What's the right way to remove a bee stinger?

If several bees are after you, get away before you do anything else, since stinging bees release a chemical that attracts other bees.¹ Then look for the stinger. Only a honey bee leaves one behind: the barbs usually keep it in your skin, and it tears off the bee along with the venom sac.² Venom keeps flowing in for up to about a minute, and the longer the stinger stays in, even by a few seconds, the more venom you get.³ Wasps, hornets, yellowjackets and bumble bees have smooth stingers, so their stings usually leave nothing to pull out.⁴

Don't stop to hunt for a credit card or tweezers.³ A fingernail scraped across the stinger works, and so does pinching it and pulling it out.² Much first-aid advice says never to squeeze a stinger or use tweezers, on the assumption that squeezing the venom sac pushes more venom in.¹ The one experiment that tested this found no difference.³ Two researchers stung themselves again and again, removed each stinger at two seconds by scraping or pinching, and got welts of about the same size either way.³ It's a single small study, and the evidence is weak, but it's the only direct test so far.³ Pinch or scrape, whichever is faster.³

Once it's out, wash the spot with soap and water and hold ice or a cold pack on it.² Pain, redness and swelling around the sting are normal.⁵ Try not to scratch, since that can carry germs from your skin into the wound.² An antihistamine can ease the itch.² In some people the swelling grows much larger, up to 8 to 10 inches across over a day or two.⁶ That typically fades within about a week and doesn't need antibiotics.⁶

A sting becomes an emergency when signs show up away from the sting: swelling of the face, throat or tongue, trouble breathing, dizziness, or hives over large areas of the body. That's anaphylaxis, a severe allergic reaction, and it can happen to someone with no known allergy.⁴⁷ Use an epinephrine auto-injector right away if one is on hand, and call 911.⁵ Do not wait on an antihistamine, which can't reverse the airway swelling.⁵ These signs can start right away or up to 30 minutes after the sting, so stay with anyone who's been stung.² And several stings at once can need medical care even without an allergy, especially in a child, so get help as quickly as you can.⁴