Matthew Bellhouse-King, DNP

Dr. Bellhouse-King is a Board Certified Family Nurse Practitioner who received his Doctor of Nursing Practice from the University of Hawaii at Manoa. He’s worked throughout the Pacific region for 11 years and is currently a primary care provider in Oahu. An advocate for health promotion and disease prevention, Dr. Bellhouse-King believes that affordable and quality healthcare should be accessible to everyone in Hawaii and beyond.


Insect Bites and Stings Treatment

Insect bites are common. This article will discuss the differences between insect bites and stings and will review treatment, too. 

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Insect sting treatment

To start, typically bee and wasp stings lead to a mild local skin reaction. For this:

  • Firstly, use a cold compress to ease pain and reduce swelling.
  • Secondly, use a painkiller to reduce pain symptoms.
  • Lastly, for itching, apply a steroid cream like hydrocortisone or antihistamine tablet. The itching may take time to subside. 

Bee stings

In addition, if the stinger is still in place, scrape it out using the edge of a knife or a credit card. Make sure you do not grab the stinger or squeeze it, as this could release more venom into the skin.

Of note, wasps do not leave stingers.

Localized allergic reaction

If you have an allergic reaction to the sting, you will notice swelling at the site that will become larger over the first few hours. Then it subsides. Unless the swelling is on your face and affects your airway, it is not dangerous. To manage the allergy you could:

  • Take an antihistamine tablet as soon as possible
  • Apply a cold compress to ease the pain and minimize swelling
  • Take painkillers such as paracetamol or ibuprofen

Generalized allergic reaction

Rarely, insect stings may cause a serious reaction. This happens most often in reaction to wasp stings. The severe allergic reaction is called anaphylaxis, which can be fatal.


  • Itchy skin followed by an itchy blotchy rash can appear anywhere 
  • Swelling on the face, which may extend to the lips, tongue, throat and upper airway.
  • Abdominal cramps
  • Nausea
  • Dilation of the blood vessels, which can cause:
    • Redness of the skin
    • Rapid heart rate
    • Low blood pressure, which can make you feel faint
  • Wheezing or difficulty in breathing

A severe, generalized reaction will usually develop within 10 minutes of a sting. You must call an ambulance immediately on noticing symptoms of a severe reaction. If you have an Epi pen, use it immediately.

When to seek medical advice?

If the sting looks infected or you think you are having a severe allergic reaction, seek medical help.

Insect Bites Treatment

The treatment is the same as that for stings, except there is no need to worry about the stinger.

When to seek medical advice?

If the bite looks infected or you think you are having an allergic reaction.

What insect bites cause swelling?

Bites from midges, gnats, mosquitoes, flies, mites, ticks, fleas, and bedbugs can cause swelling or bumps.

How do you know if a bite or sting is infected?

If the area is red and tender with a yellow discharge (pus), it is likely infected. You may need a course of antibiotics to help clear it.

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