Abstract
The comprehensive article (1) does not make any mention of a very simple and risk-free acute treatment option for insect stings, which can be administered by the patients themselves or those around them: heat therapy. In my 25 years as a general practitioner I have always found this to be an instant route to success. Most insect venoms are thermolabile even at temperatures around 50°C at the actual puncture site. Heat treatment is incredibly simple to administer: hold a coin between thumb and index finger into a naked flame (such as a cigarette lighter) for as long as this is tolerable and then press the coin on the site of the bite for about 10 seconds. Repeat. Any symptoms will disappear after 2–3 minutes. For sensitive patients and especially for children, a battery-driven heat pen is commercially available, which can be used to selectively and reproducibly heat the site of the sting to a temperature of 50°C. In theory, this treatment should be administered as immediately as possible after the sting, but I have seen the full successful result after hornet stings even after a 20 minute delay.
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