Bee sting

Diagnosis

To diagnose an allergy to venom from a bee sting, your healthcare professional may suggest that you have one or both of the following tests:

• Skin test. During skin testing, a small amount of bee venom is injected into the skin of the arm or upper back. If you're allergic to bee stings, you'll get a raised bump on your skin at the test site.
• Blood test. A blood test can measure how your immune system reacts to bee venom.

Your healthcare professional also may want to test you for allergies to yellow jackets, hornets and wasps. Stings from these insects can cause allergic reactions similar to those of bee stings.

Treatment

For most bee stings, home treatment is enough. Multiple stings or an allergic reaction may be a medical emergency that needs treatment right away.

Emergency treatment for allergic reactions

During an anaphylactic attack, an emergency medical team may perform cardiopulmonary resuscitation (CPR) if you stop breathing or your heart stops beating. You may be given medicines including:

• Epinephrine to reduce your body's allergic response.
• Oxygen to help you breathe.
• Antihistamines and glucocorticoids, such as prednisone, to reduce inflammation of your air passages and improve breathing.
• A beta agonist such as albuterol to ease breathing symptoms.

Epinephrine autoinjector

If you're allergic to bee stings, your healthcare professional is likely to prescribe emergency epinephrine that you inject yourself (EpiPen, Auvi-Q, others). You'll need to have it with you at all times. An autoinjector is a combined syringe and concealed needle that injects a single dose of medicine when pressed against the thigh. Always be sure to replace an autoinjector by its expiration date.

Be sure you know how to use the autoinjector. Also make sure the people closest to you know how to give you the medicine. If they're with you in an anaphylactic emergency, they could save your life. If you use an epinephrine autoinjector, go to the emergency department after.

Wear an alert bracelet that identifies your allergy to bee or other insect stings. And carry chewable antihistamines with you. Use the antihistamines if you're stung, begin to have symptoms of an allergic reaction and are able to swallow. You may use both an autoinjector and the oral antihistamine.

Allergy shots

Bee and other insect stings are a common cause of anaphylaxis. If you've had a severe reaction to a bee sting or multiple stings, your healthcare professional may refer you to an allergist for allergy testing. The allergist may suggest immunotherapy. This type of therapy is sometimes called allergy shots. These shots are generally given regularly for a few years. They can reduce or stop your allergic response to bee venom.

Lifestyle and home remedies

For a minor or moderate bee sting, follow these first-aid steps:

• Move to a safe area to avoid more stings.
• If you see a stinger sticking out of the wound — it looks like a black dot — remove it as soon as possible. Try scraping it off with a fingernail or the blunt edge of a knife. A stinger may not be present, as only bees leave a stinger. Other stinging insects, such as wasps, do not.
• Wash the sting area with soap and water.
• Remove any rings in the sting area right away, before swelling gets worse.
• Apply to the area a cloth dampened with cold water or filled with ice. Keep it on the sting for 10 to 20 minutes. Repeat as needed.
• If the sting is on an arm or leg, raise it. Swelling may increase over the next two days but usually goes away with time and elevation.
• Apply hydrocortisone cream or calamine lotion to ease itching and swelling. Do this up to four times a day until your symptoms go away.
• If needed, take a pain reliever. Pain medicine you can buy without a prescription can help ease pain. Examples are ibuprofen (Advil, Motrin IB, others) and acetaminophen (Tylenol, others). If the sting area itches, take an anti-itch medicine by mouth. This type of medicine is also called an antihistamine. Examples are diphenhydramine (Benadryl), chlorpheniramine, loratadine (Alavert, Claritin, others), cetirizine (Zyrtec Allergy) and fexofenadine (Allegra Allergy). Some of these products can make you drowsy.

What to avoid

• Don't scratch the sting area. Scratching can lead to infection.
• Don't rub the sting with mud, as mud contains many germs.
• Don't try to remove a stinger below the skin surface. It will come out over time as the skin sheds.
• Don't apply heat.

Preparing for your appointment

Bee and other insect stings are a common cause of anaphylaxis. If you've had a severe reaction to a bee sting but did not seek emergency treatment, contact a healthcare professional. You may be referred to an allergy specialist, who can find out whether you're allergic to bee or other insect venom.

List questions you want to ask your healthcare professional, such as:

• What do I do if I get stung again?
• If I have an allergic reaction, do I need to use emergency medicine such as an epinephrine autoinjector?
• How can I prevent this reaction from happening again?

Don't hesitate to ask other questions, as well.

Your healthcare professional is likely to do a physical exam and ask you a number of questions, such as:

• When and where were you stung?
• What symptoms did you have after getting stung?
• Have you had an allergic reaction to an insect sting in the past?
• Do you have other allergies, such as hay fever?
• What medicines do you take, including herbal remedies?
• Do you have other health conditions?