What is the treatment for a bee sting?

Bee Sting Treatment

The treatment for a bee sting should begin with immediate removal of the stinger by scraping or plucking it out as soon as possible, followed by washing the area with soap and water. 1

Initial Assessment and Management

For Normal Local Reactions:

1. Remove the stinger immediately - Either scrape or pluck it out as quickly as possible 1, 2

   • Speed of removal is more important than the method used
   • Honeybee stingers can continue delivering venom for up to 60 seconds after the sting 1

2. Clean the area

   • Wash with soap and water 1

3. Manage local symptoms

   • For pain:
     • Apply ice or cold packs to the affected area 1
     • Take over-the-counter pain relievers such as acetaminophen or NSAIDs 1
   • For itching:
     • Use over-the-counter oral antihistamines 1
     • Apply topical corticosteroids 1

For Severe Reactions:

1. Recognize signs of anaphylaxis (requires immediate emergency treatment):

   • Difficulty breathing
   • Tongue or throat swelling
   • Lightheadedness
   • Vomiting
   • Disseminated hives 1, 3

2. Emergency treatment for anaphylaxis:

   • Self-administer epinephrine via autoinjector if available 1, 3
   • First aid providers should assist with epinephrine administration if needed 1
   • Activate emergency response system immediately 1
   • Fatal sting reactions have been associated with delay in epinephrine administration 1

Special Considerations

Large Local Reactions

• Extensive swelling that persists for several days
• Treatment options:
  • Oral antihistamines
  • Cold compresses
  • Short course of oral corticosteroids in severe cases 1
  • Antibiotics are usually not necessary as the swelling is due to allergic inflammation, not infection 1

Eye Stings

• Stings to the eye itself (not just eyelid) require immediate professional medical evaluation 1, 4
• Can lead to permanent vision loss if not properly treated 1

Important Cautions

1. Multiple stings can be dangerous:

   • Death can occur from massive envenomation (≈20 stings by large hornets or hundreds of stings from honeybees) 1, 5

2. Delayed complications:

   • Rarely, untreated bee stings can lead to skin and soft tissue necrosis requiring surgical intervention 6

3. Monitoring:

   • All individuals with bee stings should be monitored for potential allergic reactions, which can develop even in those who have previously tolerated stings 1, 5

Prevention for Those with Known Allergies

• Individuals with history of systemic reactions should consult an allergist 1
• Those with severe allergies should carry epinephrine autoinjectors 1, 3
• Venom immunotherapy can significantly reduce the risk of future systemic reactions in allergic individuals 1, 7

Remember that most bee stings cause only transient localized reactions that resolve without treatment, but prompt recognition and treatment of severe reactions is critical to prevent serious complications or death.