Stung by a Bee

If I don't see a stinger is it still under the skin?

Apis mellifera (honey bee) - the stinger of a black honey bee, torn from the bee's body
A venom sac still stuck to a barbed honey bee stinger. Paul Starosta / Getty Images

Question

After being stung by a bee, if I don't see a stinger is it still under the skin?

A reader told a story of being stung by a bee and not seeing the stinger when he looked. He wanted to know: does that mean the stinger is still under the skin?

Answer

Very unlikely.

Only a few species of bees have barbed stingers. The bees with sharply barbed stingers—that leave a venom sac and stinger behind—are only female worker honeybees.

Those are the bees that we think of when we consider how to properly remove the stinger. A few yellowjackets also have small barbs on their stingers, but they're not big enough to catch in the skin. Different species of bees and wasps are going to have differently sized stingers.

If you're stung by a bee and the bump (called a weal) swells up large and turns red, watch for redness and swelling spreading out away from the weal. Spreading, swelling, or fever (meaning it feels hot) can be signs of infection or allergy. 

Be aware of any itching or burning on skin that's not touching the weal, or of trouble breathing, difficulty swallowing, scratchy throat, dizziness, or weakness after the sting. Any of these signs and symptoms could indicate anaphylaxis (a severe allergic reaction). Anaphylaxis is a life-threatening medical emergency that requires immediate medical treatment.

Patients who know they are allergic to bee stings might be carrying epinephrine.

Epinephrine is a form of adrenaline and it is used to treat severe anaphylaxis. If the patient is carrying an epinephrine auto-injector, help the patient use the auto-injector as soon as they or you begin to recognize the symptoms of anaphylaxis.

People who are allergic to bee stings will most likely be allergic to all bee species.

Treat all bee stings the same: You don't have to worry about removing a stinger if you don't see one. The way that stingers and venom sacs are shaped leads to the fact that it is really hard to get a stinger under the skin. 

In the unlikely case part or all of a stinger has become lodged underneath the skin, it will probably work its way out over a few days much like a splinter. If the swelling doesn't go down after a couple of days, you may need to see a doctor to rule out or confirm a possible infection.

If the patient is allergic to bee stings, make sure the patient goes to the doctor right away if you or the patient think there is a stinger still under the skin. It's the exception to the rule.

Source:

Farrar, C.L. "The Life of the Honey Bee." American Bee Journal. Vol. 108, No.2, 1968.

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