What to do if…
you get a bite or sting and the swelling keeps increasing over hours

What to do now

1. Check for emergency allergy signs. Call 999 now if any of these are happening: trouble breathing, wheezing, throat tightness, trouble swallowing, swelling of the lips, tongue, mouth, throat, or face, blue, grey, or pale lips or skin, sudden confusion or drowsiness, fainting, collapse, or feeling suddenly very unwell, especially with a widespread itchy or raised rash.

2. If anaphylaxis is possible and you have been prescribed an adrenaline auto-injector, use it now. Then call 999 and say “anaphylaxis.”

   • Lie down and raise your legs if you can.
   • If breathing is difficult, sit up slowly enough to breathe, but avoid standing or walking.
   • If symptoms have not improved after 5 minutes and you have a second auto-injector, use it.

3. Reduce pressure from swelling now.

   • Remove rings, watches, tight clothing, socks, or shoes from the swollen area before they become trapped.
   • Rest the area and raise it if it is on an arm or leg.
   • Put a cold pack wrapped in cloth, or a clean cold wet cloth, on the area for about 20 minutes.

4. Remove a visible sting only if it is on the surface.

   • If you can see a bee, wasp, or hornet sting, brush or scrape it sideways with a fingernail or the edge of a card.
   • Do not use tweezers on a sting if you can avoid it, because squeezing it may push in more venom.

5. Wash and track the edge of the swelling.

   • Wash the area with soap and water.
   • Draw a pen line around the edge of the redness or swelling and write the time next to it.
   • Take a clear photo. If the swelling or redness crosses the line over the next few hours, mention this when you ask for help.

6. Use simple symptom relief if it is safe for you.

   • Consider an oral antihistamine for itching.
   • Consider paracetamol or ibuprofen for pain if you can take them.
   • Consider over-the-counter hydrocortisone cream for itching or swelling, following the label.

7. Get same-day advice because the swelling is still increasing.

   • Use NHS 111 where available, or the urgent medical advice route for your UK nation. NHS 111 online is England-only, but the page links to routes for Scotland, Wales, and Northern Ireland.
   • Ask for urgent advice sooner if symptoms are getting worse, you feel dizzy or lightheaded, you have tummy pain or vomiting, you have a high temperature or swollen glands, you were stung more than once, the sting is in your mouth or throat or near your eyes, or you have had a serious reaction before.
   • If the person bitten or stung is under 1 year old, ask for GP or NHS 111 advice.
   • Speak to a pharmacist the same day if the person is aged 1 year or older and the area is hot, red, painful, swollen, weeping, or has pus. A pharmacist can advise on treatment and may direct you to urgent medical help.

8. Escalate if it is worsening quickly or you cannot get prompt advice.

   • Go to an urgent treatment centre, minor injuries unit, or A&E if swelling, redness, heat, or pain is spreading quickly, or you feel feverish or unwell.
   • Call 999 or go to A&E if you may have cellulitis and also have a very high temperature, fast heartbeat, fast breathing, purple patches, dizziness, faintness, confusion, cold clammy skin, or loss of consciousness.
   • Call 999 instead of travelling yourself if emergency allergy signs appear or you feel too unwell to travel safely.