Treating Bee Stings

Dr. Greene, My son (along with several of his classmates) was recently stung by bees. The sting was on his foot, and the next morning, the entire foot was swollen. Is this serious? How do you treat bee stings? What insect repellents work the best at preventing them?
California

Treating Bee Stings

Dr. Greene’s Answer:

Bee stings have been a nuisance long enough to have appeared in prehistoric cave paintings in Spain. Bee stings are part of our collective memory and they are part of our individual memories as well. While many moments of childhood come and go, the surprise, the pain, and the tears etch bee stings into images that we can recall even in old age, when our short-term memory begins to fade.

Bees have a highly developed social culture. The many species of bees have an important role in our environment. Most species of bees are clearly beneficial to humans. They are also the only insects that make food consumed by humans. But their stings hurt… and can be lethal.

Typically, bees are not aggressive creatures. Their stingers are for defense, not attack. Honeybees die when they sting. Preventing stings is best for all concerned. Traditional insect repellents are of no use in preventing bee stings. What does work?

Effective prevention means not attracting bees and not frightening them if they are present. Prevention techniques are especially important in the fall, when most stings occur. It takes 2 million visits to flowers to make one pound of honey. In the autumn, as flowers disappear, bees search more widely for food and take more risks.

Today, I spent some time with a beekeeper who was standing inside a screened cage full of honeybees. The bees rested on his bare face and arms as he described how to avoid stings. Flowers attract bees by their fragrant aroma, their bright colors, and their sweet taste.

Tips to Avoid Bee Stings

  • Avoid fragrances, including hair spray, scented soaps, lotions, and oils. Bees usually approach children with a sweet scent.
  • Don’t wear brightly colored clothing, particularly floral patterns, i.e. don’t look like a flower patch. Bees also see in the ultraviolet range. If the pattern lights up under black light, it is particularly interesting to bees.
  • Be very careful with food. Cans of soda are notorious: Bees climb in unobserved, and are frightened into stinging when the child drinks. Something as small as a forgotten raspberry jam stain on a sweater can be a problem.

If a Bee Does Land, Take Steps to Avoid Frightening It

  • Hold still. Tell kids to pretend they’re statues. Rapid movement startles the bee and encourages stinging.
  • Try blowing gently on the bee. This can encourage it to move on while not startling it.
  • Wear shoes. Bees will of course be frightened if you step on or near them. Shoes don’t make them less frightened, but they do protect feet from frightened bees.
  • Wear long pants when you know you are going to be in an area that is likely to have bees in it, such as a field.
  • Wear a hat. Furry animals steal honey from bees. Bees are in a heightened state of readiness when they are close to hair or fur. They have been proven to have a higher threshold for stinging people with hats. The beekeeper today was wearing a pastel baseball cap.

The bee’s stinger is barbed. In the act of stinging, the stinger is torn from the bee, along with the venom-filled poison sac and attached muscles. The barbs continue to work the stinger deeper into the flesh for several minutes, while venom continues to be injected. This led to statements such as this, which appear in most books on pediatric advice: “The stinger should be removed with a scraping motion by using the rigid edge of a credit card or a dull butter knife. Never attempt to pull out the stinger using fingers or tweezers, since this will result in the injection of more venom.”

An excellent study published in the Lancet, August 1996, turns this advice on its ear. Researchers at the University of California, Riverside, and Pennsylvania State University tested what really happened by measuring the size of the wheals raised on their own forearms by bee stings. After stings in the left arm, they left the stinger in for 0.5 seconds, 1, 2, 4, or 8 seconds and then scraped the stinger out with a credit card. On the right arm, the stinger was removed by pinching the stinger between the thumb and forefinger at the same time intervals. There was no difference in wheal size between the different methods of extraction. The wheals did get larger, though, with each second that the stinger remained.

Treating Bee Stings

  • Remove the stinger with all haste, in whatever manner is most convenient. If you see a little black dot in the wound, part of the stinger is still present.
  • Clean the area with soap and water.
  • Consider applying an antiperspirant to the site. An ingredient called aluminum chlorohydrate may reduce the effect of bee venom.
  • Apply cold. Use ice or cool water for 10 to 30 minutes after the sting. This blunts the body’s allergic response.
  • An antihistamine such as Benadryl, taken by mouth, can give some added relief, and help prevent the reaction from spreading.
  • A shake lotion such as calamine can be helpful. A paste made of baking soda and water can have a similar effect.
  • Topical hydrocortisone can also provide some symptomatic relief.
  • Give acetaminophen or ibuprofen for systemic pain relief.

After a Bee Sting

Different children will have different reactions:

  • Bee stings cause immediate, painful red bumps.
  • In most cases, the pain has largely disappeared within 2 hours, although swelling may not be apparent until the next day.
  • Large local reactions, larger than 3 inches in diameter, will often persist for up to a week. A physician should be consulted if the reaction continues to spread.
  • Systemic reactions such as hives, redness, or swelling elsewhere on the body, vomiting, dizziness, hoarseness, thickened speech, or difficulty breathing, should receive prompt medical care from a physician.
  • Also, be sure to see a doctor if there were 10 or more stings, or if one of the stings was inside the nose or mouth, since swelling can interfere with breathing.

A child who has had a systemic reaction to a bee sting (which I can personally relate to) should follow special precautions set forth by his or her pediatrician. This will include carrying injectable epinephrine (which I do).

Although systemic reactions occur in about 3% of people who are stung, and anaphylactic shock can follow as many as 0.8% of bee stings, only about 40 people in the United States are killed by bee stings each year, and only 1 to 2 of these are children.

Dr. Alan Greene

Dr. Greene is the founder of DrGreene.com (cited by the AMA as “the pioneer physician Web site”), a practicing pediatrician, father of four, & author of Raising Baby Green & Feeding Baby Green. He appears frequently in the media including such venues as the The New York Times, the TODAY Show, Good Morning America, & the Dr. Oz Show.

  1. Jessica

    My husband got stung on the forehead lastnight around 6pm, this morning around 4am hes been vomiting alot & has headaches + where he was stung is quite swollen & red. Could he be having an allergic reaction?

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    • Jessica,

      This sounds like a Toxic Reaction. Dr. Greene says, “[A toxic reaction] is a direct result of bee venom, and not an allergic reaction. Symptoms can include fever, weakness, nausea, vomiting, and pain. Toxic bee sting reactions are rarely serious, but do sometimes sensitize the child and herald future allergic reactions.”

      Best,
      @MsGreene

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  2. Alexis Lira

    Hi my dad got stung by 3 bees on his hand called avispas how long does it take to get off

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    • Stung

      Many (I do not know if all) vasp venoms break down in heat. So.. I usually put the stung part (after removing the stinger, and if it is possible to do so at the time) in as hot water that I can manage without getting burnt. And for as long as possible.

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  3. Sydney

    A bee stung the inside of my ear and the stinger is still in it. What do I do?

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    • Sydney,

      It’s important to get the stinger out. The sooner you can get it out the better.

      You will likely need help. Use a magnifying glass (or the camera on your smart phone) to get an enlarged view of the area that has been stung. If there’s a black dot still present after you’ve removed the stinger, some of it is still in the skin. Use tweezers to get it all out.

      Hope that helps.

      @Msgreene

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  4. Zack kasson

    Hi I was stung by 9bees or so yesterday and my whole body was covered in hives! I went to the ER they gave me benedryl and steroids! By the time I went to bed all the hives were gone. When I woke up this morning they continued to come back and as of 2 my whole body is covered again! I don’t know what I should do

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    • Oh, no! Sounds like the meds have worn off. If you’re still having difficulty, call your doctor who may prescribe more.

      @MsGreene

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  5. Laura

    Ok was riding on motorcycle got stung by bee or wasp .Hurt terribly got a swollen mark now today the area is itching and hurting and huge red spot. Put benedryl cream on it should I be concerned or will it take it course. I am 59 and have RSD auto immune disease.

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  6. Blaine

    Hey i stepped on a bee yesterday and the area on my toe has swelled up bad and my whole foot is swollen and i cant put any pressure and bombs are starting to grow on the the of my foot

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  7. Teresa

    My daughter was stung 4times yesterday and today her legs are all swollen ,red and itchy,she’s been very shaky the swelling is worse today than it was yesterday any suggestions? She’s been putting ice on it taking Benadryl

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    • Jasmine

      I am no docter so I Canot diagnose her but I know you should take her to the hospital right away.

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  8. Grace Jacobs

    I was stung 2 days ago, and there was no stinger. It was swollen earlier but has gone down but there is still redness and it itches. But, now it’s hard underneath the skin around it. Is this bad?

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    • christine

      Have you gotten a response to this? I am having the same problem.

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      • Magik wiz

        NO..I’m sure by now it’s gone..
        It’s just a sting… swelling.redness itching ..lol alot of itching..it’s goes away on its own…

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  9. Rebekah

    Hi Doc,

    A bee was inside my old outside shoes and when I put my left foot in a bee stung me on the left foot on the side.

    Now foot is very bright pink and swollen and hurts. Both the back and side are swollen a lot.

    I have taken Benadryl as directed by my pharmacist. What can I do? It hurts a lot.

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  10. Munish

    Hey doc.
    I was bitten by 4 bees and swelling is keep on increasing and the worst problem is that I live in a remote area .
    So please recommend me any easy treatment
    Thankyou

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  11. Wonnegauer

    In my experience the follow-ups of insect bites and wasp or bee stings like itching, aching and swelling is easily avoided with heat treatment in most situations.

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  12. Kaleb dykens

    Can I survive a bee sting over night without treatment

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    • Hi Kaleb,

      Different people have different sensitivity to bee stings. Some need immediate attention and medication. Others never need treatment.

      If you have severe swelling, it’s wise to be checked immediately.

      Best,
      @MsGreene

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  13. nomt

    3days ago I got sting by a Bee and I did nothing about it and by now its swollen and painful what must I do and am 14 years in age

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  14. a

    thankfully only 40 people in the United States are killed by bee stings each year, and only 1 to 2 of these are children.

    “THANKFULLY”??? You probably should look at rewording this…. Definitely other things one should be thankful for…

    “ABOUT” probably a better choice of words. What do you think?

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    • Excellent point. Change made, though I think what Dr. Greene meant was thankfully it’s not a larger number. Still, your point is well taken.

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  15. Kate

    I think I got stung by a wasp last night because there was a bee on the window seal and a bump on my arm and it really does sting I would always remember to take of any perfume before bed by having a shower or bath

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  16. Alexis

    I have a swollen foot and I can barely walk on it

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  17. Beezlebub

    This is Obama’s fault.

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    • ImperialCrab

      Nah… he’s pretty much outta the picture. My guess? Hillary.

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  18. Kaylee Nicole Simmons

    I can’t walk because of the swelling on my foot its sad

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    • Kate

      Poor you

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  19. Dee

    Dr Green you suck

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    • ImperialCrab

      So… get him over here to get rid of this damn stinger.

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  20. seleste

    I got stung in my lip. It’s pretty swollen and hasn’t gone down. How much longer will it stay swollen?

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    • kaden

      i just got stung in the lip too. How long did it take?

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  21. Greg

    I was stung yesterday on the tip of my nose. Didn’t think much of it at the time. When I woke up this morning my nose was red and swelled up. I hope it doesn’t last long.

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    • Julie

      That happened to me before too. You have to ice it a lot! The swelling should die down in a few hours. If it hurts apply a dap of mustard.

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  22. Margo

    I was stung by a bee over 24 hours ago. Area is very red over large area around bee sting. Never been stung before. Stinger is not imbedded in skin but very sore and still itchy. Applying ice and cream. How long will symptoms last?

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  23. lois-ann

    This message has nothing about how long your swelling stays up.

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  24. jrj90620

    Long article didn’t say anything about what to do,for large swelling.Will look elsewhere

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  25. Angela

    What if your swelling is worse the next day what do you do
    A

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