A bee sting during a picnic or camping trip can make a child’s skin puff up within minutes, which is alarming. Most stings cause only a local reaction that can be handled at home, but a small number trigger a whole-body allergic reaction, so it helps to know the difference. For a mosquito bite that has swollen up, see the mosquito bite guide.

Why It Swells and Hurts

Bee venom irritates the skin, causing pain, swelling, redness and itching at the site. According to the AAP, swelling can keep growing for about 48 hours and may last up to a week, and large local swelling by itself is not a sign of allergy. An allergic reaction involves symptoms beyond the sting site, such as the skin elsewhere, the airway or circulation.

How Reactions Differ

  • Typical local reaction: a sharp sting followed by a red, swollen, itchy spot.
  • Large local reaction: swelling that spreads over a larger area, such as most of an arm or leg, and builds over a day or two. It is uncomfortable but different from an allergy.
  • Anaphylaxis: usually within minutes after the sting, signs may include swelling of the face, lips or tongue, hives over the body, wheezing or trouble breathing, trouble swallowing, dizziness, pallor, fainting or vomiting.
  • Only honey bees typically leave the stinger behind; wasps and yellow jackets usually do not.

What to Do at Home

  • If a stinger is visible, scrape it sideways with a fingernail or the edge of a card. Squeezing it or using tweezers may push in more venom. If a piece stays in the skin, it is fine to leave it.
  • Wash with soap and water, then apply a cold pack wrapped in cloth to ease pain and swelling.
  • For pain, a pediatrician can advise on an age- and weight-appropriate dose of acetaminophen or ibuprofen.
  • Hydrocortisone 1% cream may help itching; for severe itching, ask about an oral antihistamine.
  • Keep nails short to prevent scratching. Home remedies such as pastes can irritate skin and are not advised.

Common Misunderstandings

  • Big swelling does not automatically mean allergy; it may be a large local reaction.
  • Having tolerated a past sting does not guarantee the next one will be mild, and a child who ever had a serious whole-body reaction needs extra caution.
  • Allergic reactions usually appear fast, so staying close to the child for the first hour or two is wise.

When to Seek Care

Call 911 right away for trouble breathing, wheezing, a tight throat, trouble swallowing or drooling, slurred speech, confusion or fainting, or if a child with a past serious bee allergy is stung. Use a prescribed epinephrine auto-injector without delay. Go to the emergency room for hives or swelling all over the body, stings inside the mouth or near the eye, or many stings at once. Call the doctor if the area looks infected, a fever appears, or redness keeps growing after 3 days. This information isn’t a diagnostic tool and doesn’t replace advice from a medical professional.