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Allergies to Insect Stings

Topic Overview

What are allergies to insect stings?

When you are stung by an insect, poisons and other toxins enter your skin. It's normal to have some swelling, redness, pain, and itching around the sting. But you may have an allergic reaction if your immune system reacts strongly to allergens in the sting.

You probably won't have a severe allergic reaction the first time you are stung. But even if your first reaction to a sting is mild, allergic reactions can get worse with each sting. Your next reaction may be more severe or even deadly.

What causes an allergic reaction to insect stings?

An allergic reaction occurs when your immune system reacts strongly to the allergens in the sting.

A few types of stinging insects cause most allergic reactions. They are:

  • Bees.
  • Wasps.
  • Hornets.
  • Yellow jackets.
  • Fire ants.

What are the symptoms?

Symptoms of an allergic reaction can range from mild to severe.

Mild reactions may cause:

  • Redness, pain, and swelling around the sting.
  • Itching around the sting or anywhere on your body.

Large, local reactions may cause the same symptoms as mild reactions, plus:

  • Redness and swelling that affects an entire arm, leg, or large part of your body.
  • Swelling that continues to increase for up to 48 hours.

A large local reaction can take up to 10 days to go away.1

Severe reactions may cause:

  • Hives.
  • Swelling of your tongue, throat, or other body parts.
  • Nausea, vomiting, or diarrhea.
  • Anaphylaxis, which is a severe, life-threatening reaction that requires emergency treatment. It causes confusion, trouble breathing, and other symptoms.

How are allergies to insect stings diagnosed?

Your doctor may do a physical exam and ask you questions about your symptoms and past health. He or she also may want you to have allergy tests after you get better from the allergic reaction. Allergy tests, such as skin prick tests or blood tests, can help you find out which types of insect stings you are most allergic to.

How are they treated?

When you are stung

  • For a severe reaction, such as confusion and trouble breathing:
    • Call 911.
    • If you have your allergy kit, use the antihistamine medicine and epinephrine shot. Then go to the emergency room.
  • For a large, local reaction or a mild reaction, you can typically treat it at home.
    • Use an ice pack to reduce swelling. If you can, raise the body part where you were stung.
    • Take a nonprescription pain reliever, such as aspirin, acetaminophen (Tylenol, for example), or ibuprofen (Advil, for example). Do not give aspirin to anyone younger than age 20 because of the risk of Reye syndrome.
    • Take an antihistamine to help with the itching. Read and follow the warnings on the label. And don't give antihistamines to your child unless you've checked with the doctor first.

Other treatment

If you or your child has severe reactions, your doctor may prescribe epinephrine, such as an EpiPen, and antihistamine medicine that you keep in an allergy kit. Keep the kit with you or your child at all times. Teach others, such as teachers, friends, or coworkers, what to do if you're stung and how to give the shot. Also, be sure to wear a medical alert bracelet or other jewelry that lists your allergies. During an emergency, these can save your life.

You may also want to try allergy shots, called immunotherapy, to help prevent worse allergic reactions in the future.

Preventing stings

To reduce your chances of being stung:

  • Stay away from places where insects nest.
  • Wear shoes, long sleeves, and long pants when you are outdoors.
  • Don't wear perfume or scented lotions.

If you are stung, stay as calm and quiet as you can. Then move away from the insect and leave the area, because the nest may be close by.

Remove the stinger from your skin. It may be best to scrape or flick the stinger off your skin—squeezing or gripping the stinger to pull it out may inject more venom into your wound. If you were stung in your arm or leg, lower it to slow the spread of venom. Then treat the insect sting based on the type of reaction you have.

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Other Places To Get Help

Organizations

American Academy of Allergy, Asthma, and Immunology
555 East Wells Street
Suite 1100
Milwaukee, WI  53202-3823
Phone: (414) 272-6071
Email: info@aaaai.org
Web Address: www.aaaai.org
 

The American Academy of Allergy, Asthma, and Immunology publishes an excellent series of pamphlets on allergies, asthma, and related information. It also provides physician referrals.

American College of Allergy, Asthma, and Immunology (ACAAI)
85 West Algonquin Road
Suite 550
Arlington Heights, IL  60005
Phone: 1-800-842-7777 (allergist referral service)
Email: mail@acaai.org
Web Address: www.acaai.org
 

The American College of Allergy, Asthma, and Immunology (ACAAI) provides allergy information for consumers, including a nationwide allergist referral service.

Asthma and Allergy Foundation of America (AAFA)
1233 20th Street NW
Suite 402
Washington, DC  20036
Phone: 1-800-7-ASTHMA (1-800-727-8462)
Email: info@aafa.org
Web Address: www.aafa.org
 

The Asthma and Allergy Foundation of America (AAFA) provides information and support for people who have allergies or asthma. The AAFA has local chapters and support groups. And its Web site has online resources, such as fact sheets, brochures, and newsletters, both free and for purchase.

KidsHealth for Parents, Children, and Teens
10140 Centurion Parkway North
Jacksonville, FL  32256
Phone: (904) 697-4100
Fax: (904) 697-4220
Web Address: www.kidshealth.org
 

This website is sponsored by the Nemours Foundation. It has a wide range of information about children's health, from allergies and diseases to normal growth and development (birth to adolescence). This website offers separate areas for kids, teens, and parents, each providing age-appropriate information that the child or parent can understand. You can sign up to get weekly emails about your area of interest.

References

Citations

  1. Golden DB, et al. (2011). Stinging insect hypersensitivity: A practice parameter update 2011. Journal of Allergy and Clinical Immunology, 127(4): 852–854.e23.

Other Works Consulted

  • Golden DBK (2011). Allergic reactions to hymenoptera. In EG Nabel, ed., ACP Medicine, section 6, chap. 15. Hamilton, ON: BC Decker.
  • House H (2006). Insect bites and stings. In MR Dambro, ed., Griffith's 5-Minute Clinical Consult, pp. 590–591. Philadelphia: Lippincott Williams and Wilkins.
  • Reisman RE (2007). Insect sting allergy. In P Lieberman, JA Anderson, eds., Allergic Diseases Diagnosis and Treatment, 3rd ed., vol. 1, pp. 71–81. Totowa, NJ: Humana Press.
  • Schwartz LB (2012). Systemic anaphylaxis, food allergy, and insect sting allergy. In L Goldman, A Shafer, eds., Goldman's Cecil Medicine, 24th ed., vol. 3, pp. 1633–1638. Philadelphia: Saunders.
  • Bernstein IL, et al. (2008). Allergy diagnostic testing: An updated practice parameter. Annals of Allergy, Asthma, and Immunology, 100(3, Suppl 3): S1–S148.
  • Tankersley MS (2008). The stinging impact of the imported fire ant. Current Opinion in Allergy and Clinical Immunology, 8(4): 354–359.

Credits

By Healthwise Staff
Primary Medical Reviewer E. Gregory Thompson, MD - Internal Medicine
Specialist Medical Reviewer Rohit K Katial, MD - Allergy and Immunology
Last Revised January 5, 2012

Last Revised: January 5, 2012

Author: Healthwise Staff

Medical Review: E. Gregory Thompson, MD - Internal Medicine & Rohit K Katial, MD - Allergy and Immunology

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