From the Guidelines
For a wasp sting that is swollen and painful, the most effective management approach is to apply a cold compress to the area for 20 minutes to reduce swelling and pain, as recommended by the 2024 American Heart Association and American Red Cross guidelines for first aid 1. This approach is supported by the guidelines, which suggest that cold compresses can help alleviate local pain and swelling.
- Additional measures to alleviate symptoms include:
- Taking an over-the-counter antihistamine like diphenhydramine (Benadryl) 25-50mg every 4-6 hours or cetirizine (Zyrtec) 10mg once daily to help with itching and swelling, as suggested by the guidelines 1.
- Using acetaminophen (Tylenol) 500-1000mg every 6 hours or ibuprofen (Advil, Motrin) 400-600mg every 6-8 hours for pain relief, as recommended by the guidelines 1.
- Cleaning the sting site with soap and water to prevent infection, as advised by the guidelines 1.
- Elevating the affected area if possible to minimize swelling.
- Applying a paste of baking soda and water or calamine lotion to soothe the skin. It is essential to note that most wasp stings improve within a few days with these measures, and the treatments work because cold reduces inflammation, antihistamines block histamine released during the allergic reaction, and pain relievers target the inflammatory response.
- It is crucial to seek immediate medical attention if signs of a severe allergic reaction develop, such as difficulty breathing, dizziness, rapid heartbeat, swelling of the face or throat, or if the pain and swelling worsen significantly or don't improve after a few days, as emphasized by the guidelines 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 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.
The management for a wasp sting that is swollen and painful may involve epinephrine (IM) for emergency treatment of allergic reactions, including anaphylaxis caused by insect stings.
- Key symptoms of anaphylaxis that may require epinephrine administration include swelling, particularly of the face, lips, tongue, or throat, which can lead to airway obstruction.
- Patients experiencing a wasp sting with symptoms of anaphylaxis should seek immediate medical attention. 2
From the Research
Management for Wasp Sting
- The management for a wasp sting that is swollen and painful typically involves conservative therapy, which may include:
- It is essential to monitor the patient closely for any signs of anaphylaxis, a severe and life-threatening allergic reaction, which can occur rapidly after a wasp sting 3, 4
- In cases of anaphylaxis, prompt recognition and initiation of treatment with epinephrine (adrenaline) is critical 5, 3
- However, it is crucial to use epinephrine inhalers correctly to avoid potential problems, such as lung edema and erosive gastroduodenitis, which can occur with overuse 5
- In rare cases, wasp stings can cause more severe complications, such as acute myocardial infarction, stroke, or acute renal failure, which require immediate medical attention 4, 6, 7