Bee stings

Bee stings are a common outdoor nuisance. In most cases, bee stings are just annoying and 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 — as well as hornet and wasp stings — and find out how to treat them if you do get stung.

Symptoms

Bee stings can produce different reactions, ranging from temporary pain and discomfort to a severe allergic reaction. Having one type of reaction doesn't mean you'll always have the same reaction every time you're stung.

Minor reaction
Most of the time, signs and symptoms of a bee sting are minor and include:

• Instant, sharp burning pain at the sting site
• A red welt at the sting area
• A small, white spot where the stinger punctured the skin
• Slight swelling around the sting area

In most people, swelling and pain go away within a few hours.

Large local reaction
About 10 percent of people who get stung by a bee or other insect have a bit stronger reaction (large local reaction), with signs and symptoms such as:

• Extreme redness
• Swelling at the site of the sting that gradually enlarges over the next day or two

Large local reactions tend to resolve over five to 10 days. Having a large local reaction doesn't mean you'll have a severe allergic reaction the next time you're stung. But some people develop similar large local reactions each time they're stung. If this happens to you, talk to your doctor about treatment and prevention.

Severe allergic reaction (anaphylaxis)
A severe allergic reaction (anaphylaxis) to bee stings is potentially life-threatening and requires emergency treatment. About 3 percent of people who are stung by a bee or other insect quickly develop anaphylaxis. Signs and symptoms of anaphylaxis include:

• Skin reactions in parts of the body other than the sting area, including hives and itching and flushed or pale skin (almost always present with anaphylaxis)
• Difficulty breathing
• Swelling of the throat and tongue
• A weak and rapid pulse
• Nausea, vomiting or diarrhea
• Dizziness or fainting
• Loss of consciousness

People who have a severe allergic reaction to a bee sting have a 30 to 60 percent chance of anaphylaxis the next time they're stung. Talk to your doctor or an allergy specialist about prevention measures such as immunotherapy to avoid a similar reaction in case you get stung again.

Multiple bee stings
Generally, insects such as bees and wasps aren't aggressive and only sting in self-defense. In most cases, this results in one or perhaps a few stings. However, in some cases a person will disrupt a hive or swarm of bees and get stung multiple times. Some types of bees — such as Africanized honeybees — are more likely than are other bees to swarm, stinging in a group.

If you get stung more than a dozen times, the accumulation of venom may induce a toxic reaction and make you feel quite sick. Signs and symptoms include:

• Nausea, vomiting or diarrhea
• Headache
• Vertigo
• Feeling faint or fainting
• Convulsions
• Fever

Multiple stings can be a medical emergency in children, older adults, and people who have heart or breathing problems.

When to see a doctor
In most cases, bee stings don't require a visit to your doctor. In more-severe cases:

Call 911 or other emergency services if:

• You're having a serious reaction to a bee sting that suggests anaphylaxis, even if it's just one or two signs or symptoms.
  If you were prescribed an emergency epinephrine autoinjector (EpiPen, Twinject), use it right away as your doctor directed.

Seek prompt medical care if:

• You've been swarmed by bees and have multiple stings.

Make an appointment to see your doctor if:

• Bee sting symptoms don't go away within a few days.
• You've had other symptoms of an allergic response to a bee sting.