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Sarah’s Health Notes: How to treat a wasp sting

Bzzzz. Bzzzz. Tckkkkkk! No, not a bee but an apparently angry wasp, offended that I had sat on my desk chair and disturbed his snooze. For which, he (or she? How do you tell…?) shot venom into the top of my left thigh, under my dress. It was on the outer side, thank goodness, but that proved a small mercy.

I don't remember being stung by a wasp before, a bee, yes – and though that can be distressing this was a monster. After the initial bolt of pain, the area became swollen and red, felt burning, sore and itchy and grew like topsy until the red lump was about three inches by two inches, with a white centre.

I felt a bit groggy and that was made worse by not sleeping much owing to the pain. My husband asked if I was allergic and my reaction does fit what the NHS UK website describes as ‘a mild allergic reaction, where a larger area of skin around the bite or sting becomes swollen, red and painful. Bracingly, they add that ‘this should pass within a week’. US medical sites describe this condition it as ‘a large local reaction’, which is pretty accurate.

About 10% of people suffer in the same way (the rest usually suffer for just a few hours or a day) and, while unpleasant, it is not dangerous. But wasp stings, like bee stings, can cause a severe potentially life threating reaction called anaphylaxis where the body goes into shock.

Anaphylaxis to insect stings, which has occurred in 3% of adults, develops suddenly and gets worse very quickly. Symptoms include feeling lightheaded or faint, breathing difficulties, fast heartbeat, clammy skin, confusion and anxiety, collapsing and losing consciousness. Other possible symptoms are swelling, which can affect face, including lips and throat, stomach pain, feeling/being sick, and/or an itchy raised rash. It’s vital to call 999 immediately. More information here.

I didn't know the effect of that grumpy wasp sting was going to last several days and we had a lot on over that time so I didn't do anything sensible like look up what to do. Until now…

Here are guidelines for what to do if you’ve been bitten or stung:

1. Remove the sting or tick quickly if it’s still in the skin - impossible for me, as I couldn't get to the site. One method is to scrape it out with a credit card (didn't read that until too late)

2. Wash the site with soap and water; apply an antibiotic ointment if you have some

3. Apply a cold compress or ice pack to any swelling for at least ten minutes – an ice pack gave instant relief though I had to hold it manually in place or lie on it

4. Raise or lift the affected area if possible to reduce swelling

5. Don’t scratch the itch – or you risk infection.

According to the NHS site, you should avoid traditional home remedies such as vinegar and bicarbonate of soda, as they’re unlikely to help, they say. Hmmmm. Pharmacist Shabir Daya (our go to guru) suggests apple cider vinegar can help. If it ever happens again, I shall be swabbing on that. (Don't see why you should avoid that anyway, as it can’t hurt.)

For analgesia, I took an aspirin/paracetamol/caffeine product, which helps me usually but was pretty ineffective with this. But the most useful painkiller is something like ibuprofen, which helps quell the inflammation.

If you’re near a pharmacy, do ask for advice. You may be recommended to take an antihistamine to help with the itching and swelling. You could also try calamine lotion for itching.

A small percentage (5-10%) of those experiencing large local reactions may suffer anaphylaxis if stung in the future. So I’ve decided it’s worth taking more care including covering up before I garden and wearing shoes – I normally pad around barefoot. Also apply insect repellent – I make a cocktail for my horses so I’m going to spray it on me too. (1:1 strong tea and malt vinegar with a lot of citronella.)

Worth pointing out that US healthcare sites are adamant that if you have suffered a large local reaction you should talk to your doctor and get tested to see if you are allergic to insect stings. You may then want to explore the possibility of immunotherapy, where you are given shots of purified venom, starting with very small amounts and increasing gradually until you can tolerate the amount in two or more stings. The NHS website doesn't mention anything like this but Nice (the National Institute for Health and Clinical Excellence) has produced positive guidance here.  Also see notes on venom immunotherapy at bsaci.org, the website of the British Society for Allergy and Clinical Immunotherapy.

 

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