Ouch! There are few people who haven’t experienced a bug bite in their life. Be it a bee, wasp, ant or spider-these bites and stings can be painful, itchy and sometimes require medical care.

Getting stung in the mouth by a bee? That sounds unlikely to some, but riding your bike, relaxing on a hammock or reaching for your lemonade are all opportunities for an unwelcome surprise.

The Buzz on Bee Stings

Bee stings, whether in your mouth or elsewhere, can potentially be a serious situation-especially for those with known allergic reactions. What to do?

The Mayo Clinic shares what to do and look out for if you are stung by a bee, wasp, or hornet.

“Bee stings are a common outdoor nuisance. In most cases, bee stings are just annoying, and home treatment is all that’s necessary to ease the pain. But if you’re allergic to bee stings or you get stung numerous times, you may have a more-serious reaction that requires emergency treatment.”

“You can take several steps to avoid bee stings — as well as hornet and wasp stings — and find out how to treat them if you do get stung.”

The following information is from www.mayoclinic.org:

Symptoms and Reactions

Bee stings can produce different reactions, ranging from temporary pain and discomfort to a severe allergic reaction. Having one type of reaction doesn’t mean you’ll always have the same reaction every time you’re stung or that the next reaction will necessarily be more severe.

To sting, a bee jabs a barbed stinger into the skin. Bee sting venom contains proteins that affect skin cells and the immune system, causing pain and swelling around the sting area. In people with a bee sting allergy, bee venom can trigger a more-serious immune system reaction.

Most of the time, bee sting symptoms are minor and include instant, sharp burning pain at the sting site, a red welt at the sting area, and slight swelling around the sting area. In most people, the swelling and pain go away within a few hours.

Some people who get stung by a bee or other insect have a bit stronger reaction, with signs and symptoms such as: extreme redness, swelling at the site of the sting that gradually enlarges over the next day or two.  Moderate reactions tend to resolve over five to 10 days. Having a moderate reaction doesn’t mean you’ll have a severe allergic reaction the next time you’re stung. But some people develop similar moderate reactions each time they’re stung. If this happens to you, talk to your doctor about treatment and prevention, especially if the reaction becomes more severe each time.

Stung in the Mouth? Seek Immediate Help.

Let’s hope you don’t get stung at all, but if you do, the reaction to being stung in the mouth can be much worse than other parts of your body. More than likely, your lips will be the “landing zone” for an unwanted sting, but should you be stung inside your mouth, nose, or throat area, seek immediate help.

Mouth and throat tissues are much looser and more sensitive than skin. A sting in this area can cause rapid and dramatic swelling, potentially blocking airways and hindering breathing. If you have been stung in the mouth or throat, seek immediate medical attention.

As the mouth is well-supplied with blood vessels, venom from a sting can enter the bloodstream quicker. This can worsen allergic reactions for people with bee sting allergies.

John Hopkins also recommends calling 911 or your local emergency medical service (EMS) for immediate care if you are stung in the mouth, nose, or throat area, or if any other serious symptoms happen.

Emergency medical treatment may include the following:

• Intravenous (IV) antihistamines
• Epinephrine
• Corticosteroids or other medicines
• Lab tests
• Breathing support

Severe allergic reactions!

A severe allergic reaction (anaphylaxis) to bee stings is potentially life-threatening and requires emergency treatment. A small percentage of people who are stung by a bee or other insect quickly develop anaphylaxis. Signs and symptoms of anaphylaxis include:

• Skin reactions, including hives and itching and flushed or pale skin
• Difficulty breathing
• Swelling of the throat and tongue
• A weak, rapid pulse
• Nausea, vomiting or diarrhea
• Dizziness or fainting
• Loss of consciousness

People who have a severe allergic reaction to a bee sting have a 25% to 65% chance of anaphylaxis the next time they’re stung. Talk to your doctor or an allergy specialist about prevention measures such as immunotherapy (“allergy shots”) to avoid a similar reaction in case you get stung again.

Multiple bee stings

Generally, insects such as bees and wasps aren’t aggressive and only sting in self-defense. In most cases, this results in one or perhaps a few stings. In some cases a person will disrupt a hive or swarm of bees and get multiple stings. Some types of bees — such as Africanized honeybees — are more likely than are other bees to swarm, stinging in a group.

If you get stung more than a dozen times, the accumulation of venom may induce a toxic reaction and make you feel quite sick.

Signs and symptoms include nausea, vomiting or diarrhea, headache, vertigo, convulsions, fever, dizziness or fainting.

Multiple stings can be a medical emergency in children, older adults, and people who have heart or breathing problems.

The USDA (U.S. Department of Agriculture) also shares the dangers of anaphylactic and allergic reactions:

Anaphylactic reactions include swelling of the mouth or throat, shortness of breath, difficulty in swallowing, and shock. These types of reactions typically occur within minutes or even seconds of being stung and are very rare. It is estimated that less than 1% of the population will have an anaphylactic reaction. Immediate medical attention is required.

Anaphylaxis, if treated in time, usually can be reversed by epinephrine (adrenaline) injected into the body. Individuals who are aware that they are allergic to stings should carry epinephrine in either a normal syringe (sting kit) or an auto-injector (Epi-Pen) whenever they think they might encounter stinging insects. Epinephrine is obtainable only by prescription from a physician.

The average person can safely tolerate 10 stings per pound of body weight. This means that although 500 stings can kill a child, the average adult could withstand more than 1100 stings.

Allergic reactions can range from mild to severe. It is important to seek medical care if an allergic reaction is suspected. Symptoms can begin immediately following the sting or up to 30 minutes later and might last for hours. It is possible to have a severe allergic reaction to a bee sting that is not life-threatening. Symptoms can include hives, feeling nauseous or lightheaded, stomach cramps, vomiting, diarrhea, low blood pressure and swelling in areas other than the general sting site. For example, if stung on the left hand and the right hand or neck shows swelling you should seek medical attention immediately. Oral antihistamines can help minimize the symptoms.

How to Treat a Bee Sting (from the American Academy of Dermatologists)

To treat a sting from a bee, wasp, or hornet, dermatologists recommend the following tips:

1. Stay calm. Although most bees usually only sting once, wasps and hornets can sting If you are stung, calmly walk away from the area to avoid additional attacks.
2. Remove the stinger. If the stinger remains in your skin, remove it by scraping over it with your fingernail or a piece of gauze. Never use tweezers to remove a stinger, as squeezing it can cause more venom to release into your skin.
3. Wash the sting with soap and water.
4. Apply a cold pack to reduce swelling. However, if the swelling moves to other parts of your body, such as your face or neck, go to the emergency room immediately, as you might be having an allergic reaction. Other signs of an allergic reaction include difficulty breathing, nausea, hives, or dizziness.
5. Consider taking over-the-counter pain medication. Bee, wasp, and hornet stings are painful. Painkillers like acetaminophen or ibuprofen can help relieve the pain. Always follow the directions on the label and use the correct dose.

When to see a doctor

In most cases, bee stings don’t require a visit to your doctor. In more-severe cases, you’ll need immediate care. Call 911 or other emergency services if you’re having a serious reaction to a bee sting that suggests anaphylaxis, even if it’s just one or two signs or symptoms. If you were prescribed an emergency epinephrine autoinjector (EpiPen, Auvi-Q, others), use it right away as your doctor directed. If symptoms don’t go away in a few days, contact your doctor.

Seek prompt medical care if you’ve been swarmed by bees and have multiple stings.

Reduce Your Risks of Getting a Bee Sting

• Take care when drinking sweet beverages outside. Wide, open cups may be your best option because you can see if a bee is in them. Inspect cans and straws before drinking from them. Tightly cover food containers and trash cans.
• Clear away garbage, fallen fruit, and dog or other animal feces (flies can attract wasps).
• Dress to avoid bee stings. Wear closed-toe shoes when walking outside. Don’t wear bright colors or floral prints, which can attract bees. Don’t wear loose clothing, which can trap bees between the cloth and your skin.
• When driving, keep your windows rolled up.
• Be careful when mowing the lawn or trimming vegetation, activities that might arouse insects in a beehive or wasp nest. Have hives and nests near your home removed by a professional.

If a few bees are flying around you, stay calm and slowly walk away from the area. Swatting at an insect may cause it to sting. If a bee or wasp stings you, or many insects start to fly around, cover your mouth and nose and quickly leave the area. When a bee stings, it releases a chemical that attracts other bees. If you can, get into a building or closed vehicle.

Spider Bites

“Most spider bites cause only minor injury. Bites from a few spider species can be dangerous.”

The following information is from www.mayoclinic.org:

Seek medical care right away if:

• You were bitten by a dangerous spider, such as a black widow or a brown recluse (both are found in North Carolina).
• You’re unsure if the bite was from a dangerous spider.
• You have severe pain, stomach cramping or a growing wound at the bite site.
• You’re having problems breathing or swallowing.
• The area of inflamed skin is spreading or has streaks.

Clean the wound with mild soap and water. Then apply an antibiotic ointment three times a day to help prevent infection. Apply a cool cloth over the bite for 15 minutes each hour. Use a clean cloth dampened with water or filled with ice. This helps reduce pain and swelling. If possible, raise the affected area. Take a nonprescription pain reliever as needed. If the wound is itchy, an antihistamine might help. Examples are diphenhydramine or cetirizine. Or try calamine lotion or a steroid cream.

For pain and muscle spasms, your healthcare professional might prescribe pain medicine, muscle relaxants or both. You might also need a tetanus shot.

You can usually identify a black widow spider by the red hourglass marking on its belly. Symptoms of a black widow spider bite can include inflamed skin, pain and swelling, severe stomach pain or cramping, nausea, vomiting, shaking or sweating.

The brown recluse spider has a violin-shaped marking on its back, but this mark can be hard to see. Symptoms of a brown recluse spider bite can include an initial mild pain, fever, chills and body aches, a sore with a purple or blue center and a ring around it.

Your Summer Tool Kit

For those who know they have allergic responses, keep your emergency epinephrine autoinjector handy. Know how to use it and instruct others how to use it and where it is located.

Keep a first aid kit with you at all times. Pack one in your beach bag, or with your sports equipment, in your purse or in your car. Going on vacation? Don’t forget your first aid kit!   Make sure, no matter where you put it, that you can get to it quickly in times of emergency. Your first aid kit should include basic items such as a variety of adhesive and rolled bandages, nitrile gloves, CPR barrier, instant ice pack, tweezers (for those stingers and removing other insects-like ticks), scissors, hydrocortisone, antibiotic cream and a thermometer. If you are hiking or rock climbing, you’ll need more items specific to that activity. For bug bites, include acetaminophen or ibuprofen (for pain and inflammation), an anti-itch over-the-counter product and perhaps add diphenhydramine (brand name: Benadryl) for the itching and swelling. For the younger kids, make sure you have products suitable for them. Build your own kit or buy one ready made from organizations like the American Red Cross or from your local drug or grocery.

Have Fun this Summer, But Pay Attention

Know your surroundings, should you have an emergency, can you tell the 911 operator where you are? It may seem easy, but if you are at a lake, park or a destination new to you, it might be tricky. Some remote areas may have no cell coverage.  Plan ahead and pay attention to signs and landmarks.  Keep your mobile phone charged when heading out. That may seem easy, but we’ve all forgotten to recharge from time to time.

The team at Adam Brown, DDS wants you to have safe outdoor adventures and looks forward to seeing your smiles soon!