My thoughts on How To Treat Bee Stings, and related information

I'm a beekeeper with 2 hives in my backyard for the past 8 years. I have over 100K honeybees in the summer, and I get stung occasionally (anywhere from 0-6 times a season).  The following is some hopefully useful information about treating bee stings in the normal case (no serious allergic reaction):

1. It usually takes almost 30 seconds or so for the bee's stinger (which is barbed to hold itself into you and comes with 2 little venom pumps attached to it) to deliver its full load of venom. Therefore, the first action when stung should be to remove the stinger as quickly as possible. Get it out in 5-10 seconds and you'll greatly reduce the reaction compared to a full dose.  It is really not hard at all to quickly remove the stinger if you can get to it, it's normally visible.

There used to be a lot of talk about the proper way to remove a stinger (i.e., should it be pinched or scraped, etc.). Let me assure you that the proper way is to do it QUICKLY, whatever works to get it out the soonest. Usually a quick rub with a fingernail is all it should take, assuming the sting is where you can get at it. (Not always possible, say if the bee gets inside your clothing, but try anyway.) If the assailant is still there after you get stung, don't worry about her, she can no longer hurt you (only female honeybees can sting you).

2. If other bees are around, you'll want to move away from them, as the first bee to sting you may have marked you (with pheromones) as an enemy and it is possible that other bees could react. If a bee stings you accidentally (most of my stings are this type), this is less likely than if she was mad at you. Anyway it's something to be aware of.

3. If possible, apply an alkali such as a paste of baking soda and water or, better yet, liquid ammonia. I keep a sting-treatment pen handy, it's basically an ammonia preparation, and I think it works a little better than baking soda. Urine might be effective in the field, I'm not sure.

4. Ice it! This is really effective too. It keeps the venom localized and keeps the swelling down.

5. (This should really be #1) Stay calm! Panic makes things much worse.

Using the above techniques, most of my bee stings are a very minor annoyance. I was stung twice last week, both times by bees who panicked while I was trying to rescue them from drowning in honey. Both times there was no swelling or after-effects (itching, etc.) In fact an hour after I was stung in my finger I was unable to remember which finger it was.

If a sting does make you swell or itch afterwards, you can take a Benadryl or other OTC antihistamine and of course you can use all sorts of topical preparations for pain./swelling/itching..

Most honeybees are generally very docile most of the time. They don't go around stinging things for no reason. Unless you are a beekeeper or are actively disturbing some bees, your stings are likely to be of the accidental type too. They rarely sting away from the hive, as they have nothing to defend. Believe me, when the bees are mad at you, you will know it — even before you get stung. Their sound changes to a higher pitch and they stop ignoring you. A mad bee will sting you deliberately, and it will hurt more as she drives that stinger home after a quick attack flight in your direction. All of this is more likely when the bees are irritated to begin with, say on a very hot day or shortly after any sort of stress.  Don't annoy the bees and you are highly unlikely to be annoyed by them.

A bee "sting" doesn't really hurt at all, it's the venom that causes the pain, and lots of it in some cases. That's why the feeling if being stung is a slightly delayed-reaction, the pain builds as the venom is injected (remember, the bee has gone off to die by this point).

Obviously, the part of the body that gets stung is a big factor affecting the intensity of the after-effects, some spots have a lot more nerves and/or blood vessels to spread the venom. You wouldn't want a flu shot on your face or in your hand. Gravity can make the swelling relocate. E.g., if you get stung on the head, where there's not really much tissue between the skin and bones, the fluid may sink and you might swell up under your chin. This happened to Amy once. I would probably try to lay down for a few hours if this were to happen again, to keep the gravity effect at bay until some of the swelling is reduced.Ice!

Rule of thumb:
If, say, your hand gets stung and it swells up, that's pretty normal (though the above tips should be preventative). But if your hand gets stung and your face starts to swell, CALL 911, or GET THEE TO AN EMERGENCY ROOM. In other words, local reactions are normal and usually not serious unless you get stung in some critical spot (let's not talk about those, I don't want to think about it!) But any remote or systemic/general reaction should be treated as an emergent situation.

Some bee magazines I've read suggested that beekeepers keep epinephrine pens, in case someone allergic gets stung. So I asked my internist about this a few years ago (at the time he was Chief of Medicine at El Camino Hospital. He thought it was a bad idea, unless you were very remote from medical assistance. Get them to the ER was his advice, he said that I was more likely to kill someone with an Epi-pen than a bee sting. But if you are allergic, then of course you need to discuss it with your doctors.  It seems like most adults I meet have been stung at least once and know their status.  Of course, allergies to bee stings are somewhat rare, maybe less than 5%, but should be taken very seriously in all cases. 

It's possible to get sensitized over time, i.e. not react to the first sting but have an allergic reaction on a subsequent sting. This happened to one of my dogs. I saw him get stung the first time, and he had zero effects from it (well, not really, he was pretty pissed off for a little while). But now he breaks out in bad hives when he gets stung and we worry about him. I give him Benadryl and Prednisone (my veterinarian approved this) and it starts to clear immediately.

(These are my opinions, based on my experiences I urge people to read them and remember them in case of a sting, but I must disclaim any responsibility for any results if you use this information for any purpose).

- Jay Keller, Sunnyvale California, 2011     My Homepage

(After I wrote this I found a longer and better article at Honeybee World: http://www.honeybeeworld.com/misc/stings.htm but I stand by what I wrote as well).