When to Seek Medical Care

Although most stings can be treated at home, some will require more medical care.

Call your doctor or go to a hospital's emergency department if a large localized reaction (greater than about 10 inches in diameter) occurs, evidence of infection (increasing pain, swelling, redness, drainage of pus or fever) is present at the sting site, or any symptoms last for more than a day or two.

If it has been more than 10 years since your last tetanus booster immunization, contact your doctor about getting a tetanus immunization.

Although most stings do not require medical care, remember some stings can be serious or even fatal. If you have the slightest suspicion that someone is having a generalized or allergic reaction, seek emergency medical care immediately. In many areas dialing 911 for an ambulance may be your best option. (Try to avoid driving yourself to the hospital if you believe you are suffering from an allergic reaction—you may lose consciousness and have an accident.)

Go to a hospital's emergency department immediately if someone is showing evidence of an allergic reaction. Remember, an allergic reaction may occur in people with no prior history of allergic reactions. Any of the following may indicate an allergic reaction:

• difficulty breathing

• Difficulty speaking

• Swelling in the mouth or throat

• Rash all over the body

• Faintness or decreased level of consciousness

If more than 10-20 stings have occurred, especially with wasp stings or in children, elderly people, or people with underlying medical problems

If the sting involves the inside of the mouth or throat, especially if in children and/or involves more than one sting.

If the sting involves the eyeball itself.

If a person has been stung by an insect species that has previously caused an allergic reaction in the person—even if there is no evidence of a current allergic reaction (The safe thing to do is to head for an emergency department in case the person suddenly develops an allergic reaction.)

If a large localized reaction (redness greater than about 10 inches across) or evidence of infection (increasing pain, swelling, redness, drainage of pus or fever) is present at the sting site or sites and you cannot contact your personal doctor promptly

Self-Care at Home

Most simple insect stings in a nonallergic person require no more than first aid at home.

Avoid further stings by wearing protective clothing, using insect repellant, and avoiding infested areas.

Remove any stingers remaining in the skin (most likely from bees) immediately. Some experts recommend scraping out the stinger with a credit card. However, it is probably more important to get the stinger out as quickly as possible than to be overly concerned about how it is removed.

Application of ice to the sting site may provide some mild relief. Ice may be applied for 20 minutes once every hour as needed. Cloth should be placed between the ice and skin to avoid freezing the skin.

Consider taking an antihistamine such as diphenhydramine (Benadryl) for itching.

Consider taking ibuprofen (Motrin) or acetaminophen (Tylenol) for pain relief as needed.

Wash the sting site with soap and water. Place an antibiotic ointment on the sting site.

If it has been more than 10 years since your last tetanus booster immunization, get a booster within the next few days.

Most insect stings require no additional medical care. More serious reactions may need immediate medical care.

If you have been stung by a bee or wasp and have previously had a serious allergic reaction, seek medical attention. Consider taking an antihistamine such as diphenhydramine (Benadryl) as soon as possible. If any allergic symptoms develop, consider using the epinephrine part of an emergency allergy kit (EpiPen) if previously prescribed by a doctor.