Bee Stings: Normal Swelling or an Allergic Reaction?
How to tell normal bee sting swelling from an allergic reaction, what to do right after a sting, and when a sting needs urgent care or the ER.
Most bee stings cause pain, redness and swelling right around the sting, and that is a normal reaction, not an allergy. An allergic reaction shows up away from the sting: hives spreading over the body, swelling of the face or throat, trouble breathing, dizziness or vomiting. That kind of reaction is an emergency. Here is how to tell the two apart, and what to do for an ordinary sting.
Call 911 or go to the ER if after a sting someone has trouble breathing or wheezing, tightness in the throat or a hoarse voice, swelling of the lips, tongue or face, hives spreading over the body, dizziness, fainting or a racing heartbeat, vomiting or stomach cramps, or a feeling that something is very wrong. Also go if someone was stung many times at once, or stung inside the mouth or throat. If the person has a prescribed epinephrine auto-injector, use it as directed and still call 911.
What a normal bee sting looks like
A typical sting hurts sharply right away, then turns into a red, raised, swollen spot that may itch or burn. It is usually smaller than a few inches across and settles over a few hours to a day or two. This is the body reacting to the venom where it went in, and it happens to almost everyone.
What is a large local reaction?
Some people swell much more, sometimes across a whole hand, forearm or foot. The swelling often grows for a day or two and can take up to a week to go down. It looks dramatic, but if the swelling is connected to the sting site and there are no symptoms elsewhere in the body, it is usually still a local reaction rather than a dangerous allergy.
A large local reaction is a good reason to get seen if it is very painful, limits how you use a hand or foot, or keeps spreading after the second day. A clinician can examine it and discuss treatment to ease the swelling and itching.
Signs of an allergic reaction to a bee sting
An allergic reaction involves parts of the body away from the sting. It usually starts within minutes, though it can come on later. Look for:
- Hives or itchy welts in places you weren't stung
- Swelling of the lips, tongue, eyes or face
- Throat tightness, a hoarse voice, coughing, wheezing or trouble breathing
- Feeling dizzy, faint or lightheaded
- Nausea, vomiting, diarrhea or stomach cramps
The most serious form, anaphylaxis, can get worse quickly. It is the reason for the ER box at the top of this post. Someone who has had a reaction like this before is at higher risk of another, so it is worth talking to a clinician about carrying epinephrine and about seeing an allergist.
What to do right after a bee sting
- Get the stinger out fast. Honeybees leave a stinger with a venom sac attached. Scrape it out with a fingernail or the edge of a card, or pull it out; how you remove it matters less than how quickly you do it. Wasps and yellow jackets usually don't leave a stinger.
- Move away from the area. Stinging insects can release a scent that draws others in.
- Wash the spot with soap and water.
- Cool it. A cold pack wrapped in a cloth, on and off for 10 to 20 minutes at a time, helps the pain and swelling.
- Raise it. If the sting is on an arm or leg, keeping it raised can limit swelling.
- Leave it alone. Scratching can break the skin and let infection in. Ask a pharmacist or clinician which over-the-counter options are right for you, especially for children or anyone on other medicines.
Could a bee sting get infected?
Infection after a sting is uncommon, but it happens, usually from scratching. A normal sting is at its worst in the first day or two and then improves. Signs that it may be infected include redness and pain that get worse after the second or third day, warmth, red streaks spreading from the area, pus, or a fever. Those are reasons to have it looked at.
When to come to urgent care for a bee sting
Come in the same day if:
- The swelling is large, very painful or still spreading after a day or two
- The sting is near the eye
- The area looks infected
- Part of the stinger seems to be stuck in the skin
- You had a mild reaction away from the sting, such as a few hives, that has already settled, and you want to talk about what to do next time
A clinician can remove a stinger, examine the reaction and discuss treatment for bites and stings. Anything involving breathing, the throat or feeling faint belongs in the ER, not urgent care.
What a visit costs
We contract with all major commercial and government plans, including Colorado Medicaid and Medicare. We can't guarantee a commercial plan has us in network; if you turn out to be out of network or your benefits are denied, we charge our self-pay rates instead. Self-pay in-clinic visits start at $175, and every tier is on our cost and insurance page.
Where to find us
Four clinics across metro Denver, all ages welcome, se habla español:
- Hampden (Southeast Denver): 8 AM–11 PM daily
- Littleton: 8 AM–11 PM daily
- Thornton: 8 AM–11 PM daily
- Highlands: Mon–Fri 5–11 PM, Sat–Sun 8 AM–11 PM
Walk in, or book online.
Medically reviewed by Peter Martinuzzi, MD
This article is general health information, not medical advice for your situation. If you are worried, come in or book a telehealth visit — and if it is an emergency, call 911.