Some Basics...

• Over 95% of stings are from honeybees or yellow jackets.
• In most cases, these stings only cause a minor reaction at the sting site.
• A severe reaction can happen to people who have an allergy to stings. A severe reaction is a medical emergency.
• A tetanus shot is not needed after a sting.

Symptoms

The stinger injects venom into the skin. The venom causes all of the bee sting symptoms.

• Pain: There may be severe pain or burning at the sting site for 1-2 hours.
• Swelling: The bee sting may swell for 24 hours after the sting. Sometimes the swelling is mild. Other times, it can be more severe. It depends on the person and what part of the body was stung. A bee sting near the eye can cause lots of swelling of the eyelids. This looks bad but it is not serious.
• Itching: As the pain goes away, the sting feels itchy.
• Redness: A bee sting often has a red or pink color. Skin redness may be hard to see in people with darker skin color.
• What to Expect: The redness can last 3 days and the swelling 7 days.

Does the Stinger Need to be Removed?

• The stingers on honeybees come off and can get stuck in skin. This is the reason a honeybee can only sting one time. The bee will die when its stinger comes off. If there is a stinger in the skin, it should be removed.
• It is better to get the stinger out quickly. There are a few ways to remove the stinger. Scratching it out with a fingernail is quick and easy. A person can also use the edge of a credit card.
• The stingers on wasps, hornets, and yellow jackets do not come off. They can sting many times.

What is Anaphylaxis?

Anaphylaxis is the medical term for a life-threatening allergic reaction. Symptoms include:

• Feeling faint or passing out
• Trouble breathing
• Swelling of the tongue
• Hives
• Wheezing
• Cough

It can begin within seconds of the sting. This nearly always starts within 20 minutes. It is very rare for anaphylaxis to start more than 2 hours after a sting.

People who have had severe reactions to stings should have an anaphylaxis kit. They should keep it nearby if there is any chance of a sting. A doctor has to write a prescription for these kits. Examples are EpiPen and Twinject.

How Can Stings be Prevented?

Here are some outdoor tips for preventing stings.

• Wear long-sleeved shirts, long pants, and shoes when outdoors.
• Avoid using perfumes and hair sprays. These attract insects.
• Wear dark or drab colored clothes, not bright colors.
• Take special care when eating or making food outdoors. Odors can attract insects like yellow jackets.

1. What You Should Know:
   • In most cases, bee stings only cause a minor reaction at the sting site.
   • You can treat minor sting reactions at home.
   • Here is some care advice that should help.
2. Try to Remove the Stinger:
   • The stinger looks like a tiny black dot in the sting.
   • There are lots of ways to remove a stinger.
   • Use a fingernail, credit card edge, or knife-edge to scrape it off. If the stinger is below the skin surface, leave it alone. It will be shed with normal skin healing.
   • In many cases there will be no stinger to remove. Only honeybees leave their stingers. Wasps, yellow jackets, and hornets do not.
3. Cold Pack:
   • For pain or swelling, use a cold pack or ice wrapped in a wet cloth.
   • Put it on the bee sting for 10-20 minutes.
   • You may repeat this as needed.
4. Pain Medicines:
   • You can take one of the drugs listed below if you have pain.
   • They are over-the-counter (OTC) pain drugs. You can buy them at the drugstore.
   Acetaminophen (Tylenol):
   • Regular Strength Tylenol: Take 2 pills (650 mg) every 4-6 hours. Each pill has 325 mg of acetaminophen.
   • Extra Strength Tylenol: Take 2 pills (1,000 mg) every 8 hours. Each pill has 500 mg of acetaminophen.
   • Do not take more than (3,000 mg) of this drug per day.
   Ibuprofen (Motrin, Advil):
   • Motrin and Advil: Take 2 pills (400 mg) every 6 hours. Each pill has 200 mg of ibuprofen.
   • A second choice is to take 3 pills (600 mg) every 8 hours.
   Naproxen (Aleve):
   • Aleve: Take 1 pill (220 mg) every 8 hours. Each pill has 220 mg of naproxen.
   • A second choice is to take 2 pills (440 mg) every 12 hours.
   Extra Notes:
   • Use the lowest amount of a drug that makes your pain feel better.
   • Your doctor might tell you to take more than what is shown above. That is because your doctor knows you and your health problems.
   • Acetaminophen is safer than ibuprofen or naproxen in people over 65 years old. Acetaminophen is in many OTC and prescription drugs. It might be in more than one drug you are taking. Be careful how much you take. Too much of this drug can hurt the liver.
   • Caution- Acetaminophen: Do not take it if you have liver disease.
   • Caution- Ibuprofen and Naproxen:
     • Do not take ibuprofen or naproxen if you are pregnant.
     • Do not take these drugs if you have stomach problems or kidney disease.
     • Do not take these drugs for more than 7 days without checking with your doctor.
   • Read all package instructions.
5. Hydrocortisone Cream for Itching:
   • Rub the hydrocortisone cream on the sting 4 times a day. This can help with the itching. Use the cream until the itch is mild.
   • Sold over-the-counter (OTC) in the United States as 0.5% and 1% cream.
   • Sold OTC in Canada as 0.5% cream.
6. Antihistamine Medication for Itching: If the sting becomes very itchy, take diphenhydramine (Benadryl; adult dose 25-50 mg).
   • Do not take diphenhydramine if you have prostate problems.
   • Antihistamines may make you feel tired. Do not drink, drive, or use dangerous machinery while taking these drugs.
   • Read all package instructions.
7. What to Expect:
   • Pain and Itching: Severe pain or burning near the sting lasts 1-2 hours. After 2 hours it should become less painful. After the pain goes away, the sting often starts to feel itchy.
   • Redness and Swelling: These may increase for 24 hours after the sting. Redness at the sting site is normal. It doesn't mean that it is infected. The redness can last 3 days and the swelling 7 days.
   • Stings rarely get infected.
8. Call Your Doctor If:
   • Swelling becomes huge
   • Sting begins to look infected
   • You get worse

1. What You Should Know:
   • There are things you can do to avoid getting stung.
   • Here is some care advice that should help.
2. Outdoor Tips:
   • Wear long-sleeved shirts, long pants, and shoes when you are outdoors.
   • Avoid using perfumes and hair sprays. These attract insects.
   • Wear dark or drab colored clothes, not bright colors.
   • Take special care when eating or preparing food outdoors. Odors can attract insects like yellow jackets.

1. What You Should Know:
   • You cannot get tetanus from a bee sting or other insect sting.
   • You do not need a tetanus shot after a sting.
2. Routine Tetanus Booster: If it has been more than 10 years since your last tetanus shot, you need a booster shot. Make an appointment to see your doctor.