Diagnosis

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 test. During skin testing, a small amount of allergen extract (in this case, bee venom) is injected 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'll develop a raised bump on your skin at the test site.
  • Allergy blood test. A blood test can measure your immune system's response to bee venom by measuring the amount of allergy-causing antibodies in your bloodstream. A blood sample is sent to a medical laboratory, where it can be tested for evidence of sensitivity to possible allergens.

Allergy skin tests and allergy blood tests are often used together to diagnose insect allergies. Your doctor may also want to test you for allergies to yellow jackets, hornets and wasps — which can cause allergic reactions similar to those of bee stings.

Treatment

For ordinary bee stings that do not cause an allergic reaction, home treatment is enough. Multiple stings or an allergic reaction, on the other hand, can be a medical emergency that requires immediate treatment.

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 medications including:

  • Epinephrine (adrenaline) to reduce your body's allergic response
  • Oxygen, to help you breathe
  • Intravenous (IV) antihistamines and cortisone to reduce inflammation of your air passages and improve breathing
  • A beta agonist (such as albuterol) to relieve breathing symptoms

Epinephrine autoinjector

If you're allergic to bee stings, your doctor is likely to prescribe an emergency epinephrine autoinjector (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 medication when pressed against your thigh. Always be sure to replace epinephrine by its expiration date.

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.

Consider wearing an alert bracelet that identifies your allergy to bee or other insect stings.

Allergy shots

Bee and other insect stings are a common cause of anaphylaxis. If you've had a serious reaction to a bee sting or multiple stings, your doctor likely will refer you to an allergist for allergy testing and consideration of allergy shots (immunotherapy). These shots, generally given regularly for a few years, can reduce or eliminate your allergic response to bee venom.

Lifestyle and home remedies

If a bee stings you or your child, follow the suggestions below.

Treatment for minor reactions

  • Remove the stinger as soon as you can, as it takes only seconds for all of the venom to enter your body. Get the stinger out any way you can, such as with your fingernails or a tweezer.
  • Wash the sting area with soap and water.
  • Apply a cold compress.

Treatment for moderate reactions

The following steps may help ease the swelling and itching often associated with large local reactions:

  • Remove the stinger as soon as you can.
  • Wash the affected area with soap and water.
  • Apply a cold compress.
  • Take an over-the-counter pain reliever as needed. You might try ibuprofen (Motrin IB, Children's Motrin, others) to help ease discomfort.
  • If the sting is on an arm or leg, elevate it.
  • Apply hydrocortisone cream or calamine lotion to ease redness, itching or swelling.
  • If itching or swelling is bothersome, take an oral antihistamine that contains diphenhydramine (Benadryl) or chlorpheniramine (Chlor-Trimeton).
  • Avoid scratching the sting area. This will worsen itching and swelling and increase your risk of infection.

Preparing for your appointment

Bee and other insect stings are a common cause of anaphylaxis. If you've had a serious reaction to a bee sting but did not seek emergency treatment, consult your doctor. He or she may refer you to an allergy specialist (allergist) who can determine whether you're allergic to bee or other insect venom and can help you find ways to prevent future allergic reactions.

Your doctor or allergist will do a thorough physical examination and will want to know:

  • When and where you were stung
  • What symptoms you had after getting stung
  • Whether you've had an allergic reaction to an insect sting in the past, even if it was minor
  • Whether you have other allergies, such as hay fever
  • What medications you take, including herbal remedies
  • Any health problems you have

Some questions you might want to ask your doctor include:

  • What do I do if I get stung again?
  • If I have an allergic reaction, do I need to use emergency medication such as an epinephrine autoinjector (EpiPen, Auvi-Q, others)?
  • How can I prevent this reaction from happening again?

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

Aug. 10, 2017
References
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