Bee Sting: What to Do, How Long It Lasts, and When It Is Serious

That is the whole of the treatment, and it is deliberately short. The American Academy of Dermatology lists five steps, Cleveland Clinic lists much the same, and nothing else carries good evidence. The rest of this page does the harder job: telling you whether what you are looking at is normal, and working out what stung you.

What a bee sting looks like

A fresh sting is a red swollen bump with a pale raised centre and a tiny dark puncture point in the middle. The skin around it is hot, and the redness usually spreads an inch or two. On brown and black skin the redness reads as a darker or purplish patch rather than bright red, so judge it by swelling and heat instead of colour.

The detail worth looking for is the stinger. After a honey bee sting, a small black shaft often stays in the skin with a pale sac attached. It looks like a dark splinter. Finding it tells you two useful things at once: the insect was a honey bee, and it is now dead. Nothing else in a garden leaves its sting behind.

How long a bee sting lasts

Most people expect a sting to peak on the first day, then worry when day two looks worse. That is normal. Here is the ordinary course of an uncomplicated sting.

Normal reaction, large local reaction, or allergy

This is the question almost everyone is really asking, and most guides answer it vaguely. The rule that settles it is simple. What matters is not how big the swelling is, but where the symptoms are. Trouble near the sting is local. Trouble somewhere the bee never went is systemic, and systemic is the dangerous one.

A large local reaction looks frightening and is not usually dangerous. A forearm that swells from wrist to elbow is still a local reaction. By itself it does not mean the next sting will cause anaphylaxis. Anyone who has had a systemic reaction should ask an allergist about venom immunotherapy. The American Academy of Allergy, Asthma and Immunology describes it as highly effective at cutting the risk of a severe reaction to a later sting.

Infection, and how it differs from an allergy

Infection is the complication people miss, because they are watching for allergy instead. Timing separates the two cleanly. An allergic reaction happens inside the first hour. An infection arrives a day or two later, in a sting that had already started improving.

• Pain returning after it had settled, rather than steadily fading.
• Redness spreading outward at 24 to 48 hours instead of shrinking.
• Pus or cloudy discharge, and skin that is warm and tender to touch.
• Fever or feeling unwell, which an ordinary sting does not cause.

Together those point to cellulitis, a bacterial skin infection that needs antibiotics. Scratching is the usual way bacteria get in, which is why the itch is worth treating properly. Do not keep piling hydrocortisone on a sting that looks infected, since the cream can quiet the redness while the infection carries on underneath.

Bee sting or wasp sting? Read the wound

Most pages answer this by describing the insect, which is no help at all when it flew off two seconds ago. The wound itself is better evidence, and it gives you an answer that actually changes what you do next.

One caveat keeps this honest. A bumble bee also leaves no stinger, because its sting is smooth too. So an empty puncture means wasp or bumble bee, while a stinger in the skin is proof of a honey bee. If you got a photograph of the insect itself, our visual identification guide will narrow it down faster than the wound will. Where it happened usually settles the rest. A sting at a picnic table is nearly always a yellow jacket, which is the insect most often blamed on bees.

First aid is identical either way, so do not delay treatment while you work it out. For the wider picture, see our bug bite identification guide.

Which bees actually sting

A fact that surprises most people: only female bees can sting. The stinger evolved from the ovipositor, the tube an insect lays eggs through, so males never had the equipment. That rule holds right across Hymenoptera, the insect order covering bees, wasps, hornets, and ants. Every worker bee you have ever been stung by was female, and every male bee in the world is harmless.

Honey bees, and why they die

The honey bee (Apis mellifera) has a barbed sting. In tough insect cuticle those barbs release cleanly. In elastic mammal skin they anchor instead. So the bee tears itself away, leaving the sting, the venom sac, and part of its abdomen behind. The bee dies within minutes. That detached sac keeps contracting and injecting venom for up to a minute, which is exactly why speed matters when you remove it.

Bumble bees

Bumble bees (Bombus) have smooth stings, survive stinging, and can do it more than once. They are also far less inclined to. A bumble bee bumbling around your flowers is not interested in you, and stings usually happen when one is trapped in clothing or a nest is disturbed.

Carpenter bees, and the male that cannot sting

The answer has two halves. A female carpenter bee (Xylocopa virginica) can sting, though she stays busy boring into wood and will not bother you unless someone handles her. The large bee that hovers in your face and dive-bombs you is the male, and he has no stinger at all.

So the carpenter bee that acts aggressive is the one that cannot hurt you. Our carpenter bee guide covers how to tell males from females, the round holes they leave in wood, and how to tell them apart from bumble bees.

Sweat bees, the most misidentified sting

Sweat bees (family Halictidae) are the small dark or metallic green bees that land on people in hot weather to drink perspiration. They sting only when pressed against skin, and the sting is genuinely mild. People often report being stung by something they could not identify and assume it was a wasp, when a sweat bee is the likelier answer.

The ones that cannot sting you

Drones, which are male honey bees, have no sting. Nor do male bumble bees or male carpenter bees. Stingless bees, a whole tribe of them in the tropics, cannot sting either, though some bite. And mining bees, the ones that make small holes in lawns every spring, are solitary, docile, and almost never sting anybody.

How much bee venom is actually dangerous

Bee venom, properly called apitoxin, is a mixture rather than a single poison. Its main active component is melittin, which breaks open cell membranes and causes the burning pain, alongside phospholipase A2, the protein most sting allergies are actually directed at. The body answers by releasing histamine, and the histamine produces the swelling and the itch.

For someone who is not allergic, venom toxicity is a numbers game, and the numbers are reassuring. The USDA Carl Hayden Bee Research Center puts safe tolerance at roughly 10 stings per pound of body weight. On that basis around 500 stings could kill a child, while an average adult could survive more than 1,100. Almost nobody meets those numbers outside a mass attack.

How much a bee sting hurts, measured

The entomologist Justin Schmidt spent a career being stung deliberately and built the Schmidt Sting Pain Index, a four-point scale for insect stings. The honey bee sits at 2.0, and it is the reference point every other sting on the scale is compared against. A yellow jacket scores about the same, a paper wasp slightly higher, and a sweat bee only 1.0. The notorious ones, the tarantula hawk and the bullet ant, reach 4.0, which is well beyond anything in a garden.

The practical value of knowing this is calibration. A honey bee sting is the benchmark for insect pain because it is so ordinary. So a sting that feels far worse than that deserves attention rather than a shrug.

Stings on dogs and cats

Dogs get stung on the nose and in the mouth, because they investigate bees with their faces and sometimes eat them. Scrape the stinger out the same way, and use a cold pack. Then watch, because the window for a reaction in dogs is about 30 to 60 minutes.

Some stings need an emergency vet straight away. Go if the sting landed inside the mouth or throat, where swelling can block the airway. Go too if your dog took several stings, vomits within minutes, has pale gums, or collapses. Do not give any antihistamine without asking a vet first, since dose and product both matter and some human medicines are unsafe for pets.

Preventing stings

• Do not swat. Crushing a honey bee releases an alarm pheromone that recruits others. Walk away calmly instead.
• Check the can. Yellow jackets climb into open drinks, so most late-summer mouth stings come from a soda can rather than a flower.
• Wear shoes on clover. Most barefoot stings are a honey bee that was working a lawn flower and got stood on.
• Cover food outdoors, and keep bins shut. Wasps hunt protein and sugar, bees do not.
• Skip strong scent near nests, and avoid loose flapping clothing that can trap an insect against skin.
• Carry the auto-injector if one has been prescribed, and make sure someone with you knows where it is.

Three things people believe about bee stings that are wrong

That you should pinch the stinger out

Pinching squeezes the venom sac, and the advice has always been to scrape rather than grip. What has shifted is the emphasis. Current guidance stresses that removing it quickly matters more than the method used, so do not lose seconds hunting for a credit card. Get it out with whatever is to hand, and avoid tweezers if you have a choice.

That a paste of baking soda or toothpaste neutralises the venom

It does not. The theory is that an alkaline paste cancels acidic venom. Yet the venom is only mildly acidic, and it already sits under the skin. Nothing spread on top can reach it. No dermatology body recommends it. Cold, an antihistamine, and hydrocortisone are what actually help.

That a big swelling means you are allergic

It usually means the opposite of what people fear. Large swelling around the sting is a local reaction, even when it covers a whole arm. The reaction that signals danger is the one that appears somewhere the bee never touched. Judge by location, not by size.

Medical disclaimer. This page is for general information only. It is not a medical diagnosis. If you have severe symptoms, trouble breathing, swelling of the face or throat, fast spreading redness, fever, severe pain, pus, or signs of infection, contact a doctor or your local emergency number.