Insect stings: avoiding, treating

​​​​​​​​​​For most people, insect stings are a common outdoor nuisance, especially in late summer when bees, wasps, hornets and yellow jackets become more active.

Most stings involve a minor local reaction, which can be treated with antihistamines, ice and a pain reliever. But for people who are allergic to insect stings or who get stung numerous times, a more serious reaction may require emergency treatment.

A severe systemic allergic reaction involves multiple body organs and can progress to a life-threatening reaction. The most severe and rarest such reaction is anaphylaxis, which can include difficulty with breathing, hives, weak and rapid pulse, dizziness or fainting, and swelling of the throat and tongue. In severe cases, a rapid fall in blood pressure may result in shock and loss of consciousness, and the reaction may be fatal. Medical attention should be sought immediately for any reaction occurring beyond the immediate sting area.

Anyone who has had a severe allergic reaction to stings should see an allergist to consider testing and allergy shots, the standard of care for this potentially dangerous condition, and should carry an emergency epinephrine injector during seasons when bees are active. The epinephrine is rescue medication only. If you are stung, you will still need to have someone drive you to an urgent care center as you may need additional medical treatment.

Prevention

To prevent stings, the first step is to use caution when near stinging insects' nests and areas where they feed, such as trash receptacles, fruit trees and picnic areas.

These insects are most likely to sting if their homes are disturbed, so it's important to destroy hives and nests around your home. This can be dangerous. If you are allergic, this is not a good idea to undertake yourself. Consider hiring a trained exterminator. If you encounter stinging insects that are flying, remain calm and move slowly away from them.

Many stinging insects are simply foraging for food, so try not to look or smell like a flower. In other words, avoid brightly colored clothing and perfume when outdoors.

The smell of food also attracts insects, so be careful when cooking, eating or drinking soda or juice outdoors. Keep food covered until eaten, wear closed-toe shoes and avoid going barefoot or wearing loose-fitting clothes.

Honeybee stings

If you are stung by a honeybee that has left its stinger (and attached venom sac) in your skin, remove the stinger within 30 seconds to avoid receiving more venom. A quick scrape of a fingernail can remove the stinger and sac, but avoid squeezing the sac, which forces more venom through the stinger. (Hornets, wasps and yellow jackets do not usually leave their stingers.)

First aid for insect stings

It is normal for a sting to cause some pain and mild swelling at the sting site. In most cases, this clears in several hours. For more extensive swelling, elevate the affected arm or leg and apply ice or a cold compress to reduce swelling and pain. Contact your doctor if swelling progresses beyond the immediate sting area, if the sting site seems infected or if swelling lasts longer than one to two days.​