A bee sting is the painful sting caused by a common outdoor insect, the bee. Bee stings are caused by the bee inserting the venom-filled stinger on its back end into a person’s skin. Many insects sting, including bees and wasps. These stings cause pain and swelling and, in some people, a very severe allergic reaction. Normally, bee stings go away quickly on their own. However, in some cases of multiple stings or a severe allergic reaction, you may have to go to the emergency room. The venom that bees have in their stingers causes the human immune system to fight back, causing redness and swelling. If a bee sting causes a severe allergic reaction called anaphylaxis, you may have severe swelling that causes your airway to swell and may lead to death. For people with allergy and children, multiple bee stings are even more dangerous because the amount of bee venom in the body is increased. The risk of bee stings increases with increased time outside or you have beehives near your home or work. You are more likely to have a severe allergic reaction to bee stings if you have allergies to other things or have had an allergic reaction to a bee sting before, no matter how minor the previous bee sting was.
Sharp pain at location of sting, burning pain at location of sting, redness at area of sting, swelling at site of sting, swelling of other parts of the body, difficulty breathing, hives on the body, lightheadedness
You doctor will first talk to you about the history of your problem and then do a physical exam. Your doctor will want to know how severe your symptoms are and about any associated problems like shortness of breath. Your doctor may recommend that you see a specialist in allergy/immunology to figure out the source of your allergic reaction. The allergist will check for allergy to bee stings as well as other stinging insects like wasps and yellow jackets. The allergist may want to do testing either by looking at the blood for evidence of allergy. Your allergist may also want to do skin prick testing, where a small amount of the substance causing the allergic reaction (the allergen) is placed into the skin with a needle to test for allergies. If a bump appears where the allergen was placed, you allergist knows that you are allergic.
Most of the time, no treatment is necessary for a bee sting, other than a cold compress to relieve swelling. For a bee sting, removing the stinger as soon as possible helps prevent more venom from entering the body. The stinger should be removed by scraping it with a credit card or fingernail, rather than tweezers because squeezing the stinger can release extra venom. Washing the affected area with soap and water can help remove residual venom as well as help keep the area clean and prevent secondary infections of the open area with bacteria. You can use an ice pack or hydrocortisone cream to reduce swelling and pain. If the pain and swelling are still bothersome some medications can be taken by mouth including antihistamines like diphenhydramine (Benadryl). I you have a severe allergic reaction that causes swelling of areas other than just the sting or difficulty breathing, you need to go to the emergency room as soon as possible. In the emergency room, doctors can appropriately treat you with epinephrine, steroids, and antihistamines through your vein as well as supportive treatment to maintain your breathing and blood pressure. If your airway is at risk of swelling closed, the doctors in the emergency room can help keep the airway open by placing a tube to keep the center open (endotracheal intubation). If you are a person who has severe allergy, your allergist may recommend allergy shots which help your body adjust to exposure to allergens to help prevent a severe allergic reaction in the future. You should discuss all your treatment options with your doctor or allergist.
