When most people are stung by an insect, the site develops redness, swelling and itching. However, some people are actually allergic to insect stings. This means that their immune systems overreact to the venom.
If you are insect-allergic, after the first sting, your body produces antibodies called Immunoglobulin E (IgE). If stung again by the same kind of insect, the venom interacts with this specific IgE antibody, triggering the release of substances that cause an allergic reaction.
Symptoms of a Severe Reaction
For a small number of people with venom allergy, stings may be life-threatening. This reaction is called anaphylaxis (an-a-fi-LAK-sis). Symptoms may include two or more of the following: itching and hives, swelling in the throat or tongue, difficulty breathing, dizziness, stomach cramps, nausea or diarrhea. In severe cases, a rapid fall in blood pressure may result in shock and loss of consciousness.
Anaphylaxis is a medical emergency and may be fatal. If you have these symptoms after an insect sting, get emergency medical treatment. After this treatment, you should also ask for a referral to an allergist / immunologist, often referred to as an allergist, to learn how to stay safe in the future.
Identifying Stinging Insects
To avoid stinging insects, it is important to identify them.
Yellow jackets' nests are made of a paper-maché material and are usually located underground, but can sometimes be found in the walls of frame buildings, cracks in masonry or woodpiles.
Honeybees and bumble bees are non-aggressive and will only sting when provoked. However, Africanized honeybees (AKA "killer bees") found in the Southwestern U.S. are more aggressive and may sting in swarms. Domesticated honeybees live in man-made hives, while wild honeybees live in colonies or "honeycombs" in hollow trees or cavities of buildings.
Paper wasps' nests are usually made of a paper-like material that forms a circular comb of cells which opens downward. The nests are often located under eaves, behind shutters, or in shrubs or woodpiles.
Hornets are usually larger than yellow jackets. Their nests are gray or brown, football-shaped and made of a paper material similar to that of yellow jackets' nests. Hornets' nests are usually found high above ground on branches of trees, in shrubbery, on gables or in tree hollows.
Fire ants build nests of dirt in the ground that may be quite tall (18 inches) in the right kinds of soil.
Stay away! These insects are most likely to sting if their homes are disturbed, so it is important to have nests around your home destroyed.
If flying stinging insects are close by, remain calm and move slowly away. Avoid brightly colored clothing and perfume when outdoors. Because the smell of food attracts insects, be careful outdoors when cooking, eating or drinking sweet drinks like soda or juice. Beware of insects inside straws or canned drinks. Keep food covered until eaten. Wear closed-toe shoes outdoors and avoid going barefoot. Also, avoid loose-fitting garments that can trap insects between material and skin.
If the insect left its stinger in your skin, remove the stinger within 30 seconds to avoid receiving more venom. A quick scrape of your fingernail removes the stinger and sac. Avoid squeezing the sac – this forces more venom through the stinger and into your skin. For all stinging insects, try to remain calm and brush these insects from the skin. Then immediately leave the area.
These steps can help in treating local reactions to insect stings:
• Raise the affected limb and apply a cold compress to reduce swelling and pain.
• Gently clean area with soap and water to prevent secondary infections; do not break blisters.
• Use topical steroid ointments or oral antihistamines to relieve itching.
• See your physician if swelling progresses or if the sting site seems infected.
If you are severely insect-allergic, carry auto-injectable epinephrine. Learn how and when to self-administer the epinephrine, and replace the device before the labeled expiration date.
Remember that epinephrine is a rescue medication only, and you must still have someone take you to an emergency room immediately if you are stung. Those with severe allergies may want to consider wearing a bracelet or necklace that identifies the wearer as having severe allergies.
Consult Your Allergist
If you have had a serious reaction to an insect sting, make an appointment with an allergist. With proper testing, your allergist can diagnose your allergy and determine the best form of treatment.
With a proper diagnosis, treatment plan and careful avoidance, people with an insect allergy can feel more confident and enjoy being outdoors.
• Symptoms of a non-allergic insect sting include redness, swelling and/or itching at the site of the sting.
• Symptoms of an allergic reaction may include itching and hives, swelling in the throat or tongue, difficulty breathing, dizziness, stomach cramps, nausea or diarrhea.
• An allergist is the best physician to diagnose stinging insect allergy and provide a treatment plan designed to keep you safe and healthy.
• If you have a serious reaction, get emergency medical treatment and then follow-up with your allergist.
Feel Better. Live Better.
An allergist / immunologist, often referred to as an allergist, is a pediatrician or internist with at least two additional years of specialized training in the diagnosis and treatment of problems such as allergies, asthma, autoimmune diseases and the evaluation and treatment of patients with recurrent infections, such as immunodeficiency diseases.
The right care can make the difference between suffering with an allergic disease and feeling better. By visiting an allergist, you can expect an accurate diagnosis, a treatment plan that works and educational information to help you manage your disease.
The AAAAI's Find an Allergist / Immunologist service is a trusted resource to help you find a specialist close to home.
Find out more about stinging insect allergies.
This article has been reviewed by Thanai Pongdee, MD, FAAAAI