Getting stung by a bee is a universal human experience that absolutely sucks. One minute you're walking through the grass or enjoying a soda on the patio, and the next, there’s that sharp, electric jolt of pain. Then comes the swelling. It’s usually red, it’s definitely itchy, and it feels like a tiny hot coal is pressed against your skin. Most people panic a little when the swelling doesn't go away after twenty-four hours. They start wondering, how can you tell if a bee sting is infected, or if this is just what happens when a bug injects you with venom?
The truth is that real infections from bee stings are actually pretty rare in the first few hours. What you're usually seeing is a "large local reaction." But things change around the two or three-day mark. If the redness is spreading like a wildfire or you're starting to feel like you have the flu, the math changes.
Understanding the "Normal" Kind of Awful
Venom is literally designed to cause a reaction. When a honeybee sinks its barbed stinger into you, it leaves behind a cocktail of proteins and enzymes like melittin and phospholipase A2. These chemicals immediately start breaking down cell membranes and ramping up blood flow to the area. That's why it gets red and hot. It’s supposed to do that.
For most people, the pain fades in an hour. The swelling might peak at around 48 hours. You might have a welt the size of a quarter or even a silver dollar. This is standard. It’s annoying, but it isn’t an infection. Doctors call this "envenomation." Your body is just processing the poison.
How Can You Tell If a Bee Sting Is Infected vs. Just Irritated?
Timing is everything. This is the biggest giveaway. If your sting looks angry and red the moment it happens, that’s the venom. If it looks fine on day one, starts to settle down, but then suddenly gets worse on day three or four? That is a massive red flag for a secondary bacterial infection like cellulitis.
Bacteria don't usually travel on the stinger itself. Instead, the infection happens because you scratched the living daylights out of the sting with dirty fingernails. You create tiny micro-tears in the skin, and Staphylococcus aureus or Streptococcus—which live on your skin anyway—decide to move in and set up shop.
The "Expanding Redness" Test
If you're worried, take a Sharpie. Draw a circle around the edge of the redness. Check it in four hours. If the redness has hopped over that line and is sprinting down your arm or leg, that’s not just a reaction. That’s a sign that bacteria are spreading through the deeper layers of your skin.
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Pus and Drainage
Normal bee stings might weep a little bit of clear fluid (serum) right after the stinger is pulled out. That’s fine. However, if you see thick, yellow, or greenish opaque fluid oozing from the site, you're dealing with pus. Pus is essentially a graveyard of white blood cells that died fighting an infection. If the sting site looks like a pimple that’s about to burst, it's infected.
The Heat Factor
A normal sting feels warm. An infected sting feels "angry" hot. If the skin feels significantly hotter than the surrounding area, or if you start to see red streaks (lymphangitis) radiating away from the sting toward your heart, you need to get to an urgent care. Those streaks are a sign that the infection is trying to enter your lymphatic system.
When It's Not an Infection, but a "Large Local" Reaction
Sometimes, people get stings that look absolutely terrifying but aren't actually infected. My neighbor once got stung on the forehead, and by the next morning, his entire eye was swollen shut. It looked like he’d been in a boxing match.
This is a "Large Local Reaction" (LLR). About 10% of people get these. The swelling can exceed 10cm in diameter and last for up to ten days. It’s an immune overreaction, but it’s still just the venom.
- LLR: Swelling starts fast, peaks at 24-48 hours, is very itchy, but doesn't cause a fever.
- Infection: Swelling often starts later, involves "throbbing" pain rather than itching, and might make you feel feverish or chilled.
The Role of Cellulitis
Cellulitis is the medical term for the skin infection that most commonly follows a bug bite or sting. According to the Mayo Clinic, cellulitis can become serious if left untreated because it can spread to your lymph nodes and bloodstream.
It feels different than a sting. A sting is a sharp, localized pain. Cellulitis is a dull, heavy ache that feels deep. If you touch the area and it feels firm or "indurated" (like there's a hard knot under the skin), the infection is likely localized. If the skin looks pitted like the peel of an orange (called peau d'orange), that’s a classic sign of significant skin edema related to infection.
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Why Do Some Stings Get Infected?
Honestly, it’s usually our fault. We scratch.
The itch from a bee sting is intense. It’s a histamine-driven itch that feels like it’s coming from the bone. But every time you use a fingernail to dig at it, you’re introducing bacteria.
There is also the "stinger factor." Honeybees have barbed stingers that get stuck. If you use tweezers to pull it out and squeeze the venom sac, you're just pumping more toxin in. But if you leave a fragment of the stinger behind? Your body treats it like a splinter. It will eventually try to push it out, often causing a small localized infection or "foreign body granuloma."
Real-World Treatment: What Actually Works?
If you've realized your bee sting is likely just a normal reaction, you can handle it at home. But you have to be aggressive with the early stages to prevent it from becoming an infection later.
- The Scrape Method: Don't pinch the stinger. Take a credit card or a blunt knife and scrape it across the skin. You want to flick the stinger out without squeezing the venom bulb.
- Ice is King: Forget the "baking soda paste" or the "onion trick" for a minute. Cold constricts the blood vessels and keeps the venom from spreading. 20 minutes on, 20 minutes off.
- Antihistamines: Take a Benadryl or a Claritin immediately. This dampens the immune response so the swelling doesn't get out of control.
- Elevation: If you got stung on the leg, sit on the couch and put your leg up. Gravity is your enemy when it comes to swelling.
When to Stop Reading and Call a Doctor
There is a massive difference between an infection and anaphylaxis.
An infection takes days. Anaphylaxis takes minutes. If you were just stung and you're having trouble breathing, your throat feels tight, or you feel a sense of "impending doom," stop looking for infection symptoms and call 911 or your local emergency services. That’s an allergic reaction, and it’s a life-and-death situation.
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For the infection side of things, see a doctor if:
- You develop a fever or chills.
- The red area is larger than the palm of your hand and growing.
- You see red lines moving away from the sting.
- The pain is getting worse after 48 hours instead of better.
- The sting is near your eye or inside your mouth.
Misconceptions About Bee Sting Infections
People often think that if a sting is itchy, it must be infected. That’s actually the opposite of the truth. Infections usually hurt or throb. Itching is almost always a sign of a histamine reaction—meaning your body is just doing its job reacting to the venom.
Another myth is that you need antibiotics for every "bad-looking" sting. Most "bad" stings are just large local reactions. Doctors are increasingly hesitant to prescribe antibiotics for these because they don't help with venom; they only help with bacteria. Taking unnecessary antibiotics just messes with your gut biome and contributes to drug resistance.
Actionable Next Steps
If you are currently staring at a red lump on your arm, here is exactly what you should do right now:
- Clean the site: Use plain soap and water. Don't scrub. Just get the surface bacteria off so you don't push them in if you accidentally scratch it later.
- The Sharpie Trick: Seriously, do this. Mark the borders of the redness. It’s the only way to know for sure if it’s spreading.
- Stop the Scratching: If you can't stop, put a Band-Aid over it. It acts as a physical barrier between your nails and the wound.
- Monitor your temperature: If you start feeling "crummy" or run a fever over 100.4°F, it's time for professional help.
- Check your Tetanus status: While rare, any break in the skin from an animal or insect can technically introduce tetanus. If you haven't had a booster in 10 years, it’s a good excuse to get one.
Bee stings are a temporary misery, but they shouldn't turn into a weeks-long medical saga. By watching the clock and tracking the movement of the redness, you can usually tell exactly when a "normal" sting has crossed the line into a real infection. Keep it clean, keep it cold, and keep your hands off it.