Diseases & Conditions

Bee stings

Bee stings are a common outdoor nuisance. In most cases, bee stings are just annoying and pain and swelling go away quickly. Usually home treatment is all that's necessary to ease the pain of bee stings. But if you're allergic to bee stings or you get stung numerous times, you may have a more serious reaction that requires emergency treatment. You can take several steps to avoid bee stings — and find out how to treat them if you do get stung.

Bee sting venom contains proteins that affect skin cells and the immune system, causing pain and swelling around the sting area. In people with a bee sting allergy, bee venom can trigger a more serious immune system reaction.

If you've had a reaction to bee stings that suggests you might be allergic to bee venom, your doctor may suggest one or both of the following tests:

• Skin prick test. During skin testing, a small amount of purified allergen extract (in this case, bee venom) is pricked into the skin of your arm or upper back. This test is safe and won't cause any serious reactions. If you're allergic to bee stings, you develop a raised bump (hive) at the test location on your skin. Allergy specialists usually are best equipped to perform allergy skin tests.
• Allergy blood test. A blood test (sometimes called the radioallergosorbent, or RAST, test) can measure your immune system's response to bee venom by measuring the amount of allergy-causing antibodies in your bloodstream, known as immunoglobulin E (IgE) antibodies. A blood sample is sent to a medical laboratory, where it can be tested for evidence of sensitivity to possible allergens.

Allergy skin tests are the most accurate tests for insect allergies. But if the allergy skin test is negative — and your doctor still thinks you might have a stinging insect allergy — you may need an allergy blood test to double-check. Your doctor may also want to test you for allergies to yellow jackets, hornets and wasps — which can cause similar allergic reactions to bee stings.

For most bee stings, home treatment is enough. For more serious reactions, you may need to see your doctor or go to the emergency room. Multiple stings or an allergic reaction can be a medical emergency that requires immediate treatment.

Bee sting first aid
When a bee stings, it jabs a barbed stinger into the skin. Removing the stinger and attached venom sac right away will keep more venom from being released.

• Remove the stinger as soon as you can. Scrape the stinger out with the edge of a credit card, a fingernail, or use a pair of tweezers. Avoid squeezing the attached venom sac, which can release more venom.
• Wash the sting area with soap and water.
• Put a cold pack or a cloth filled with ice on the sting area. This will help reduce swelling.
• Apply hydrocortisone cream or calamine lotion to ease redness, itching or swelling.
• Take an oral antihistamine that contains diphenhydramine if itching or swelling is bothersome (Benadryl, Tylenol Severe Allergy) or chlorpheniramine (Chlor-Trimeton).
• Don't scratch the sting area. This will worsen itching and swelling — and increase your risk of infection.

Emergency treatment for allergic reactions
If you're allergic to bee stings, your doctor will likely prescribe an emergency epinephrine autoinjector (EpiPen, TwinJect). You'll need to carry it with you at all times during seasons when bees are active. An autoinjector is a combined syringe and concealed needle that injects a single dose of medication when pressed against your thigh. Always be sure to replace epinephrine before its expiration date, or it may not work properly.

Be sure you know how to use the autoinjector. Also, make sure the people closest to you know how to administer the drug — if they're with you in an anaphylactic emergency, they could save your life. Medical personnel called in to respond to a severe anaphylactic reaction also may give you an epinephrine injection or another medication.

Allergy shots
If you're diagnosed with a bee sting allergy, your doctor may suggest getting allergy shots (immunotherapy). These shots are generally given on a regular basis for a few years and can reduce or completely eliminate your allergic response to bee venom.