Bee and Wasp Stings: Symptoms, Treatment & First Aid

What Happens When a Bee or Wasp Stings You?

When a bee or wasp stings, it injects venom through its stinger into your skin, causing immediate pain followed by redness, swelling, and itching. The venom contains proteins and enzymes that trigger your body's immune response. Most reactions are localized and resolve within 1-2 days, but some people may experience larger local reactions or severe systemic allergic reactions.

Understanding the mechanics of insect stings helps explain the symptoms you experience and guides appropriate treatment. When a bee or wasp perceives a threat, it uses its stinger as a defense mechanism, injecting venom that contains a complex mixture of biologically active substances designed to cause pain and deter predators.

The venom from bees and wasps contains several key components including histamine, which causes immediate pain and itching; melittin (in bee venom), which destroys cell membranes; and phospholipase, which breaks down cell structures. These substances work together to create the characteristic symptoms of a sting: the sharp initial pain, followed by spreading redness and swelling as your immune system responds to the foreign proteins.

There is an important distinction between bee stings and wasp stings that affects how you should respond. Honeybees have barbed stingers that become lodged in human skin, tearing away from the bee's body along with the venom sac. This kills the bee but allows the venom sac to continue pumping venom for up to a minute after the sting. Wasps, hornets, and bumblebees have smooth stingers that they can retract and use multiple times, which is why a single wasp can sting you repeatedly during an encounter.

The Body's Immune Response

Your body's reaction to insect venom involves a complex cascade of immune responses. Within seconds of the sting, mast cells in your skin detect the foreign proteins and release histamine along with other inflammatory chemicals. This triggers the classic inflammatory response: blood vessels dilate and become more permeable, allowing immune cells and fluid to flood the area. This is why you see redness (from increased blood flow), swelling (from fluid accumulation), and feel warmth and pain (from inflammatory mediators stimulating nerve endings).

In most people, this local inflammatory response remains confined to the sting area and resolves as the immune system neutralizes the venom. However, in people with insect venom allergy, the immune system has previously produced specific antibodies (IgE) against venom proteins. When they are stung again, these antibodies trigger a much more dramatic response that can spread throughout the body, potentially causing life-threatening anaphylaxis.

Differences Between Bee and Wasp Venom

While bee and wasp venoms share some common components, they contain different proteins that act as allergens. This means that being allergic to bee stings does not necessarily mean you are allergic to wasp stings, and vice versa. Bee venom is slightly acidic (pH around 5.0-5.5), while wasp venom is more alkaline. Both contain phospholipases and hyaluronidases, but the specific forms differ between species.

Wasp stings are often described as more immediately painful than bee stings due to differences in venom composition and delivery. Wasps can control the amount of venom they inject and may deliver a larger dose when they feel particularly threatened. Additionally, because wasps can sting multiple times, an encounter with an aggressive wasp can result in multiple stings and a larger total venom dose.

What Are the Symptoms of Bee and Wasp Stings?

Symptoms of bee and wasp stings range from mild local reactions (pain, redness, swelling at the sting site) to severe allergic reactions (hives over the body, facial swelling, difficulty breathing, dizziness). Normal reactions peak within 12-24 hours and resolve within a few days. Warning signs of severe allergy include itching in palms, soles, and scalp, throat tightness, and rapid heartbeat.

Recognizing the different types of reactions to insect stings is crucial for determining the appropriate response. The vast majority of bee and wasp stings cause only local reactions that, while uncomfortable, are not dangerous and will resolve on their own with basic first aid. However, a small percentage of people experience more significant reactions that may require medical attention or emergency care.

The symptoms you experience depend largely on whether you have developed sensitivity to insect venom and the amount of venom injected. First-time stings typically cause only local reactions, but subsequent stings in sensitized individuals can trigger progressively more severe responses. Understanding the spectrum of possible reactions helps you know what to expect and when to seek help.

Normal Local Reactions

The most common response to a bee or wasp sting is a normal local reaction confined to the immediate sting area. Symptoms typically begin within seconds to minutes and include sharp, burning pain at the sting site that gradually transitions to a dull ache. The area becomes red, warm, and swollen, with a raised welt or bump forming around the sting. Itching often develops as the initial pain subsides and may persist for several days.

In normal reactions, swelling is usually limited to a few centimeters around the sting and peaks between 12-24 hours after the sting. Most symptoms resolve within 2-5 days, though some residual itching or discoloration may persist longer. The severity of local reactions can vary based on factors like the location of the sting (areas with more soft tissue tend to swell more), the amount of venom injected, and individual variation in inflammatory response.

Large Local Reactions

Some people experience what doctors call large local reactions, where swelling extends more than 10 centimeters (4 inches) from the sting site and may affect an entire limb. For example, a sting on the hand might cause swelling that extends up to the elbow. These reactions develop over 12-24 hours, peak at 48-72 hours, and can take up to a week to fully resolve.

Large local reactions are not the same as allergic reactions, though they can be uncomfortable and concerning. They occur because some people's immune systems mount a more vigorous localized inflammatory response to venom. While not immediately dangerous, people who experience large local reactions have a slightly increased risk (about 5-10%) of developing systemic allergic reactions to future stings compared to those with only normal local reactions.

Systemic Allergic Reactions

Systemic allergic reactions occur when the immune response to venom spreads beyond the sting site to affect other parts of the body. These reactions can range from mild (hives, generalized itching) to severe and life-threatening (anaphylaxis). Systemic reactions typically develop within 30 minutes of the sting, though they can occasionally be delayed by several hours.

Early warning signs of a systemic reaction include unusual symptoms that seem unrelated to the sting location: itching in the palms of your hands, soles of your feet, or scalp; a metallic taste in your mouth; or a feeling of impending doom. These may be followed by visible signs like hives or flushing spreading across the body, swelling of the lips, tongue, or face, and symptoms affecting breathing or circulation.

How Do You Treat a Bee or Wasp Sting at Home?

Treat bee and wasp stings by first removing any stinger (for bee stings), then washing the area with soap and water. Apply a cold compress for 10-15 minutes to reduce pain and swelling. Over-the-counter antihistamines help with itching, and hydrocortisone cream reduces inflammation. Most stings heal completely within 24-48 hours with this basic first aid.

Effective first aid for bee and wasp stings focuses on three goals: removing the venom source (if a stinger is present), reducing pain and swelling, and preventing infection. The sooner you begin treatment, the more effective it will be, particularly when it comes to stinger removal. With proper first aid, most stings cause only temporary discomfort and heal completely within a few days.

Before beginning any treatment, move away from the area where you were stung to avoid additional stings. Bees release alarm pheromones when they sting that can attract other bees, and disturbed wasp nests may send out multiple defenders. Once you're in a safe location, you can focus on treating the sting.

Removing the Stinger

If you've been stung by a honeybee, removing the stinger quickly is the most important first step. The stinger continues to pump venom into your skin for up to 60 seconds after the sting, so fast removal significantly reduces the total venom dose. Research has shown that speed of removal matters more than the method used, so don't waste time searching for the "perfect" tool.

The traditional advice was to scrape the stinger out with a flat object like a credit card to avoid squeezing more venom into the wound. However, studies have found that the method of removal doesn't significantly affect venom delivery - what matters is getting it out fast. Use whatever is immediately available: your fingernail, a credit card edge, or even carefully grasping it between two fingers. Scrape or pull in the direction away from the venom sac to minimize any additional venom release.

Wasps, hornets, and bumblebees typically do not leave their stingers behind, so if you don't see a stinger, don't spend time looking for one that isn't there. The absence of a visible stinger suggests you were stung by a wasp rather than a bee, though occasionally bee stingers fall out on their own.

Cleaning and Cooling

After removing any stinger, wash the sting area thoroughly with soap and water. This helps remove any remaining venom on the skin surface and reduces the risk of secondary bacterial infection. Pat the area dry gently with a clean cloth.

Applying cold is one of the most effective ways to reduce pain and swelling from insect stings. Wrap ice cubes in a cloth or use a commercial cold pack and apply it to the sting site for 10-15 minutes. Never apply ice directly to skin as this can cause cold burns. You can repeat cold applications every few hours as needed for the first day or two.

The cold works by constricting blood vessels, which slows the spread of venom and inflammatory chemicals, reduces swelling by limiting fluid accumulation, and numbs nerve endings to decrease pain. Many people find that alternating 15 minutes of cold application with 15 minutes without provides the best relief.

Medications for Pain and Itching

Over-the-counter medications can significantly improve comfort during sting recovery. Oral antihistamines like diphenhydramine (Benadryl), cetirizine (Zyrtec), or loratadine (Claritin) help reduce itching and can limit the histamine-driven inflammatory response. Non-drowsy antihistamines are often preferred during daytime hours.

Topical treatments applied directly to the sting site can provide additional relief. Hydrocortisone cream (0.5-1%) reduces inflammation and itching when applied 2-3 times daily. Calamine lotion has a soothing, cooling effect. Some people find relief from products containing lidocaine or benzocaine, which provide local numbing, though these should be used sparingly and not on broken skin.

For pain management, standard over-the-counter pain relievers like acetaminophen (paracetamol) or ibuprofen can help. Ibuprofen has anti-inflammatory properties that may provide additional benefit for swelling. Follow package directions for appropriate dosing and be aware of any contraindications based on your health conditions.

When Should You See a Doctor for a Bee or Wasp Sting?

See a doctor for bee or wasp stings if you experience symptoms away from the sting site (hives, facial swelling), were stung in the mouth or throat, have increasing pain and swelling after 24-48 hours, or show signs of infection (pus, fever, spreading redness). Call emergency services immediately for breathing difficulties, dizziness, or throat swelling.

While most bee and wasp stings can be safely managed at home, certain situations require professional medical evaluation or emergency care. Knowing when to seek help can be lifesaving in cases of severe allergic reactions and can prevent complications like secondary infections in other situations.

The key distinction is between local reactions that may be uncomfortable but are not dangerous, and systemic reactions that indicate your body is having a more serious response to the venom. Additionally, certain sting locations and pre-existing conditions increase the risk of complications and warrant medical attention even for otherwise normal reactions.

Situations Requiring Emergency Care

Call emergency services or go to an emergency department immediately if you experience any symptoms suggesting a systemic allergic reaction. These include difficulty breathing, wheezing, or a feeling of tightness in your chest; swelling of your face, lips, tongue, or throat; dizziness, lightheadedness, or feeling faint; rapid or irregular heartbeat; severe nausea, vomiting, or diarrhea; or widespread hives or flushing.

If you have a known insect venom allergy and carry an epinephrine auto-injector (such as EpiPen or Jext), use it immediately at the first sign of a severe reaction, then call emergency services. Epinephrine is most effective when given early in an allergic reaction. Even if symptoms improve after using epinephrine, you should still seek emergency care as symptoms can recur (a phenomenon called biphasic anaphylaxis).

Stings inside the mouth or throat are always an emergency, regardless of whether you have known allergies. Swelling in these areas can rapidly obstruct your airway even from a normal inflammatory response, not just an allergic reaction. If you've swallowed an insect that then stung you, or been stung while eating or drinking, seek immediate medical care.

Situations Requiring Medical Evaluation

Contact a healthcare provider (urgent care, emergency department if after hours) if you experience symptoms spreading beyond the immediate sting area, such as hives appearing on other parts of your body or swelling of your face when stung on an extremity. These suggest a systemic response that, while not immediately life-threatening, indicates increased risk and may benefit from medical treatment.

Seek medical evaluation if you receive multiple stings, especially 10 or more. Large venom doses can cause toxic reactions even in people without allergies, potentially affecting the kidneys, liver, or blood. Children, elderly individuals, and those with heart or lung conditions are at higher risk from multiple stings.

If symptoms worsen rather than improve after 24-48 hours, or if you develop signs of infection around the sting site (increasing redness that spreads outward, warmth, pus, red streaks, or fever), contact a healthcare provider. Secondary bacterial infections can develop if the sting area becomes contaminated, particularly if excessive scratching breaks the skin.

How Can You Prevent Bee and Wasp Stings?

Prevent bee and wasp stings by avoiding eating or drinking outdoors (especially sweet foods and drinks), not swatting at insects, wearing shoes outdoors, covering drinks, avoiding bright colors and floral patterns, and staying calm around flying insects. Never crush bees or wasps as they release alarm pheromones that attract others.

While it's impossible to completely eliminate the risk of bee and wasp stings, understanding insect behavior and making simple modifications to your activities can significantly reduce your chances of being stung. Bees and wasps generally sting only in defense - either protecting themselves when threatened or defending their colony. Avoiding situations that trigger defensive behavior is the key to prevention.

People with known insect venom allergies should be particularly careful about prevention and always carry their prescribed emergency medications (epinephrine auto-injector, antihistamines) during seasons when stinging insects are active. Discussing allergen immunotherapy with an allergist may also be appropriate, as this treatment can provide long-term protection against severe reactions.

Behavioral Strategies

The most important prevention principle is to remain calm around bees and wasps. Sudden movements, swatting, and flailing arms are perceived as threats and provoke defensive stinging. If a bee or wasp lands on you, stay still and wait for it to fly away, or gently brush it off with a slow, smooth motion. If an insect is flying around you, move away slowly rather than running or swatting.

Never kill a bee or wasp near others of its species. When crushed, these insects release alarm pheromones that signal danger to nearby colony members, potentially triggering a swarm of defensive attacks. This is particularly dangerous near nests or hives. If you encounter a nest, move away calmly and quietly.

Be especially careful in late summer and early fall when wasp populations peak and food sources become scarcer. Wasps become more aggressive as they search for food and are more likely to investigate human activities. This is also when yellowjackets, which nest in the ground, are most numerous and when people are most likely to accidentally disturb their nests while doing yard work.

Food and Drink Precautions

Bees and wasps are strongly attracted to sweet foods and drinks, as well as proteins (wasps particularly like meat). When eating outdoors, keep food covered until you're ready to eat it, clean up spills immediately, and dispose of food waste in sealed containers. Keep garbage cans tightly covered and empty them frequently during peak insect season.

Be particularly careful with open drink containers. Wasps can crawl into soda cans, cups, and bottles, and stings inside the mouth from accidentally ingesting an insect are dangerous emergencies. Use cups with lids and straws, or pour drinks into glasses where you can see the contents. Never drink directly from cans or bottles that have been sitting outdoors.

Avoid wearing sweet-scented perfumes, lotions, hair products, or sunscreens when you'll be outdoors in areas with bee or wasp activity. These scents can attract insects investigating potential food sources. Unscented products are a safer choice for outdoor activities during insect season.

Clothing and Environmental Awareness

Bright colors, especially yellow and white, can attract bees and wasps. When spending time outdoors in areas where stinging insects are common, consider wearing light-colored, earth-toned clothing. Avoid floral prints, which may be investigated by bees searching for flowers. Loose-fitting clothing is also advisable, as tight clothing can trap insects against your skin.

Always wear shoes outdoors, particularly when walking in grass. Bees often forage in clover and other low-growing flowers, and bare feet are at risk of stepping on them. Wasps and yellowjackets may also be on the ground feeding on fallen fruit or nesting in underground burrows.

Be aware of your environment. Learn to recognize the appearance and locations of bee hives and wasp nests. Honeybee hives are often in tree hollows or man-made structures; wasp nests may be under eaves, in bushes, or underground. If you notice increased insect activity in an area, there may be a nest nearby that you should avoid.

Are Bee and Wasp Stings Different in Children?

Children generally handle bee and wasp stings well, with severe allergic reactions being less common in children than adults. Treatment is the same as for adults: remove stinger, clean area, apply cold, and use age-appropriate antihistamines. Seek immediate care if a child shows any signs of allergic reaction, has multiple stings, or was stung in the mouth.

Parents naturally worry when their children are stung by bees or wasps, but in most cases, children experience only local reactions that resolve quickly with basic first aid. The good news is that severe systemic allergic reactions (anaphylaxis) are actually less common in children than in adults. When children do have allergic reactions, they tend to be milder, often involving only skin symptoms like hives.

That said, children deserve close monitoring after stings because they may have difficulty communicating their symptoms, and their smaller body size means that the relative venom dose is higher than for adults from the same sting. Any child showing signs of a reaction beyond the immediate sting area needs prompt medical attention.

Treatment Considerations for Children

First aid for children follows the same principles as for adults: quick stinger removal, cleaning, cold application, and symptomatic treatment. When applying ice packs to children, take extra care to avoid cold burns by always wrapping ice in cloth and limiting application to 10-15 minutes at a time. Children's skin is more sensitive than adult skin.

Over-the-counter antihistamines can be used in children but require age-appropriate dosing. Liquid formulations are often easier for young children. Check package labels for age restrictions and appropriate doses, or consult a pharmacist or healthcare provider if unsure. Diphenhydramine (Benadryl) causes drowsiness, which may be helpful at bedtime but can impair a child's normal activities. Non-drowsy options like cetirizine (children's Zyrtec) are available for daytime use.

Topical hydrocortisone cream can be used on children over 2 years of age. For younger children, consult a healthcare provider before using topical medications. All topical treatments should be applied only to intact skin and kept away from eyes and mouth.

When to Worry About Your Child

Seek immediate emergency care if your child shows any of the following after an insect sting: difficulty breathing or unusual breathing sounds; swelling of the face, lips, or tongue; widespread hives or skin color changes; dizziness, fainting, or unusual lethargy; persistent vomiting; or any behavior that seems abnormal compared to their usual response to pain.

Multiple stings in children warrant medical evaluation because their smaller body size means they receive a relatively larger venom dose. Children who are stung 10 or more times should be seen by a healthcare provider even if they seem fine, as toxic effects can be delayed.

If your child has had a previous allergic reaction to an insect sting, they should be evaluated by an allergist. The allergist can determine whether your child has venom allergy, prescribe emergency medications including an epinephrine auto-injector, and discuss whether allergen immunotherapy is appropriate.

What Is Anaphylaxis and How Is It Treated?

Anaphylaxis is a severe, potentially life-threatening allergic reaction that can occur within minutes of a bee or wasp sting. Symptoms include difficulty breathing, swelling of throat and tongue, rapid pulse, dizziness, and loss of consciousness. Treatment requires immediate injection of epinephrine (adrenaline) followed by emergency medical care. Anyone who has had anaphylaxis should carry an epinephrine auto-injector.

Anaphylaxis represents the most severe end of the allergic reaction spectrum and constitutes a true medical emergency. Understanding anaphylaxis - its causes, symptoms, and treatment - is essential for anyone who spends time outdoors where stinging insects live, and is especially critical for people with known insect venom allergies and their families.

The term anaphylaxis comes from Greek words meaning "against protection," reflecting the paradox that the immune system, which normally protects us, can sometimes cause harm. In anaphylaxis, the immune system's response to venom proteins becomes so overwhelming that it threatens vital organ function, particularly breathing and circulation.

Understanding the Anaphylactic Reaction

Anaphylaxis occurs in people who have become sensitized to insect venom through previous exposure. During sensitization, the immune system produces specific antibodies (IgE) against venom proteins. These antibodies attach to mast cells throughout the body, essentially "arming" them to respond if that allergen appears again.

When a sensitized person is stung again, the venom proteins bind to these antibodies, triggering mast cells to release massive amounts of histamine and other inflammatory chemicals simultaneously throughout the body. This causes blood vessels to dilate and become leaky, leading to dangerous drops in blood pressure; airways to constrict and swell, making breathing difficult; and various other symptoms affecting the skin, digestive system, and nervous system.

The speed of onset varies but can be extremely rapid - symptoms may begin within seconds of the sting. Generally, the faster symptoms develop, the more severe the reaction is likely to be. However, there can be a delay of up to several hours in some cases, which is why monitoring after stings is important.

Recognizing Anaphylaxis

Anaphylaxis typically involves multiple organ systems. Skin symptoms are most common and may include widespread hives, flushing, itching (especially palms, soles, scalp), and swelling of the face, lips, or tongue. Respiratory symptoms include throat tightness, hoarseness, difficulty swallowing, wheezing, shortness of breath, and coughing. Cardiovascular symptoms include dizziness, lightheadedness, rapid heartbeat, weak pulse, and fainting. Gastrointestinal symptoms may include nausea, vomiting, abdominal cramps, and diarrhea.

Not all symptoms need to be present for a reaction to be anaphylaxis. The diagnosis is made when there is rapid onset of symptoms after exposure to a known allergen (like insect venom) with involvement of the skin/mucous membranes plus either respiratory compromise or reduced blood pressure/associated symptoms (dizziness, fainting).

Emergency Treatment of Anaphylaxis

Epinephrine (adrenaline) is the first-line treatment for anaphylaxis and should be given immediately. If the person having the reaction has an epinephrine auto-injector (EpiPen, Jext, or similar device), it should be used right away - do not wait to see if symptoms worsen. The injection is given into the outer thigh and can be administered through clothing if necessary.

After giving epinephrine, call emergency services immediately. Even if symptoms improve, professional medical evaluation is essential because symptoms can recur (biphasic reaction). The person should lie down with legs elevated (unless having breathing difficulty, in which case they should sit up), and a second dose of epinephrine can be given after 5-15 minutes if symptoms don't improve or return.

Antihistamines and corticosteroids are supplemental treatments that may help with skin symptoms and potentially prevent biphasic reactions, but they work too slowly to be effective for immediate treatment and should never replace epinephrine as first-line therapy.