What to do if you get stung by a bee

From U.S. News & World Report

By Ruben Castaneda

In his heyday, boxing legend Muhammad Ali boasted that he could “float like a butterfly, sting like a bee.”

It was an apt metaphor. Like punches thrown in the boxing ring, stings by bees – and other flying insects, like wasps and hornets – cause a wide range of physical distress.

The immediate harm caused by bee stings ranges from “minimal discomfort to incredible pain,” says Dr. Kathleen Funk, an emergency medicine physician with Northside Hospital in Atlanta. “The pain response can vary depending on the type of bee, wasp or hornet involved, mostly due to differences in the level of aggression and number of stings, and the length and shape of the stinger,” Funk says. “Bees have barbed stingers, so they can be left in the skin, but then a bee can only sting once. Wasps and hornets have straight stingers, so no barbs to cause more pain, but they can sting multiple times.”

In unusual cases, bee stings can even lead to death due to anaphylactic shock.

Here are six steps you should take if you’re stung by a bee, wasp or hornet.

  • Get to safety.
  • Remove the stinger as soon as possible.
  • Wash the affected area and apply an ice pack.
  • Take an over-the-counter painkiller if needed.
  • Consider a DIY approach.
  • Seek medical attention if you show signs of anaphylaxis.
  1. Get to safety. The first thing to do if you’re stung by a bee or other flying insect is to find a safe place, Funk says.”Different insects have different levels of aggression, ranging from just wanting you out of their immediate vicinity to chasing you to inflict multiple stings, because they’re aggressive by nature or are protecting their hive or nest,” she says. “Leave the area, go in the house, shelter from the insects.” More stings means more venom, which would put you at greater risk for a toxic response or an allergic reaction.
  2. Remove the stinger as soon as possible.If the stinger is left in, it will continue to release venom, which will increase the chances of more severe reactions, says Dr. Tania Dempsey, founder of Armonk Integrative Medicine in Purchase, New York. You can remove the stinger by scraping under it with a piece of gauze or your fingernail. You shouldn’t try to remove it with tweezers, because the stingers of some flying insects – like honeybees – contain a venom sac. “If you use a tweezer to remove the stinger, you risk releasing more venom from the sac,” Dempsey says. This isn’t the case with wasps and hornets, which don’t leave behind a venom sac. “Since it’s sometimes difficult to identify which insect is responsible for the sting, and you might not be able identify whether there’s a venom sac, play it safe and avoid using tweezers,” she says.
  3. Wash the affected area and apply an ice pack. Once you’ve removed the stinger, wash the affected area with soap and water and apply a cold compress, says Dr. J.D. Zipkin, a New York City-based associate medical director of Northwell Health-GoHealth Urgent Care. Washing the area that was stung diminishes the chances of subsequent bacterial infections, and the cold compress reduces swelling, Zipkin says.
  4. Take an over-the-counter painkiller if needed. Most people who are stung by a flying insect will experience moderate to sharp pain that typically subsides after a couple hours, Zipkin says. The majority of people will also have red, swollen and irritated skin in a diameter going out 2 or 3 inches from the location of the sting. Swelling can last about a week, and redness should subside after about three days. However, about 10% of the population will experience more exaggerated symptoms. These include redness, swelling and irritation about 4 inches or more overlying the sting site. “Unlike minor reactions, these typically worsen over the first two days and resolve around one week after the sting,” Zipkin says. If this happens to you, over-the-counter pain medicines such as ibuprofen (Advil, Motrin) and acetaminophen (Tylenol) can reduce pain. Antihistamines like cetirizine (Zyrtec) and a topical steroid cream can help reduce itchiness, he says. Infants age 2 or younger and pregnant women shouldn’t take antihistamines without first consulting a health care provider.
  5. Consider a DIY approach. A do-it-yourself remedy that involves a paste that consists of baking soda and water can be effective in reducing itching, swelling and redness, Dempsey says. Mix water and baking soda to create a thick paste, and apply it to the area that was stung. Mix 1/4 of a cup of aluminum-free baking soda with 1 to 2 teaspoons of water together, and then apply the paste to the area that was stung. Reapply every 15 minutes or so. It’s believed that baking soda can help neutralize the acidity of the sting and mitigate inflammation. “While this might be considered by some to be an old-fashioned home remedy, I’ve seen it really help in family members and patients,” Dempsey says.
  6. Seek medical attention if you show signs of anaphylaxis.For most people, being stung by a bee, wasp or hornet causes short-term pain and discomfort. But such stings can be life-threatening for people who are allergic. Less than 1% of children and 3% of adults are allergic, says Dr. Wan-Yin Chan, a pediatric allergist at CHOC, a pediatric health care system based in Orange, California. These people are at risk for anaphylaxis, a severe and potentially life-threatening allergic reaction, and should immediately seek medical attention.

“For anaphylaxis, the patient will be given at least one dose of epinephrine (also called adrenaline), which can help constrict blood vessels,” Chan says. This will increase blood pressure, improve breathing and reduce hives, swelling and wheezing.

Here are 11 symptoms of anaphylaxis:

  • Hives.
  • Flushing.
  • Swelling of the face, throat or tongue.
  • Difficulty breathing.
  • Shortness of breath.
  • Wheezing.
  • Dizziness.
  • Nausea.
  • Vomiting.
  • Diarrhea.
  • Loss of consciousness.