June 1999
TAMPA, Fla. - Bees are one of the most commonly encountered members of the Hymenoptera, the primary stinging insects. If their space is violated, they will sting humans, causing immediate pain and burning, a red flare and swelling. In addition the stinger, which contains the pain-causing venom, is often left behind.
"A normal, nonimmune response to a bee or wasp sting obviously has immediate pain and burning sensation," said Philip D. Shenefelt, MD, associate professor, section of dermatology, University of South Florida, here.
Soon after this response, there is a white wheal that forms with a red punctum in the center where the sting has occurred. The punctum fades fairly rapidly, he said, and then a red flare and local swelling occur, persist for a day or two, and then also fade.
On average, said Shenefelt, a bee or wasp sting usually lasts one or two days. If there is an allergic reaction to the sting, it may last longer.
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After a honeybee stings, the stinger is often left in the wound, and that needs to be removed first. If there is a small dark object where the sting occurred, it is the stinger that detached from the worker bee as it pulled away, said Shenefelt. This contains the poison glands.
"It is not a good idea to grasp the stinger with forceps to remove it because you could be squeezing the poison glands and injecting more venom into the person who was stung," said Shenefelt.
The best way to remove the stinger is to scrape it away with a tongue blade, the side of a slide, or, if necessary, a scalpel blade or handle. After the stinger is removed, he said, the site of the sting can be treated.
Bee venom contains enzymes and peptides. Allegedly, said Shenefelt, a meat tenderizer is supposed to help alleviate the sting because it is a proteolytic enzyme that breaks down some of the proteinaceous material in the sting, but there is no scientific proof. Cold compresses do help to relieve the pain, and they sometimes help to relieve swelling, said Shenefelt.
The "old fashioned" way of treating stings was using mud, Shenefelt said. People would put mud on the sting site because it had a cooling and drying effect. Unless sterile mud is available or there is no better treatment available, this practice is not recommended.
It is also important to prevent infection in the affected area. Using a topical antibiotic will help reduce the chance of secondary infection. Epinephrine is effective if an anaphylactic reaction occurs; it may be necessary to help counteract the reaction.
Treatment for children vs. adolescents depends on the kind and number of stings. If the person is stung only once, then the treatment probably does not vary, said Shenefelt.
"An infant obviously has a much smaller body mass and would proportionately get a higher dose of venom from a sting." On average, said Shenefelt, approximately 300 honeybee stings within a short time period might produce enough venom in an adult to be fatal. "So, proportionately fewer stings would be serious for an infant," he said.
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