Treating Bee Stings: A Dive Into Reactions, Treatment & Prevention

Bees have an important role in our environment, but their stings hurt & can be lethal. Treating bee stings varies by severity.

Question

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

Dr. Greene's Answer

While it may not be readily apparent in the insulated, air-conditioned society most of us are accustomed to in the U.S., the fact of the matter is that the survival of bees and human beings is inextricably linked. It is estimated that one in every three bites of food we eat exists because of animal and insect pollinators, including 3,500 species of native bees! This means that one-third of our food is created by these industrious little beings. 

Bees are intelligent creatures with highly developed social cultures. They are not aggressive in nature, but sting when frightened or startled as a mechanism of defense. Honeybees in particular die after engaging their stingers. In light of recent threats such as colony collapse, it is in the best interest of both bees and humans to support their longevity as best we can. 

Bees are never on the hunt for victims to sting, but nevertheless it does happen when they feel threatened. While bee stings are fairly common, extreme cases of allergic reaction are rare. Of the 60 or so people who die as a result of hornet, wasps, or bee stings each year, the vast majority are adults. After being stung most children and adults experience a case of innocuous, if painful, red bumps that subsides within about 2 hours. Swelling may appear into the following day, but is not generally a cause for concern. 

Types of Bee Sting Reactions

Bee venom contains more than nine components that work in concert to cause the physical reactions we humans experience at the onset of a bee sting. A bee’s stinger is barbed along the sides. When stinging, it is torn away from the body of the bee, along with the venom sac, as well as any attached muscles. The barbs then work their way a bit deeper into the skin, and continue to inject venom for a few more moments. 

It is possible to have an immediate reaction that occurs within 4 hours of being stung, a delayed reaction that begins at least 4 hours after initial contact, or both. Classifying what type of reaction your child has is important for both immediate management as well as assessing for the severity of future encounters. Additionally, types of reactions can be determined as follows: local, large local, systemic, toxic, and delayed. 

Local: Local reactions are the most common type of reaction to bee stings. There may be an area of swelling 2-3 inches across in the immediate area of the sting. Inflammation, redness and pain generally dissipate in less than 24 to 48 hours. Note that this is a natural response to the venom conveyed in a bee sting, and not an allergic reaction. 

Large Local: A larger local reaction can affect an entire limb with swelling and redness, but is consistently near or adjacent to the stinging site. These types of reactions generally come on about 12-36 hours after a sting, and persist for up to a week. While it may be uncomfortable or unsightly, large local reactions are not a serious threat to the health and wellbeing of your child. If, however, such a reaction lasts longer than a week, or it spreads to other parts of the body, contact your pediatrician. For example, a sting on the forehead accompanied by the swelling of the eyelids is considered a “large local” reaction. A sting on the foot accompanied by the swelling of eyelids is considered systemic and presents a warning sign of a more severe allergic response. 

Systemic: Unlike local and most large local reactions, systemic responses are allergic in nature, meaning the body overcompensates in its attempt to manage the presence of bee venom within the body. This may include swelling, redness, and pain in parts of the body nowhere near the original site of the sting such as hives, generalized itching and/or swelling, nausea, stomach pain, vomiting, dizziness, hoarseness, difficulty breathing, and low blood pressure. Severe reactions include most or all of these symptoms and may induce anaphylactic shock. 

Such severe reactions to bee stings occur in only about 1-3% of children, and only 0.8% experience anaphylactic shock. See a doctor immediately if your child displays any symptoms listed in this section. Children who fall into this category should follow protocols set forth by their doctor, including carrying an injectable epinephrine and possibly wearing a medical bracelet. 

Toxic: Toxic reactions, while not as frightening as the name implies, are still unpleasant. Toxic reactions occur immediately upon stinging, usually as a result of multiple stings. The term “toxic” refers to the fact that the body is responding to the presence of high levels of bee venom, and not as an allergic reaction. Toxic responses are not medically dangerous but may include fever, weakness, nausea, vomiting, and pain within the body. It is also possible that such an experience can predispose a child to future bee venom allergies. 

It is best to see a doctor if a child experiences 10 or more bee stings at once, or if there are any stings inside the nose or mouth, as ensuing swelling can interfere with the ability to breathe. 

Delayed: Delayed responses to bee stings are generally the result of the body’s attempt to over-prepare for future stings due to an unpleasant sting encounter in the past. In doing so the body unknowingly turns against itself with the onset of the next bee stings. 

Delayed reactions include serum sickness (fever, weakness, rash, swelling, and/or intense itching which begin a week after the sting), nephrotic syndrome (inflammation of the kidney), neuritis (inflammation of the nerves), or inflammation of other parts of the body. 

Treating Bee Stings

Remove the stinger as quickly and safely as possible. The longer a stinger stays in the skin, the larger the resulting welt, or wheal, will be. A credit card or dull butter knife scraped horizontally across the skin can usually dislodge the stinger effectively. Historically, medical professionals discouraged the use of tweezers for removal of stingers under the assumption that it would express more venom into the skin, but recent experiments have debunked that concern. Removing the stinger more quickly, as opposed to how it is removed, plays a bigger role in resulting swelling. If you observe a black dot in the skin, it likely means a part of the stinger is still embedded in the tissue. 

To help prevent secondary infection, gently wash the area with soap and water.  Do not break any blisters that may appear. 

To reduce pain, a solution of one part meat tenderizer and 4 parts water can be applied to the site. Meat tenderizer contains papain, an enzyme found in papaya, that breaks down protein – in this case, the protein in bee venom that causes pain and itching. If you decide to use this method, be sure to rinse the solution from the skin within 30 minutes to reduce the chances of skin irritation. An antiperspirant can also be applied, as aluminum carbohydrate will also mitigate the effects of bee venom, but not to the same degree as papain. 

Cold applications can feel soothing to inflamed areas of the skin. Applying an ice pack or rag soaked in cool water for 10-30 minutes at a time will lessen allergic reactions. An antihistamine such as Benadryl can also prevent a systemic response from spreading, and calamine lotion or a paste of water and baking soda can help reduce itching. Raising the limb (if that is where the sting is located) may also help reduce the inflammation. 

Topical hydrocortisone may be helpful for treating bee stings that are more virulent, as well as an antibiotic ointment applied to sting sites to reduce the chances of infection. 

For generalized discomfort, the appropriate dose of acetaminophen or ibuprofen can provide some relief for your child. 

If you know your child is allergic to bee stings, it is likely they will need to carry injectable epinephrine, such as an Epi-pen, with them during the warmer months. These are injected immediately after a bee sting to stop symptoms of dizziness, difficulty breathing, and/or the swelling of the lips and tongue. 

Additionally, treating bee stings include options for children with more severe allergic response include corticosteroids, antihistamines, and possibly allergy shots. The correct type of allergy shot can help to desensitize a child to bee stings, but will first need to be assessed using either a positive skin or RAST test. Test results indicate the specific type of bee allergy shot to administer. (See more on testing below). Ask your pediatrician about the best methods to manage your child’s symptoms.

Preventing Bee Stings

When it comes to bee stings, prevention means not attracting bees, to begin with, and not frightening them when they are present. More bee stings occur in fall as the proliferation of flowers begin to dwindle, so it’s helpful to carry the following practices of prevention well into autumn. 

Avoid fragrances, including those found in hair spray, soap, lotions, and oils. Try your best not to smell like a flower!

Skip floral patterns and bright colors in favor of more muted and neutral tones. Avoid black light activated fabrics – bees are able to see in the ultraviolet range, so these sorts of colors are especially appealing to them. 

If you’re going to be in a place where you expect to encounter bees, wear solid shoes that cover the whole foot, and long pants that keep the legs covered. Hats are also helpful as they keep hair contained. Bees recognize that bears and other furry animals have an interest in their honey, and are therefore more alert to defend themselves around hair and fur. 

Take extra caution when eating outside, especially sweet foods and beverages. Bees love to climb into open soda cans. They then become jostled and afraid when a person goes to drink and may end up stinging the mouth, which is especially unpleasant. Be very observant at your picnics, and try to wipe away food from your child’s hands, face, and clothing so as not to appear like a tasty treat!

When bees do land on yourself or your child, do your best not to frighten them. Stay still, even turning it into a game of “playing statue.” Unless you have inadvertently disturbed a beehive, when a bee has landed on you it believes you are a safe place; it wouldn’t hang out somewhere it felt threatened. Rather than gesturing wildly and causing the bee to become startled, gently blow in its direction, or simply wait until it flies away on its own. Once it realizes you’re not filled with nectar, it will happily be on its way. 

If a bee comes into your vehicle, stop the car slowly and open all windows.  Allow the insect to fly out on its own, if possible, to avoid making it agitated and more likely to sting. 

Allergy Testing

There are two main ways to test for bee venom allergies. Neither test is completely perfect, and in some cases it may be beneficial to engage in both types of testing. 

The most common method is skin testing. However, it is important to perform the skin test at least 1-6 weeks after being stung to obtain the most accurate results. A positive skin test is a good indicator of allergy if the child has a history of reactions to bee stings that suggest systemic response or other severe symptoms. However, up to 50% of non-allergic participants will also test positively, so skin test results must be taken in context with other factors. 

If your child has a history of anaphylaxis related to bee stings and has resulted in a negative skin test, it is highly suggested to order a blood test (RAST), and repeat the skin test in 3-6 months. Skin testing requires careful precision to prevent systemic reactions in very sensitive individuals. It is also important to be aware that the degree of a positive skin test does not necessarily correlate to the severity of an allergic reaction in real-time. 

RAST testing, while more reliable than a skin test, does present 20% false-negative or false-positive results. Again, the level of positivity does not accurately indicate the degree of allergy present. 

A final word about allergy testing: it is only necessary to test for bee venom allergy if your child has sustained symptoms indicative of a systemic reaction. Large local reactions, while unpleasant, are not suggestive of allergies. 

More Friend Than Foe

Aside from the fact that most children experience normal, mild reactions to bee stings, the good news is that even children who are allergic tend to grow out of their allergies. A study followed 174 kids, age 3-16, for 4 years. All had previously experienced a systemic reaction to bee stings before the onset of the study. Of the 196 stings experienced by the group in the following years, only 9.2% produced systemic reactions once again, and none more severe than the first encounter. It is likely that most children with a bee venom allergy will eventually cease to have such extreme reactions. 

No one wants to get stung by bees, and as far as we can tell, they don’t want to sting anyone, either! It takes 2 million visits to flowers to make just one pound of honey. Bees are far too busy tending their hives to want to go out of their way to harm anyone. With careful measures in place, you can reduce the chances of stinging, making for happy children and happy bees alike. 

References and Resources:

Gwen Z et al. Hymenoptera stings. Pediatrics in Review 33(11):534-535, 2012.

Thilo J et al. Diagnostics in Hymenoptera venom allergy: current concepts and developments with special focus on molecular allergy diagnostics. Allergo J Int 26(3):93–105, 2017.

Valentine et al. The value of immunotherapy with venom in children with allergy to insect stings. N Engl J Med 323(23):1601‐1603, 1990.

Last medical review on: July 01, 2020
About the Author
Photo of Alan Greene MD
Dr. Greene is a practicing physician, author, national and international TEDx speaker, and global health advocate. He is a graduate of Princeton University and University of California San Francisco.
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Recent Comments

The nest looked like a medium oval baseball size. Hornet or bee. I am not knowledgeable. The sting felt like a stab. Pain, then itching. Kept me awake . Itching from the thumb up past the wrist. AND continued. Nothing seemed to help. Not even Hydrocortizone. Swelling. 12 hrs later, stilll 60% uncomfortable. Barely tolerable itch.

Very good article as it relates to honeybees . I was checking out things on google as I got a honeybee sting yesterday on my index finger and it is quite swollen today. I was manipulating some comb in my top bar hive which has about 40,000 bees in it and I accidentally pinched one that took offense on my finger. The honeybee is quite docile so I don’t garb up until late summer. Twenty minutes after the honeybee sting I was walking into a shed and a yellow jacket got me in the back of my neck as I walked past. They don’t have a barbed stingers so they don’t die after they sting and can hit multiple times.

Hi last night I felt an insect crawled on my neck so i touched it and accidentally killed it with my fingers. When I felt that its big I immediately threw it away from my fingers. And then I saw it was a bee and then my middle finger stings like its been cut or something. It was just a small bite like an ant bite kind of size. Then I just went to get an alcohol to clean it in case of infection or something. This morning I woke up and theres a small bump like pimples on the side of my middle finger. How can I treat this? Is this dangerous? I felt dizzy when I woke up i dont know if thats normal. And my head hurts a bit and my body feels like im about to have a fever.

I got stung by a bee on the left side of my lower ankle last week Monday 08/14/2017 and it is now 08/23/2017 and my skin is still bright red and tender to the touch and hurts. I have checked it to see if the stinger is still in my skin but it looks more like a scab now. Why do you think that it is still hurting and any suggestions on what I should do?

Hi I stepped on a bee last night and got stung on the base of foot. Didn’t have an allergic reaction, just a bit swollen around the area of the sting. I iced it and put a cream on, but it still hurts until now, the next morning.

I did get the large part of the stinger out with a tweezer, but I think there is a small black dot still — can’t get it out because it was deep and the skin is so thick there.

Is this pain normal? Because I can’t walk normally, cant put any weight on it.

And is it ok that part of the stinger might still be in there? What to do?

Thanks so much, appreciate the answer if any..

I stepped on a bee today and it’s been hurting for several hours. Stings so bad. The only thing that helps is ice. I didn’t see any stinger left on my foot, so I have no idea why it still hurts.
HELP!

I saw a bee buzzing around my head so I swatted at it and the stinger (with bee attached) embedded into my right middle finger knuckle. I was able to fling the bee off and saw so signs of the stinger in my finger. It was the most intense pain I have EVER felt and I have given birth to children without an epidural. It was a red hot pain. My knuckle swelled and even today I cannot bend my finger fully and it stays completely stiff, still hurts like crazy. By the way this was over a YEAR AGO. Any thoughts anyone on what could have happened?

many bee stung. I got fever and now feel cold on my chest and my heart bits funny

I got stung on my little toe yesterday, this morning it was a little swollen, but now my entire foot is swollen up to an inch above my ankle. How can I get the swelling down and how long will it take

Tristan,

Thanks for writing in.

This sounds like a “large local reaction”. Dr. Greene says, “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.”

Sorry for the bad news, but it sounds like it’s time to consult your doctor.

I hope that helps.
Best, @MsGreene
Note: I am the co-founder of DrGreene.com, but I am not Dr. Greene and I am not a doctor. Please keep that in mind when reading my comments and replies.

Got stung by a yellow jack Thursdays. Its 3 days later and my but is purple and black. Is this normal? Please help!

Chrisma,

Was there a time period without reaction? Or is this one continuous reaction?

@Msgreene
Note: I answer a lot of questions on DrGreene.com, I am the co-founder of DrGreene.com, Dr. Greene’s business partner and wife, but I am a not doctor. Please keep that in mind when reading my comments and replies.

Hey yesterday I was at school and i was about to get onto the bus until i got stung on my pinky finger thingo and the next morning it was bigger and down the side of my hand felt a bit weird what do i do

Nathan,

Not all bee sting reactions are the same. Dr. Greene says, “Some immediate reactions are classified as local (a two – or three-inch area of swelling, redness and pain that lasts less than 24 hours). Others qualify as large local reactions (those that are larger — often an entire limb — or that last longer, but all symptoms are adjacent to stings). Systemic reactions are allergic responses distant from the sting and include symptoms such as hives, generalized itching, generalized swelling, low blood pressure, difficulty breathing, or anaphylactic shock — a severe reaction involving most or all of these symptoms.”

This sounds like a large, local reaction. He has a list of treatments here. The treatment changes depending on how long it’s been since the bite, so it’s wise for you to read the whole article and determine what applies to you.

I hope that helps,
@MsGreene
Co-founder & Executive Producer DrGreene.com, Mom
Note: Not Dr. Greene, not a doctor. Keep that in mind when reading my comments and replies.

My boyfriend got stung by a bee on the inside of his lip yesterday at work. He was drinking an energy drink not knowing that there was a bee inside & when he spit it out it stung him. His lip has swollen up 5x it’s size & he said it hurts & is really itchy. He put ice on it all night but this morning it has gotten worse. Should he see a Dr?

Brieanna,

If the swelling hasn’t gone down by now, I would go to an Urgent Care Clinic or Minute Clinic. There can be delayed reactions and swelling in the mouth is not to be taken too lightly.

Good luck! @MsGreene
Co-founder & Executive Producer DrGreene.com, Mom
Note: I answer a lot of questions on DrGreene.com, I am the co-founder of DrGreene.com, Dr. Greene’s business partner, but I am a not doctor. Please keep that in mind when reading my comments and replies.

I was stung on the top.of my finger two days ago it was a lil swollen and then the swelling went down yesterday. But today I woke up and my whole finger is swollen even up to my nuckles. My finger is also very hard and swollen and is turning red. I’ve iced it and took benadryl but it continues to itch and swell and continues to turn red, should I get seen by a Dr.

I was stung by a bee at the knuckle of my left thumb 4 weeks ago. My thumb was numb adter the sting!
I had taken antibiotics as well as steroids and Benadryl in the past 4 weeks prescribed by my doctor due to my allergic reaction of swelling, aches , and itch has come back twice after the sting!
I now still feel there is some hardened spot around the knuckle. How can I be sure the toxin will eventually go away and to stop the allergic reaction keep coming back?

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?

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

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

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.

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

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

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

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

@MsGreene

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.

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

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

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

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?

did you get a response

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

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.

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

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.

Can I survive a bee sting over night without treatment

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

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

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?

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.

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

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

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

Poor you

Dr Green you suck

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

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

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

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.

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.

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?

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

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

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