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Treatments and drugs
By Mayo Clinic staff
For most bee stings, home treatment is enough. Multiple stings or an allergic reaction, on the other hand, can be a medical emergency that requires immediate treatment.
Treatment for minor reactions
When a bee stings, it jabs a barbed stinger into the skin. Removing the stinger and its attached venom sac right away will keep more venom from being released.
- Remove the stinger as soon as you can, as it takes only seconds for all of the venom to enter your body. Scrape the stinger out with the edge of a credit card or a fingernail, or use a pair of tweezers. Avoid squeezing the attached venom sac, which can release more venom.
- Wash the sting area with soap and water.
- Apply cold compresses to relieve pain and ease swelling.
Treatment for large local reactions
The following steps may help ease the swelling and itching often associated with large local reactions:
- Remove the stinger as soon as possible.
- Wash the area with soap and water.
- Apply cold compresses.
- Apply hydrocortisone cream or calamine lotion to ease redness, itching or swelling.
- If itching or swelling is bothersome, take an oral antihistamine that contains diphenhydramine (Benadryl) or chlorpheniramine (Chlor-Trimeton).
- Avoid scratching the sting area. This will worsen itching and swelling — and increase your risk of infection.
Emergency treatment for allergic reactions
During an anaphylactic attack, an emergency medical team may perform cardiopulmonary resuscitation (CPR) if you stop breathing or your heart stops beating. You may be given medications including:
- Epinephrine (adrenaline) to reduce your body's allergic response
- Oxygen, to help compensate for restricted breathing
- Intravenous (IV) antihistamines and cortisone to reduce inflammation of your air passages and improve breathing
- A beta agonist (such as albuterol) to relieve breathing symptoms
Epinephrine autoinjector
If you're allergic to bee stings, your doctor will likely prescribe an emergency epinephrine autoinjector (EpiPen, Twinject). You'll need to carry it with you at all times. An autoinjector is a combined syringe and concealed needle that injects a single dose of medication when pressed against your thigh. Always be sure to replace epinephrine before its expiration date, or it may not work properly.
Be sure you know how to use the autoinjector. Also, make sure the people closest to you know how to administer the drug — if they're with you in an anaphylactic emergency, they could save your life. Medical personnel called in to respond to a severe anaphylactic reaction also may give you an epinephrine injection or another medication.
You might also consider wearing an alert bracelet that identifies your allergy to bee or other insect stings.
Allergy shots
Bee and other insect stings are a common cause of anaphylaxis. If you've had a serious reaction to a bee sting or you've been swarmed by bees, your doctor will likely refer you to an allergy specialist (allergist) for allergy shots (immunotherapy). These shots are generally given on a regular basis for a few years and can reduce or completely eliminate your allergic response to bee venom.
- Freeman T. Bee, yellowjacket, wasp and hymenoptera stings: Reaction types and acute management. http://www.uptodate.com/home/index.html. Accessed Sept. 21, 2010.
- Stinging insect allergy: How to avoid the ouch. American Academy of Allergy Asthma & Immunology. http://www.aaaai.org/patients/topicofthemonth/0607/. Accessed Sept. 21, 2010.
- Simons FER. Anaphylaxis. Journal of Allergy and Clinical Immunology. 2010;125:S161.
- Skin emergencies. National Center for Farmworker Health. http://www.ncfh.org/pdfs/BilingualEd/PDF9.pdf. Accessed Sept. 21, 2010.
- Insect stings. The Merck Manuals: The Merck Manual for Healthcare Professionals. http://www.merck.com/mmpe/print/sec21/ch325/ch325d.html. Accessed Sept. 23, 2010.
- Tracy JM. Diagnosis of hymenoptera venom allergy. http://www.uptodate.com/home/index.html. Accessed Sept. 23, 2010.
- Breisch NL, et al. Bees, yellowjackets, hornets, and wasps: Avoidance. http://www.uptodate.com/home/index.html. Accessed Sept. 23, 2010.
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