What should I do if a bee stings me, and when should I see an allergist?
What you do about a bee or any insect sting depends on your body’s reaction. A normal (non-allergic) reaction involves pain or discomfort, as well as swelling or redness in the area where you were stung. If the stinger is still in your skin, remove it by scraping the area with a straight edge such as a credit card. Don’t pinch the stinger or use tweezers because that could release more venom. Ice the area to control swelling, and elevate the arm or leg, if that’s where you were stung. Acetaminophen or ibuprofen may help ease pain. (Do not give aspirin to anyone under age 19.) For itchiness, you can take an antihistamine, ice the area, or apply calamine lotion. Though “normal” reactions are not considered life-threatening, avoiding a future sting is usually a good idea.
The second type of response is like the first type of non-allergic reaction. However, it is a larger local reaction that causes swelling, generally more than 3 inches, around the sting. For example, a sting on the front of your arm could cause your whole arm to swell. Remove the stinger and treat the swelling, pain, and itch with a combination of ice, elevation and antihistamines. The swelling usually peaks two to three days after the sting and can last a week or more. Like the first reaction, this is not life-threatening. However, you may have considerable pain and swelling that lasts for days in the area you were stung.
The last, and most dangerous response is a severe allergic or anaphylactic, life-threatening reaction. It is the most serious and needs immediate medical attention. Symptoms range from mild hives or itching, to severe reactions, including shock or airway constriction, which can be life-threatening. If you know you have a severe allergy to an insect sting, you should always carry your epinephrine auto injector (EAI) and be evaluated by an allergist skilled in the management of insect allergy. If you are stung, use your EAI, call 911 and get to the nearest emergency facility at the first sign of anaphylaxis, even if you have already administered epinephrine.
How do I know if I’ve had an allergic reaction to an insect sting?
Symptoms of an allergic reaction can range from mild to severe. They may include the following (either alone or in combination):
- Swelling in areas away from the sting
- Dizziness or a sharp drop in blood pressure
- A hoarse voice, coughing, swelling of the tongue or difficulty swallowing
- Hives, itching and swelling in areas other than the sting site
- Abdominal cramping, vomiting, intense nausea or diarrhea
- Unconsciousness or cardiac arrest
- Anaphylaxis is a severe life-threatening allergic reaction that impairs breathing, causes a sudden drop in blood pressure and can send the body into shock. It can occur within minutes of a sting. A dose of epinephrine (adrenaline), typically administered in an auto-injector, and immediate medical attention are required.
Who is affected by allergies to insect stings?
Allergic reactions to stings can occur even after many normal reactions to stings, and at any age. Estimates show that potentially life-threatening allergic reactions to insect venom occur in 0.4 percent to 0.8 percent of children and 3 percent of adults.
Can I get rid of my insect sting allergy?
Yes. For long-term protection, an allergist can treat you with allergy shots (immunotherapy), which builds tolerance over time and provides up to 98% protection if you get stung again. In addition to reducing the risk of systemic reaction to future stings, venom immunotherapy significantly improves quality of life. This is especially true for active individuals where jobs or recreational activities take them outdoors. The length of venom immunotherapy is usually three to five years, but it can be continued indefinitely depending on how severe past reactions have been, and the risk of future stings.
Do I need to have an epinephrine auto-injector?
It depends on your risk factors including your history of reaction to an insect sting. Your allergist will determine if you are at high risk of a severe allergic reaction and prescribe an epinephrine auto-injector if needed.
What is whole body extract immunotherapy?
The long-term treatment of fire ant sting allergy is called whole body extract immunotherapy, which contains the entire body of the ant, not just the venom, as is the case with other stinging insects. It is a highly effective program administered by an allergist-immunologist, which can prevent future allergic reactions to fire ant stings. At this time, we are not able to isolate venom from fire ants.
Whole body extract immunotherapy involves administering gradually increasing doses of extract to decrease a patient’s sensitivity to the fire ant sting. This can reduce the risk of a future allergic reaction to that of the general population. In a matter of weeks to months, people who previously lived under the constant threat of severe reactions to fire ant stings can return to leading normal lives.
If you think you might be allergic to fire ant stings, see an allergist. Based on your history and certain tests, the allergist will determine if you are a candidate for skin testing and immunotherapy.
This page was reviewed and updated 2/5/2018.