If you get stung by a bee, wasp, yellow jacket, hornet, or fire ant, would you know if you had an allergic reaction?
Those are the insect stings that most often trigger allergies. Most people aren’t allergic. By knowing the difference, you can decide if you need to see a doctor.
3 Types of Reactions
The severity of symptoms from a sting varies from person to person. But in general:
A normal reaction sets off pain, swelling, and redness around the sting site.
A large local reaction causes swelling that extends beyond the sting site. For example, a person stung on the ankle may have swelling of the entire leg. While it often looks alarming, it's usually no more serious than a normal reaction. Large local reactions peak at about 48 hours and then gradually get better over 5 to 10 days.
The most serious reaction is an allergic one (described below). You'll need to get it treated right away.
What Are the Symptoms of an Insect Sting Allergy?
A mild allergic reaction may cause one or more of these symptoms at the site of the sting:
- Pimple-like spots
- Mild to moderate swelling
Severe allergic reactions (also called an anaphylactic reaction) are not that common. But when they happen, they're emergencies.
Symptoms can include:
- Trouble breathing
- Hives that appear as a red, itchy rash and spread to areas beyond the sting
- Swelling of the face, throat, or any part of the mouth or tongue
- Wheezing or trouble swallowing
- Restlessness and anxiety
- Rapid pulse
- Dizziness or a sharp drop in blood pressure
Get emergency treatment as soon as possible.
How Common Are Insect Sting Allergies?
About 2 million Americans have allergies to the venom of stinging bugs. If you’re allergic to bee stings, you may also be allergic to yellow jackets, wasps, and hornets. Many of these people are at risk for life-threatening allergic reactions.
Treatment if You’re Not Allergic
First, if you’re stung on the hand, remove any rings from your fingers immediately.
If stung by a bee, the bee usually leaves a sac of venom and a stinger in your skin. Remove the stinger within 30 seconds to avoid receiving more venom. Gently scrape the sac and stinger out with a fingernail or a stiff-edged object like a credit card. Don’t squeeze the sac or pull on the stinger, or more venom will get into you.
Wash the stung area with soap and water, then apply an antiseptic.
Apply a soothing ointment, like a hydrocortisone cream or calamine lotion, and cover the area with a dry, sterile bandage.
If swelling is a problem, apply an ice pack or cold compress to the area.
Take an over-the-counter oral antihistamine to ease itching, swelling, and hives. Don’t give this medication to children under 2 years old or to pregnant women unless your doctor says it’s OK. (If you’re pregnant, it’s best to talk to your doctor before you take any medicine.)
You can also take an “NSAID” pain reliever such as ibuprofen.
Read the label on any medicines first. Parents of children and people with medical conditions should talk with a pharmacist if they have questions about a medicine's use.
Treatment if You’re Allergic
If you have a severe allergic sting reaction, you’ll need epinephrine, which you can inject yourself before you call 911. Usually, this shot will stop a more severe allergic reaction from happening.
You’ll still need emergency medical care, even if the symptoms seem to stop. You may need to stay overnight at the hospital. If you’ve ever had allergic reactions to an insect sting, carry epinephrine with you wherever you go.
How Can I Avoid Being Stung?
You can’t completely. But these steps make it less likely.
1. Learn to recognize insect nests and avoid them. Yellow jackets nest in the ground in dirt mounds or old logs and walls. Honeybees camp out in beehives. Hornets and wasps make their homes in bushes, trees, and on buildings.
2. Wear shoes and socks when outdoors.
3. Wear long-sleeved shirts, long pants, socks, and shoes when in rural or wooded areas.
4. Avoid wearing perfumes or brightly colored clothing. They tend to attract insects.
5. If you have severe allergies, make sure you have someone with you if you hike, boat, swim, golf, or do other things outdoors, just in case.
6. Consider using screens on windows and doors at home. You may also want to use insect repellents when you’re outside.
7. Spray garbage cans regularly with insecticide, and keep the cans covered.
8. Avoid or remove insect-attracting plants and vines growing in and around the home.
Also, if you're severely allergic, always wear identification that says you have an allergy. Keep an epinephrine kit on hand in case of an emergency, too. For more information on where to get a MedicAlert bracelet, you can call 800-ID-ALERT.
What Are Epinephrine Kits?
These let you give yourself medicine (epinephrine) right away if you’re stung, before you get to a doctor for treatment. The most common brand is an EpiPen. You should still see a doctor ASAP after being stung.
You'll need a prescription from your doctor to buy one of these kits. Carry two with you at all times. In order to prevent drug interactions, tell your doctor about any medicine you take.
How Can I Prevent an Allergic Reaction?
Allergy shots may help. They're about 97% effective. Allergy shots for insect stings put tiny amounts of the allergen (you may hear it called insect venom) into your body over time. Your body gets used to the allergen, and if you get stung again, you won’t have such a bad reaction.
Your doctor will first test you to find out what insects you’re allergic to. Then you’ll typically get the shots once or twice a week. The dose will go up slightly over time until you reach a maintenance dose, usually in about 3 to 6 months.
For most people, allergy shots are safe. You may have side effects like redness and warmth at the injection site. You could also have a mild or serious allergic reaction to the shot itself. They may be more risky for people who have heart or lung disease or who take certain medications.