Doc Talk: Treating Insect Stings 101

This summer, the buzz about mosquitoes and Zika virus will no doubt continue. But Southern California kids are much more likely to encounter bees, wasps, hornets or yellowjackets. All carry venom that can cause problems ranging from a slight nuisance to anaphylaxis and death. 

First-aid starts with removal of the stinger. Flick it out with a credit card or your finger. Don’t pull it, grab it or tweeze it, or you’ll squeeze more venom into the skin. 

The sooner you start to treat swelling – which, along with redness and pain, is a common reaction to stings – the less there will be. These reactions can be minor to extreme, even in people who are not allergic.  

Make a paste of Adolph’s Tenderizer (a meat tenderizer available at the grocery store) and over-the-counter steroid cream. Apply this to the area around the sting and cover with a bandage. The tenderizer breaks up the protein enzymes in the venom that cause the swelling. 

Elevate the area, the way you would a sprained ankle, and make a cool compress with a bag of frozen vegetables (which are more comfortable than ice cubes). If your child is 6 months old or older, give Tylenol or Motrin for pain and Benadryl for swelling. Leave the tenderizer paste in place for four to six hours. If your child is younger than 6 months, consult your doctor about the medication. 

Kids who are allergic to insect venom can have systemic reactions. Symptoms can include: 

• Nausea and vomiting,  
• diarrhea, 
• fever,  
• hives,  
• paleness, 
• hoarse voice,  
• chest congestion and difficulty breathing.  

Allergic reactions to stings can be life-threatening. If your child is stung and develops these symptoms, contact your doctor, bring your child to the emergency department or, if symptoms are severe, call 9-1-1.  

Allergy to insect stings tends to run in families, so if you are allergic, watch your child closely if he or she is stung. If you know your child is allergic, you should have an epinephrine auto-injector (EpiPen) available at all times, and be trained by a nurse, doctor or pharmacist in how to use it. 

Alan L. Nager, M.D., M.H.A., has been Director of Emergency and Transport Medicine at Children’s Hospital Los Angeles for the past 18 years, and is a professor of Pediatrics at the Keck School of Medicine of the University of Southern California.