Allergies to Insect Stings

Kristin Sokol, MD Allergy Medicine

APRIL 08, 2016

If you’re like me, you probably love spring — the promise of warm weather, the kaleidoscope of colors, and a chance to finally get outside and plant seeds in a garden that’s been dormant for months. But along with the season’s warmth and excitement, there are reasons to be cautious too, especially if you’re one of the nearly 2 million Americans allergic to insect stings.

What type of reactions can you have: First, it’s important to know that there’s a difference between an allergic reaction to an insect sting and a non-allergic reaction. And it’s worth keeping in mind that the severity of these reactions varies from person to person. Knowing about these different types of reactions could save you a lot of worry and prevent unnecessary trips to the doctor.

  • Normal local reaction (non-allergic) is temporary and characterized by itching, pain, swelling, and redness around the sting site. It normally gets better without treatment or with only supportive care.
  • Large local reaction (allergic) results in greater swelling around the sting site. For example, a person stung on their elbow may see swelling along parts of their arm. Local reactions peak at about 48 hours before diminishing over a period of 5 – 10 days. These rarely create serious health problems.
  • Systemic allergic reaction (allergic) is the most serious of the three. Symptoms of systemic allergic reactions — sometimes referred to as anaphylaxis — can include swelling, hives, difficulty breathing, nausea, vomiting, diarrhea, and, in extreme cases, shock. These types of reactions tend to occur immediately after the sting, but for some people can be delayed by as long as 24 hours. For systemic allergic reactions, immediate medical attention is recommended — even if you use epinephrine, as one shot might not reverse the reaction.

How to prevent insect stings: The majority of stings occur in the summer and fall when insects are most active. During this time of year, avoid wearing sweet-smelling perfume and brightly colored clothing as these can attract insects. If you’re picnicking or eating outside, keep food covered and don’t leave open cans of soda or juice exposed. If you spot a stinging insect, remain calm and quiet and slowly move away. Wear long-sleeved shirts and other protective clothing when in grassy or wooded areas. And learn about the habits of the insects you’re allergic to so you can better avoid them.

Have an action plan: The tricky thing about insect stings is that you may not experience an allergic reaction until you have been stung several times. That’s why it’s important to have an action plan. First, try to identify the insect that stings you. Bees, for example, often leave a stinger attached to a sac of venom in your skin. In this case, it’s important to immediately remove the stinger by gently brushing it away without squeezing the venom sac, as this causes more venom to be released. Next, clean the stung area with soap and water and apply ice to reduce swelling. It’s also a good idea to remove jewelry, watches, and rings if you are stung near your hand.

Know your treatment options: Attempting to avoid insect stings is best, but if you do get stung, it’s important to know about treatment options. For mild reactions, talk to your pharmacist about over-the-counter antihistamines and topical steroid creams to reduce itching and swelling. Severe allergic reactions are treated with epinephrine. If you have had a severe reaction to an insect sting, accurate diagnosis is essential, and it’s important that you learn how to use an EpiPen and carry it at all times, especially when you are far from immediate medical care. It’s also possible to prevent future severe allergic reactions by getting allergy shots.

For more information on insect sting allergy management and treatment, speak with one of our doctors. And make sure to enjoy the outdoors this spring, just keep a safe distance from all those busy bees.

Above content provided by Beth Israel Deaconess Medical Center. For advice about your medical care, consult your doctor.