Bee And Wasp Stings

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Bee sting with stinger still in place

You’d have to look far and wide for someone who hasn’t been stung by an insect at one point or another.  It’s not pleasant in any situation, but bees and wasps can inflict some real discomfort if you run afoul of them. In a small minority of cases, allergic reactions to the venom injected can be life-threatening, a condition known as “anaphylaxis.”


Most stinging insects belong to the order Hymenoptera, which includes wasps, bees, and ants. The stinger is considered a variation of what was originally an egg-laying apparatus, so only females can sting (all worker bees and wasps are female). Despite the most commonly-known stinging insects living in hives and colonies, most actually live solitary lives and are relatively peaceful if left undisturbed. The more social ones, like honey bees, hornets, and yellowjackets vigorously defend the nest, however, and some will register their annoyance in no uncertain terms if you interfere with their daily activities.

Note: Fire ants will be addressed in another article.


“killer bees” don’t look much different than honey bees

Most of you have heard of the Africanized or “killer” bee. It’s  a hybrid of the East African lowland honey bee and various European honey bee subspecies.

The two types of bees look very similar. One is about 10% larger in size, but the difference is barely noticeable with the naked eye. Their behavior is similar in many respects. Both are relatively docile when gathering pollen and nectar, but both will sting if provoked. The difference is that Africanized honey bees are less predictable and more aggressive in defense than European honey bees. They respond rapidly, defend a wider area around the hive, and attack in larger numbers than their European cousin. They’re also more persistent, and could chase intruders for hundreds of yards.


Hornets are usually larger and  have wider waists heads

Although hornets are a type of wasp, there are differences. Wasps have very slender waists as opposed to hornets, which are built thicker and rounder in the mid-section. Hornets also tend to be larger, in general, and have wider heads. In addition, most wasps have only one set of wings, while hornets have two.

From a behavior standpoint, hornets are more aggressive and inflict more painful stings. In rare cases, the neurotoxin in hornet venom can be deadly, especially if there have been multiple stings.


Bee and wasp stings are common during summer and early fall when they are most active and hives/nests are most populous. Another factor that contributes to the number of stings is that people spend more time outside during that part of the year.

Stinging incidents most often occur when nests are disturbed. If you see several wasps or bees flying back and forth from a certain area, avoid it.


Wasps can be attracted to certain odors and are drawn to flowers and fruit trees, but also the smell of perfume and scented soaps. Avoid wearing these near a hive, nest, or other bee- and wasp-rich environments. Strangely, they also seem to like the smell of garbage!

Those wearing short sleeves, short pants, or going barefoot expose more skin that could possibly be sites for wasp stings. Wearing brightly-colored clothing also attracts their attention.


Wasp sting with local allergic reaction

A wasp sting appears as a red, raised welt with a puncture hole in the middle. You can expect instant sharp, burning pain at the site of the sting. Hives or welts may develop peak signs at about 48 hours and last for up to a week. As time passes, the area may swell and look red or bruised.

Bee stings appear similar to wasp stings, but leave a barbed stinger in the wound. This proves fatal to the bee, as it leaves some of its organs with the stinger as it pulls away. Wasps have a smooth stinger that doesn’t stay in the wound, making it possible for an individual wasp to sting multiple times in a short period of time.

Pain from a sting can last a couple of hours, but the swelling and redness may last up to a week. Wasp stings tend to be more painful than bee stings. The pain from an insect sting is calculated using the Schmidt sting pain index. This scale ranges from 1-4, with 4 being the most painful. Most bees fall around level 1-2, while wasps are commonly level 3, with some species reaching level 4.


Bee and wasp stings may cause allergic reactions, which occur more commonly than you might think. Severe reactions are called “anaphylaxis” and can cause life-threatening symptoms, such as:

  • Severe pain
  • Swelling in the throat
  • Hives and itching in areas far from the sting site
  • Nausea and vomiting
  • Rapid heart rate
  • Blood pressure changes
  • Fainting
  • Difficulty breathing


Infected wound

On occasion, sting sites may become infected. The redness and discoloration in the area spreads, swelling worsens, and the area becomes warm and painful to the touch. In severe cases, pus may drain from the wound.


Rapid action will speed recovery from a bee or wasp sting. If the stinger is still in the wound, remove it immediately with a fingernail or even by scraping with a credit card. The faster you remove it, the faster symptoms will resolve. Then consider some of these options:

  • Clean the bite with soap and water or an antiseptic.
  • Use ice packs to reduce pain and swelling.
  • Use topical hydrocortisone cream or an antihistamine to reduce swelling.
  • Use calamine lotion or an antihistamine to relieve itching.
  • Take an antihistamine like Benadryl to reduce itching and swelling.

If there are signs of infection as described earlier, consider an antibiotic. Amoxicillin, cephalexin, and clindamycin will work. Cover obviously draining wounds with a dressing. Extreme allergic reactions may require epinephrine injections from vials or in the form of autoinjectors like EpiPen.

It’s important to know that you have more to worry about in the Great Outdoors than the Wizard of Oz’s lions, tigers, and bears. Watch out for tiny, but not defenseless, stinging insects. Stay away from their homes and they’re unlikely to “bug” you!

Joe Alton MD

Dr. Joe Alton

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