What is the best treatment for a wasp sting?

Best Treatment for Wasp Stings

For a typical wasp sting, the best treatment involves promptly removing the stinger (if present), washing the area with soap and water, and using over-the-counter medications to manage symptoms. 1

Initial Management

• Remove the stinger as soon as possible by plucking or scraping it out if present (wasps can typically sting multiple times, while honeybees leave their barbed stinger) 1
• Wash the sting area with soap and water 1
• Apply ice or cold packs to the affected area to reduce pain and swelling 1

Symptom Management

For Local Reactions (pain, swelling, itching)

• Use over-the-counter oral antihistamines (like diphenhydramine) to alleviate itching 1
• Apply topical corticosteroids to reduce inflammation and itching 1, 2
• Take over-the-counter pain relievers such as acetaminophen or nonsteroidal anti-inflammatory drugs (NSAIDs) for pain relief 1

For Large Local Reactions (extensive swelling)

• Continue with antihistamines and cold compresses 1
• For severe swelling, a short course of oral corticosteroids may be beneficial, though definitive proof from controlled studies is lacking 1
• Note that antibiotics are usually not necessary as the swelling is caused by allergic inflammation, not infection 1

Emergency Management for Systemic Reactions

• For signs of anaphylaxis (difficulty breathing, throat swelling, lightheadedness, widespread hives), administer epinephrine via autoinjector immediately 1, 3
• The recommended dose is 0.01 mg/kg (up to 0.3 mg) in children and 0.3-0.5 mg in adults, depending on reaction severity 1, 3
• Intramuscular injection in the anterolateral thigh is preferred for faster absorption 1
• Activate emergency response system (call 911) immediately 1, 2
• Delayed use of epinephrine can lead to fatal outcomes 1

Special Considerations

• Stings to the eye itself (not just eyelid) require immediate medical evaluation due to risk of permanent vision loss 1, 2
• Multiple stings (typically >100) can cause toxic reactions due to massive envenomation 1, 4
• Concentrated heat application devices have shown promise in quickly reducing swelling, pain, and itching after insect stings 5

Prevention Tips

• Have known nests removed by professionals 2
• Avoid bright clothing, flowery prints, and scented products 2
• Wear protective clothing when in high-risk areas 2
• Be cautious near bushes, eaves, garbage containers, and picnic areas 2
• Avoid eating or drinking outdoors when possible 2

Treatment Algorithm

1. Assess severity of reaction:

   • Local reaction: Proceed with symptom management
   • Signs of anaphylaxis: Immediate epinephrine and emergency services
   • Eye sting: Seek immediate medical attention

2. For local reactions:

   • Remove stinger → Wash area → Apply cold → Use antihistamines/pain relievers as needed

3. Monitor for 30-60 minutes for development of systemic symptoms, especially in those with previous allergic reactions 1