What is the recommended local application treatment for a wasp sting?

Local Application Treatment for Wasp Stings

For wasp stings, the recommended local application treatment includes cleaning the area with mild soap and water, applying cold compresses to reduce pain and swelling, and considering topical lidocaine cream or gel (4-5% formulation) for pain relief. 1

Initial Assessment and Management

1. Remove the stinger (if present)

   • Unlike bees, wasps typically don't leave stingers behind, but check to be certain
   • If a stinger is present, gently remove it by scraping (not squeezing) 1

2. Clean the area

   • Wash with mild soap and water 1
   • This helps prevent secondary infection

3. Apply cold compresses

   • Use cold compresses or ice packs wrapped in a thin towel 2, 1
   • Apply for 15-20 minutes at a time
   • Cold reduces pain, swelling, and inflammation

4. Pain management options

   • Topical lidocaine cream or gel (4-5% formulation) is effective for pain relief 1
   • Consider oral analgesics (acetaminophen or ibuprofen) for additional pain control 1

Monitoring and Additional Care

• Monitor for signs of:

  • Severe local reaction (extensive swelling beyond the sting site)
  • Systemic reaction (difficulty breathing, widespread hives, dizziness)
  • Infection (increasing redness, warmth, purulence) 1

• For severe pain or extensive local reactions:

  • Oral antihistamines may help reduce itching and swelling
  • Elevate the affected area if possible 1

Important Cautions

• Seek emergency medical attention immediately if signs of anaphylaxis develop (difficulty breathing, facial swelling, dizziness, or widespread hives) 1

• Avoid applying:

  • Heat (may increase inflammation and venom absorption)
  • Meat tenderizer (limited evidence for effectiveness) 2
  • Pressure immobilization bandages (may increase venom release) 2

Special Considerations

• People with known allergies to insect stings should follow their emergency action plan and use prescribed epinephrine auto-injectors if needed 1

• Local reactions typically resolve within a few hours to days with appropriate first aid measures 3

• If signs of infection develop (increasing pain, redness, swelling, or discharge after 48-72 hours), seek medical attention as antibiotics may be needed 1

The evidence strongly supports cold application as the primary local treatment for wasp stings, with topical lidocaine as an effective adjunct for pain management. This approach minimizes both the immediate discomfort and potential complications from wasp stings.