Bee Stings

Bee stings are a common outdoor nuisance, especially during summer when people tend to be outside for a longer time.

In most cases, bee stings are just annoying and make you uncomfortable and a home remedy is all that is required to ease the pain without causing complications.

If you are allergic to bee stings or you get stung by a wasp several times, you may develop a more serious reaction that needs emergency care.

There are several measures to avoid bee stings — as well as hornet and wasp stings — and ways to manage if you do get stung.

Bee stings can give rise to different type of reactions, ranging from minor symptoms such as temporary pain and discomfort to a very serious allergic reaction.

Having one type of reaction does not mean that you are going to have the same one each time you get stung by a bee.

Mild reactions

Most of the time, symptoms arising from a bee sting are minor, and include:

• Instant, sharp burning pain at the sting site
• A red colored raised welt around the sting
• A small, white spot in the center of the welt, where the stinger punctured your skin
• Slight swelling around the sting area

 In most people, swelling and pain get relieved within a few hours of being stung.

Moderate reactions (large local reactions)

Some people who get stung by a bee or another insect may show a stronger reaction with signs and symptoms such as:

• Extreme redness
• Swelling at the sting site that gradually enlarges over the next 2-3 days

These symptoms tend to resolve within 5-10 days.

Having a moderate reaction does not mean that you will have a similar allergic reaction in the future if you get stung.

Some people may develop a similar kind of moderate reaction each time they get stung.

In such cases, consult your doctor to find out about treatment and prevention, particularly, if the reaction tends to be more severe each time.

Severe allergic reactions

A severe allergic reaction to bee stings is called anaphylaxis.

It is a potentially life-threatening condition and needs prompt emergency treatment.

Anaphylactic reactions develop quickly after a bee sting.

Signs and symptoms include:

• Body going into shock as a quick response to the wasp venom
• Allergic skin reactions such as hives, itching and flushed or pale skin
• Difficulty breathing
• Swelling of the throat and tongue
• A weak but rapid pulse
• Nausea, vomiting or diarrhea
• Dizziness or faint feeling
• Loss of consciousness

People with a severe allergic reactions to a bee sting are at a 30-60% greater risk of developing anaphylaxis the next time they are stung by a wasp.

Discuss with your doctor or an allergist about preventive measures such as immunotherapy to avoid a similar reaction if you get stung again.

Multiple bee stings

Generally, insects such as bees and wasps are not very aggressive, and they sting humans for self-defense.

Most of the time, this results in more than one sting. However, if a person disturbs a hive or swarm of bees, multiple stings may result.

Some types of bees such as Africanized honeybees are more likely to swarm and these often sting in a group.

If you get stung more than a dozen times, the accumulated venom can cause a toxic reaction and make you feel very sick with symptoms such as:

• Nausea, vomiting or diarrhea
• Headache
• Vertigo
• Feeling faint or fainting
• Fever and convulsions

Multiple stings can be a medical emergency in children, elderly people, and people with heart or breathing problems.
In most cases, bee stings resolve through home remedies and do not require a visit to your doctor.

In more severe cases, you will need prompt medical attention.

Call 911 or other emergency services if:

• You are having a very serious reaction to a bee sting that is suggestive of anaphylaxis, even if only one or two symptoms occur
• If you were prescribed an emergency epinephrine autoinjector (EpiPen, Twinject), use it immediately as directed by your doctor.

Seek prompt medical care if:

• You have been attacked by a swarm of bees and have multiple stings

Schedule an appointment to see your doctor if:

• The symptoms of a bee sting do not subside within a few days
• You have other unusual symptoms resulting from an allergic response to a bee sting

Bees have a stinger that contains venom, a poisonous material that is transferred to humans during a sting and causes pain and swelling.

The venom contains proteins that affect the skin cells and the immune system, resulting in pain and swelling around area of the sting.

In people with an allergy to bee stings, bee venom can trigger a more serious immune system reaction.

No specific diagnosis is needed to determine bee stings, but it's best to consult your doctor to confirm.

Bee and other insect stings are one of the common causes of anaphylaxis.

If you have had a serious reaction to a bee sting, consult your doctor for emergency medical treatment.

After initial treatment, you may be referred to an allergy specialist (allergist) who can determine whether you are allergic to certain venom, and can help you prevent allergic reactions in the future.

Your doctor or allergist will perform a careful physical examination and will ask you these questions:

• When and where did you get stung?
• What symptoms developed after getting stung?
• Have you had allergic reactions to insect stings in the past?
• Do you have other allergies, such as hay fever?
• What medications do you take, including herbal remedies?
• Do you have any other health problems?

Some questions you might want to ask your doctor include:

• What should I do if I get stung again?
• If I have an allergic reaction, do I need to use emergency medication such as an epinephrine autoinjector (EpiPen, Twinject)?
• How do I prevent this reaction from happening again?

Your doctor may suggest one or both of the following tests if you have had an allergic reaction to bee stings, which suggests that you are allergic to the bee venom:

• Skin test: During skin testing, a very small quantity of allergen extract (bee venom) is injected subcutaneously into your arm or upper back. This test is harmless and will not cause any serious reactions. If you are allergic to bee venom, you are likely to develop a raised bump on your skin at the test site.
• Allergy blood test: A blood test is done to measure the amount of allergy-causing antibodies circulating in your bloodstream, which indicates your immune system's response to bee venom. A blood sample is tested in a medical laboratory for evidence of sensitivity to possible allergens.

Allergy skin tests and allergy blood tests are often used at the same time to diagnose insect allergies.

Your doctor may suggest tests to check for allergies to yellow jackets, hornets and wasps, which can lead to allergic reactions similar to bee stings.

Home remedies are sufficient to treat ordinary bee stings that do not cause allergic reactions.

Multiple stings or a severe allergic reaction, on the other hand, is a medical emergency that needs prompt treatment.
 

Treatment for minor reactions

When a bee stings, it pokes its barbed stinger into your skin.

Immediately try to remove this stinger with its attached venom sac so that further release of more venom can be avoided.

Remove the stinger as fast as possible, as it requires only few seconds for all the venom to enter your body.

The stinger can be removed either with your fingernails or with the help of a tweezer.

Then, wash the sting site with soap and water. Apply an ice pack or cold compress to reduce pain and swelling.
 

Treatment for moderate reactions

These self-care steps may help reduce the swelling and itching that is often associated with large local reactions:

• Remove the stinger as soon as possible
• Wash the sting area with soap and water
• Apply cold compresses or ice on the sting site/swelling
• Apply a hydrocortisone containing cream or calamine lotion to reduce the redness, itching or swelling. If itching or swelling does not subside, take an oral antihistamine that contains diphenhydramine (Benadryl) or chlorpheniramine maleate (Chlor-Trimeton). Over-the-counter pain relieving medications such as ibuprofen can be taken to control pain associated with bee stings.
• Avoid scratching the sting area as it will make itching and swelling worse, and further increase your risk of infection.

Emergency treatment for allergic reactions
 

During anaphylactic shock, an emergency medical team may perform cardiopulmonary resuscitation (CPR) if breathing has ceased or the heart has stopped beating.

You may be given medications including:

• Supplemental oxygen to help breathing
• Epinephrine (adrenaline) to reduce the body's allergic response
• Intravenous (IV) antihistamines and cortisone to decrease inflammation of your airways and improve breathing
• A beta agonist (albuterol) to relieve symptoms of breathing difficulty

Epinephrine autoinjector

If you are found to be allergic to bee stings, your doctor may prescribe an an emergency epinephrine autoinjector (EpiPen, Twinject), which you need to carry with you every time you go outdoors.

An autoinjector consist of a combined syringe and concealed needle that delivers a single dose of medication when pressed against your thigh.

Always be sure to replace epinephrine before its expiration date. Make sure you know to use the autoinjector, and also ensure other people close to you know how to administer the drug — if they are along with you in an anaphylactic emergency, they could save your life.

Medical personnel called in during a severe anaphylactic reaction may give you an epinephrine injection or another medication.

Consider wearing an alert bracelet that can identify your allergy to bee or other insect stings.

Allergy shots

Bee and other insect stings are a common cause of anaphylaxis.

If you have had a serious reaction to a bee sting, your doctor will refer you to an allergist for allergy testing and consideration of allergy shots (immunotherapy).

These shots are given regularly for a few years in order to reduce or eliminate your allergic response to bee venom.

Here are a few prevention strategies that can help reduce your chance of getting stung by bees:

• Minimize your exposure: Take care while drinking sweet beverages outside. Drinking in wide, open cups may be a best option as you can see whether a bee is present inside the cup. Tightly cover food containers and trash cans. Clear away the garbage, fallen fruits, and dog or other animal feces (flies can attract wasps).
• Wear close-toed shoes when walking outside: Avoid wearing bright colors or floral prints, which can attract bees.
• Avoid loose fitting clothing that can trap bees between the cloth and your skin.
• While driving, keep your windows closed.
• Be careful while mowing the lawn, trimming vegetation, or performing activities that might arouse bees in a beehive or wasp nest.
• If there beehives close to your home, get rid of them by a professional.
• Know what to do when you are exposed to bees: If you notice a swarm of bees flying around you, be calm and walk away from the area. Swatting at them may cause it to sting. If a bee or wasp stings you, or many insects start flying around, cover your mouth and nose and quickly leave the area. When a bee stings, it releases a chemical that attracts other bees too, so quickly get into a building or a closed vehicle.

Few alternative remedies are used for bee stings. 

Although it has not been established by research studies, a common home remedy is rubbing a wet aspirin tablet over the sting area.

Other self-care methods include application of ice or cold packs to the affected area that can reduce your body's inflammatory response.  

The risk of getting bee stings are higher if:

• You reside in an area where beehives are present in the neighborhood
• Your stay outdoors often for work or your hobbies

Your chances of having an allergic reaction to bee stings are greater if you have had a similar allergic reaction in the past, even if it was minor.

Adults tend to develop more severe reactions than children and are more likely to die because of anaphylactic reactions.

Rarely, bee stings may lead to complications involving the nervous system.

In an unusual case of a child with a wasp sting, complications such as muscle weakness, motor aphasia, and pupil dilation was seen.

These types of complications are extremely rare and are usually due to a blood clot that forms as a result of a severe reaction to a bee sting.