We found no systematic reviews, RCTs or other studies that evaluated symptomatic treatment of local and systemic toxic and/or allergic reactions after stings by bees, wasps or hornets (Hymenoptera). However, in many studies investigating the effect of venom immunotherapy, case series are reported about the treatment of potentially life-threatening adverse systemic reactions to the insect venom (similar treatment to that of anaphylaxis from any other cause).

Pinching versus scraping off the bee sting left in the skin

We found one RCT of two volunteers who either pinched or scraped off honeybee stings (20 stings in each group). The wheal response was greater for stings removed by pinching than those removed by scraping (80 mm2 versus 74 mm2) but the difference was not statistically significant.36

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