned in the guidelines 1.
• Apply a hydrocortisone cream (0.5-1%) to the sting site 2-3 times daily to reduce inflammation.
• Elevate the affected area if possible.

Emergency Situations

• Seek immediate medical attention if you experience signs of a severe allergic reaction such as difficulty breathing, dizziness, nausea, hives, or swelling of the face, lips, or throat, as these may indicate anaphylaxis requiring emergency treatment with epinephrine, as emphasized by the guidelines 1 and supported by previous studies 1.
• If a person experiences anaphylaxis due to a bee, wasp, or hornet sting and an epinephrine autoinjector is available, the person should self-administer the autoinjector, as recommended by the guidelines 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), as it is used for emergency treatment of allergic reactions, including those caused by insect stings 2.

• Key symptoms that may require treatment with epinephrine include:
  • Flushing
  • Apprehension
  • Syncope
  • Tachycardia
  • Hypotension
  • Convulsions
  • Vomiting
  • Diarrhea
  • Abdominal cramps
  • Involuntary voiding
  • Airway swelling
  • Laryngospasm
  • Bronchospasm
  • Pruritus
  • Urticaria or angioedema
  • Swelling of the eyelids, lips, and tongue

From the Research

Treatment for Bee Stings

The treatment for bee stings can vary depending on the severity of the reaction. For most people, a bee sting will only cause minor symptoms such as redness, swelling, and pain at the site of the sting. In these cases, treatment may include:

• Applying a cold compress or ice pack to the affected area to reduce swelling
• Taking an antihistamine or using a topical cream to relieve itching and reduce inflammation
• Using a pain reliever such as acetaminophen or ibuprofen to alleviate pain

Anaphylaxis Treatment

However, in some cases, a bee sting can cause a severe allergic reaction known as anaphylaxis, which can be life-threatening. Treatment for anaphylaxis typically involves:

• Administering epinephrine via an auto-injector or syringe 3
• Providing oxygen therapy to help improve breathing
• Using fluid expanders to support blood pressure
• Administering additional medications such as corticosteroids, antihistamines, and vasopressors as needed 3

Removal of the Stinger

When it comes to removing the stinger, research suggests that the method of removal is not as important as the speed of removal. A study published in the Lancet found that removing the stinger quickly, regardless of the method, can help reduce the amount of venom injected into the body 4.

Corneal Bee Stings

In cases where the bee sting occurs in the cornea, treatment may involve early surgical intervention and systemic high-dose steroid therapy to reduce inflammation and prevent further damage 5.

Prevention and Education

Prevention and education are also key components of bee sting treatment. Individuals who are allergic to bee stings should carry an epinephrine auto-injector with them at all times and know how to use it properly. They should also take steps to avoid getting stung, such as wearing protective clothing and avoiding areas where bees are present 6, 7.