Insect sting allergy

Insect Sting Allergies | Symptoms & Treatment

Insect sting allergy

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 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. 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):

  • Hives
  • Itchiness
  • Flushing
  • 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. 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.


Insect Sting Allergy Basics: What Are Allergies?

Insect sting allergy

Most people who get stung by an insect have a minor reaction. This may include some redness, swelling, or itching at the site of the sting. This normally goes away within hours. For some people, however, an insect sting can cause a severe reaction or even death. In the United States, between 90-100 stings a year result in death.

Your immune system responds to unfamiliar substances with cells that can detect the specific invader. One component of this system is antibodies.

They allow the immune system to recognize unfamiliar substances, and play a role in getting rid of them. There are multiple types of antibodies, each with a particular role.

One of these subtypes, known as immunoglobulin E (IgE), is associated with the development of allergic reactions.

If you have an allergy, your immune system becomes overly sensitized to certain substances. Your immune system mistakes these substances for invaders. In the course of responding to this mistaken signal, the immune system produces IgE antibodies specific to that substance.

The first time a person with an insect allergy is stung, the immune system may produce a relatively small amount of IgE antibodies that are targeted toward that insect’s venom. If stung again by the same kind of insect, the IgE antibody response is much more rapid and vigorous. This IgE response leads to the release of histamine and other inflammatory chemicals that cause allergy symptoms.

There are three families of insects that cause the most allergies. These are:

  • vespids (Vespidae): yellow jackets, hornets, wasps
  • bees (Apidae): honey bees, bumblebees (occasionally), sweat bees (infrequent)
  • ants (Formicidae): fire ants (commonly cause anaphylaxis), harvester ants (less common cause of anaphylaxis)

Rarely, bites from the following insects may cause anaphylaxis:

  • mosquitoes
  • bed bugs
  • kissing bugs
  • deer flies

Most of the time, allergic reactions are mild, with local symptoms that may include a skin rash or hives, itchiness, or swelling.

Occasionally, however, an insect sting can produce a more serious reaction called anaphylaxis. Anaphylaxis is a medical emergency during which breathing can become difficult and blood pressure can drop dangerously. Without prompt appropriate treatment, death is a ly outcome from an episode of anaphylaxis.

If you have had an allergic reaction to an insect sting, you have a greater chance of having a similar or more severe reaction if stung again by the same kind of insect. The best way to avoid an allergic reaction, of course, is to avoid being stung. Tips to avoid getting stung include:

  • Have hives and nests removed from your home and yard.
  • Wear protective clothing when you are outdoors.
  • Avoid wearing bright colors and strong perfumes when you are outdoors where there might be insects.
  • Be careful when eating outside. Insects are attracted by the smell of food.

If you have had a serious allergic reaction in the past, you should wear a medical alert identification bracelet and carry an epinephrine auto-injection kit.



Insect sting allergy

Many people think of warm weather when they think of insect allergies. Warm weather does signal the arrival of some unwanted visitors stinging and biting insects. However, you can find two very common “bugs” all year long in homes and buildings. Neither one needs to bite or sting you to cause an allergic reaction, but both trigger allergy and asthma in many people.

What Kinds of Insects Cause Allergic Reactions?

There are many different kinds of insects or “insect- bugs” that can cause an allergic reaction: 

Stinging Insects

Bees, wasps, hornets, yellow-jackets and fire ants are the most common stinging insects that cause an allergic reaction. When these insects sting you, they inject a toxic substance called venom. Most people stung by these insects recover within hours or days. In others, this venom can trigger a life-threatening allergic reaction.

Biting Insects

Mosquitoes, kissing bugs, bedbugs, fleas and certain flies are the most common biting insects known to cause an allergic reaction. Most people bitten by insects suffer pain, redness, itching, stinging and minor swelling in the area around the bite. Rarely, insect bites may trigger a life-threatening allergic reaction.

A bite from a Lone Star tick can cause people to develop an allergy to meat. These ticks carry alpha-gal (a sugar). When a tick bites a person, it transfers alpha-gal into the bloodstream. The person’s immune system then reacts to it. Alpha-gal is also found in mammal meat (beef, lamb, pork). If you have allergy symptoms after eating meat, see an allergist.

Household Pests

Non-stinging and non-biting insects can also cause allergic reactions, particularly cockroaches and insect- dust mites.

These two insects may be the most common cause of year-round allergy and asthma. Un a cockroach, a dust mite is too small to see with the naked eye.

The cockroach and dust mite’s waste and body cause allergic reactions. They also can trigger asthma symptoms and asthma attacks.

What Are the Signs of an Allergic Reaction to Insects?

Most people stung or bitten by insects suffer pain, redness, itching and minor swelling in the area around the bite or sting. This is a normal reaction. Most people get better within hours or days.

An allergic reaction to insects that don’t sting or bite, cockroaches or dust mites, is different. You may sneeze, cough, have a runny or stuffy nose, or itchy eyes, nose, mouth or throat. These symptoms can be confused with the common cold, but last for weeks or months at a time. If you have asthma, an allergic reaction could trigger asthma symptoms or an asthma attack.

People can have a serious allergic reaction to stinging or biting insects.

life-threatening allergic reaction (anaphylaxis) produces signs and symptoms that require immediate medical attention. Without immediate treatment, anaphylaxis may cause death.

Symptoms usually involve more than one organ system (part of the body), such as the skin or mouth, the lungs, the heart, and the gut. Some symptoms include:

  • Skin rashes, itching or hives
  • Swelling of the lips, tongue or throat
  • Shortness of breath, trouble breathing or wheezing (whistling sound during breathing)
  • Dizziness and/or fainting
  • Stomach pain, vomiting, bloating or diarrhea
  • Feeling something awful is about to happen

Other serious but non-allergic reactions include:

  • A toxic reaction that happens when the body reacts to insect venom it is a poison. A toxic reaction can cause symptoms similar to those of an allergic reaction. Other symptoms include nausea, fever, fainting, seizures, shock and even death.
  • Serum sickness whichis an unusual reaction to a foreign substance in the body. It can cause symptoms hours or days after the sting or bite. Symptoms include fever, joint pain, other flu- symptoms and sometimes hives.

Medical Review October 2015.


severe allergic reactions, insect stings, allergic reactions

Insect sting allergy

Allergic reactions occurring due to a hypersensitivity reaction to stinging insect venom may occur after a sting from a :

  • Bee
  • Wasp
  • Yellow jacket
  • Hornet
  • Fire ant

Most people are not allergic to insect stings and may mistake a normal or local reaction for an allergic reaction. By knowing the difference, the patient can prevent unnecessary worry and visits to the doctor’s office or hospital emergency room.

The severity of an insect sting reaction varies from person to person. There are three types of reactions:

  1. A normal reaction may result in pain, swelling, and redness around the sting site.
  2. A large local reaction may result in 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, generally, it resolves on its own and does not progress to a systematic reaction.
  3. The most serious reaction to an insect sting is an allergic one (described below). This condition requires immediate medical attention.

What are the symptoms?

Symptoms of a severe allergic reaction or anaphylactic reaction may include one or more of the following:

  • Difficulty breathing
  • Hives which appear as a red, itchy rash that spreads to areas other than the immediate area stung
  • Swelling of the face, throat or mouth tissue
  • Wheezing or difficulty swallowing
  • Restlessness and anxiety
  • Rapid pulse
  • Dizziness or a loss of consciousness due to a sharp drop in blood pressure

Although severe allergic reactions are not that common, they can lead to shock, cardiac arrest and unconsciousness in 10 minutes or less. This type of reaction can occur within minutes after the sting and may be life-threatening or even fatal. Get emergency treatment as soon as possible.

A mild allergic reaction to an insect sting may cause one or more of the following symptoms at the site of the sting:

  • Pain
  • Redness
  • Pimple- spots
  • Mild to moderate swelling
  • Warmth at the sting site
  • Itching

People who have experienced an allergic reaction to an insect sting roughly have a 60% chance of a similar or worse reaction if they are stung again.

How common are sting allergies?

About two million Americans are allergic to the venom of stinging insects. Many of these individuals are at risk for life-threatening allergic reactions. Approximately 50 deaths each year in the US are attributed to allergic reactions to insect stings.

How are normal or localized reactions treated?

  • First, if stung on the hand, remove any rings on your fingers immediately. A stinging insect may leave a sac of venom and a stinger in the victim's skin. If the sac is still in the skin, gently scrape it out with a fingernail or a stiff-edged object a credit card. Do not pull on the stinger as this will cause the release of more venom into the skin.
  • Wash the stung area with soap and water then apply an antiseptic.
  • Apply a soothing ointment, 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 oral anti-histamine, Benadryl, to reduce itching, swelling and hives. However, this medication should not be given to children under 3 years of age or to a pregnant woman without prior approval from a doctor.
  • To relieve pain, take aspirin or an aspirin-substitute. However, do not give a child or teenager aspirin. (Aspirin use in these age groups has been associated with a rare but serious liver and brain disorder called Reye's syndrome).

In general, pregnant women should consult their doctor before taking any over-the-counter medication. Also, it is always recommended that you read the warning label on any medication prior to taking it.

Parents of children and people with medical conditions are advised to read product labels carefully and consult a pharmacist if they have questions about use.

How are allergic reactions treated?

An allergic reaction is treated with epinephrine (adrenaline), either self-injected or administered by a doctor. Usually this injection will stop the development of severe allergic reaction. In some cases, intravenous fluids, oxygen and other treatments are also necessary.

Once stabilized, these patients are sometimes required to stay overnight at the hospital under close observation. People who have had previous allergic reactions and rely on the protection of epinephrine must remember to carry it with them wherever they go.

Also, because one dose may not be enough to reverse the reaction, immediate medical attention following an insect sting is recommended.

How can I avoid being stung?

You can lessen your chances of an insect sting by taking certain precautionary measures:

  • Learn to recognize insect nests and avoid them. Yellow jackets nest in the ground in dirt mounds or old logs and in walls. Honeybees nest in beehives. Hornets and wasps nest in bushes, trees and on buildings.
  • Wear shoes and socks when outdoors.
  • Wear long-sleeved shirts, long pants, socks and shoes, when in country or woodsy areas.
  • Limit wearing perfumes or brightly colored clothing, they tend to attract insects.
  • People who have severe allergies should never be alone when hiking, boating, swimming, golfing or otherwise involved outdoors, as they may need prompt medical treatment if stung.
  • Use insect screens on windows and doors at home; use insect repellents; spray bedrooms with aerosols containing insecticide before going to bed.
  • Spray garbage cans regularly with insecticide and keep the cans covered.
  • Avoid or remove insect-attracting plants and vines growing in and around the house.

Every allergic person should always wear a medic alert bracelet and keep a self-care kit Ana-Kit or Epi-Pen on hand for emergency use in the case of severe symptoms. You will need a prescription from your doctor to obtain one of these kits. For more information on where to get a medic alert bracelet, you can call 1-800-ID-ALERT.

How can I prevent an allergic reaction?

Allergic reactions to insect stings can be prevented with venom immunotherapy. The treatment is at least 97% effective in preventing future occurrences. It involves administering gradually increasing doses of venom to stimulate the patient's own immune system to become resistant to a future allergic reaction.

How can I find out more about venom immunotherapy?

If you've had an allergic reaction, it's important to seek information from an allergist, a doctor who specializes in the diagnosis and treatment of allergic disease.

your history and diagnostic tests, the allergist will determine if you are a candidate for immunotherapy treatment.

Although stinging insect allergy is a serious problem, the risk and fear of allergic reactions can be reduced or eliminated with immunotherapy.

What are Epinephrine sting kits?

Epinephrine self-administration kits are important for a patient to use before he or she can get to a physician for treatment. However, epinephrine kits should not be used as a substitute for an allergy evaluation and physician intervention.

Epinephrine alone is not always enough to reverse serious allergic sting reactions and may cause serious side effects in some patients with heart conditions or patients who are taking certain medications.

Before using, be sure to check with your physician to prevent drug interactions.

Reviewed by a Cleveland Clinic medical professional.

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Allergic Reactions to Insect Stings

Insect sting allergy

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.

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.

A mild allergic reaction may cause one or more of these symptoms at the site of the sting:

  • Pain
  • Redness
  • Pimple- spots
  • Mild to moderate swelling
  • Warmth
  • Itching

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.

About 2 million Americans have allergies to the venom of stinging bugs. Many of these people are at risk for life-threatening allergic reactions.

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 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, 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.

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.

You can’t completely. But these steps make it less ly.

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 lists 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.

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 know about any medicine you take.

Allergy shots may help. They're about 97% effective. Over a series of doctor visits, you’ll get gradually increasing doses of venom to train your immune system to resist to a future allergic reaction.


American Academy of Allergy Asthma & Immunology: “Stinging Insect Allergy” and “Stinging Insect Allergy: Tips to Remember.”

© 2020 WebMD, LLC. All rights reserved. Allergy Shots for Insect Stings


Insect venom allergies: Overview

Insect sting allergy

Created: July 13, 2017; Next update: 2020.

We all get stung or bitten by insects every now and then – and most people end up with a small, red, itchy bump as a result. But those who are allergic to insect stings or bites may react strongly, and the reaction might even be life-threatening in rare cases.

In insect venom allergies, the body’s immune system attacks certain parts of proteins that enter the body when the insect bites or stings. Some people are generally more ly to have allergies. But it isn’t known why some people have an insect venom allergy and others don’t.

This allergy doesn’t develop after the first sting or bite, either: Sometimes people get stung or bitten over many years without having an unusual reaction.

Over time, though, their bodies become more sensitive to the venom in the sting or bite (sensitization) and they then suddenly have an allergic reaction to it.

Allergic reactions to insect venom cause the skin around the bite or sting to become very swollen. The swelling often has a diameter of more than 10 cm and lasts longer than 24 hours. It usually hurts, burns or itches a lot.

Stings inside the mouth or throat can cause the airways to become swollen and narrow, making it harder to breathe. This is more ly to happen in people who are allergic to the insect venom. But the swelling is rarely bad enough to lead to suffocation.

The allergic reaction can also affect the whole body, though. This is known as anaphylactic shock. Sometimes it’s mild, but it can also be life-threatening.

The milder reactions include hives (a raised skin rash – also known as nettle rash), itching all over the body, dizziness, stomach and bowel problems, and nausea. People may also generally feel weak, have a swollen face or hands, or have problems swallowing.

Severe anaphylactic shock leads to breathing problems, a drop in blood pressure, loss of consciousness or even cardiac arrest.

The allergic reactions usually occur soon after the person is bitten or stung. In rare cases, though, they may only occur a few hours later. Sometimes the symptoms of anaphylactic shock get better at first and then come back again within eight hours.

Bee sting allergies and wasp sting allergies are the most common allergic reactions to insect venom. Bee stings are more ly to lead to serious allergic reactions than wasp stings are.

Allergic reactions to hornet stings (usually in people who are allergic to wasp stings) or bumble bee stings (usually in people who are allergic to bee stings) are much less common.

Mosquito bites, horsefly bites and ant bites hardly ever lead to allergic reactions in Germany and similar countries, apart from near to the area of skin that was bitten.

Knowing the difference between the behavior of bees and wasps can help to avoid them and react properly if you get stung. And knowing which insect stung you can be important for the diagnosis:

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  • don’t tend to be aggressive – unless they feel threatened.
  • are active between the spring and late summer.
  • lose their stinger when they sting someone; it usually gets stuck in the skin.
  • are typically found flying close to beehives and flowers.
  • tend to be more aggressive – they are more ly to feel threatened by movements and attempts to blow them away.
  • are mainly active between summer and late fall.
  • keep their stinger after stinging someone.
  • often fly around food and rubbish.

About 2% of the population react to insect bites and stings with symptoms that affect more than just the surrounding area of skin.

Some people are stung or bitten more often than others, and are more ly to become allergic to the venom as a result. These include beekeepers and people who live with them. Other people who are at higher risk include those who work in bakeries, sell fruit or work on a farm.

Generally speaking, allergic reactions to insect bites or stings don’t have any lasting harmful effects.

About 20 deaths due to bee sting, wasp sting, or hornet sting allergies are reported every year in Germany. The actual number is probably a little higher because allergic reactions aren’t always recognized as the cause of death.

Before performing a physical examination, the doctor will first ask about the exact symptoms. It isn’t always easy to tell the difference between wasp stings and bee stings, so it’s important to describe where you were when you were stung, and how the insect was behaving at the time. Although people usually say they have a wasp sting or a bee sting, these insects often get mixed up.

Skin tests and blood tests are only done if the allergy affects more than just the local area of skin. These tests can determine whether the person’s immune system overreacts to certain triggers.

In the skin test, a solution containing insect venom is put on an area of superficially scraped skin to see whether the skin becomes red, swollen or itchy. In the blood test, the doctor checks whether a blood sample contains antibodies to insect venom.

Un with other kinds of allergies, provocation tests generally aren’t done if it is thought that someone may have an insect venom allergy.

In provocation tests, the body is exposed to increasing doses of the suspected trigger in order to see whether there’s an allergic reaction.

But this test can lead to severe reactions in people with insect venom allergies, so it is only done in exceptional cases and in specialized centers.

The main way to prevent allergic reactions is to avoid being bitten or stung by the insect. To lower the risk, the following strategies are recommended:

  • Be careful when eating outdoors, and clear the table as soon as you have finished eating. Avoid eating outdoors if there are a lot of insects flying about.
  • Don’t spend time near rubbish.
  • Cover up your drinks and use a straw.
  • Clean your mouth and hands after eating.
  • Don’t swat at wasps or bees – most insects defend themselves by stinging. Stay calm and move slowly.
  • Cover up your skin with clothing.
  • Keep windows closed during the day.
  • Stay away from beehives and wasps’ nests.

The best way to deal with insect bites and stings will mainly depend on the symptoms that occur and whether the person has been “desensitized.” To start off with, antihistamines are taken in the form of a tablet.

Depending on how severe the skin reaction is, a steroid medication may be used too.

If more serious symptoms develop – such as breathing problems, nausea, circulation problems or swelling in the mouth and throat – adrenaline must be injected as soon as possible.

People who tend to have more severe allergic reactions are often advised to have allergen-specific immunotherapy (also known as desensitization). After having this treatment, the allergic reaction to the insect sting is usually much weaker, or they may even no longer be at all allergic to it.

People who have a confirmed insect venom allergy are advised to carry a medical ID card or bracelet on them at all times, to let people know what they are allergic to in an emergency.


  • Pryzbilla B, Rueff F, Walker A, Räwer H-C, Aberer W, Bauer CP et al. Bienen- und Wespengiftallergie, Diagnose und Therapie: AWMF-Register-Nr.: 061 – 020. Allergo J 2011; 20: 318-339.
  • IQWiG health information is written with the aim of helpingpeople understand the advantages and disadvantages of the main treatment options and healthcare services.Because IQWiG is a German institute, some of the information provided here is specific to theGerman health care system. The suitability of any of the described options in an individualcase can be determined by talking to a doctor. We do not offer individual consultations.Our information is the results of good-quality studies. It is written by ateam ofhealth care professionals, scientists and editors, and reviewed by external experts. You canfind a detailed description of how our health information is produced and updated inour methods.


Insect Sting Allergy

Insect sting allergy

Insect stings usually are minor annoyances. But they can cause serious reactions in people who are allergic to them.

Insects that can trigger allergic reactions include honeybees, yellowjackets, hornets, wasps, and fire ants. When they sting, they inject venom into the skin.

Allergic reactions to stings usually don't happen when a child is stung for the first time. Most happen when the child is stung for a second time, or even later.

If you think that your child might have had an allergic reaction to an insect sting, call your doctor. The doctor can help you understand the difference between what usually happens with an insect sting and what happens with an allergic reaction. If your child does have an allergy, the doctor will prescribe epinephrine auto injectors to use in case of a severe reaction.

What Happens in an Insect Sting Allergy?

When someone is allergic to insect stings, the body's immune system, which normally fights infections, overreacts to proteins in the insect's venom. When stung, the body sees these proteins as harmful invaders.

The immune system responds by working very hard to fight off the invader. This causes an allergic reaction, in which chemicals histamine are released in the body. This release can cause symptoms such as:

  • wheezing
  • trouble breathing
  • coughing or nasal stuffiness
  • hoarseness or trouble speaking
  • throat tightness
  • stomachache
  • vomiting
  • diarrhea
  • itchy, watery, or swollen eyes
  • hives
  • red spots
  • swelling
  • itching
  • a feeling something bad is about to happen
  • a drop in blood pressure, causing lightheadedness or passing out

A serious allergic reaction is called anaphylaxis. Anaphylaxis (an-eh-fil-AK-siss) can cause different symptoms at different times. A reaction is considered anaphylaxis if someone has:

  • any severe symptoms, such as trouble breathing, repeated vomiting, passing out, or throat tightness
  • two or more mild symptoms, such as hives with vomiting or coughing with belly pain

Anaphylaxis can begin with some of the same symptoms as a less severe reaction, but these can quickly become worse. Anaphylaxis that's not treated can be life-threatening. A person with anaphylaxis needs treatment with injectable epinephrine right away.

How Are Reactions From an Insect Sting Treated?

If your child has been diagnosed with an insect sting allergy, always keep two epinephrine auto-injectors on hand in case of a severe reaction. If your child starts having serious allergic symptoms, throat swelling or trouble breathing:

  • Give the epinephrine auto-injector right away. Every second counts in an allergic reaction.
  • Then call 911 to take your child to the emergency room. Your child needs to be under medical supervision because even if the worst seems to have passed, a second wave of serious symptoms can happen.

An epinephrine auto-injector comes in a small, easy-to-carry container. It's simple to use. Your doctor will show you how to use it. Kids who are old enough can be taught how to give themselves the injection.

Your doctor also might instruct you to give your child antihistamines in some cases. But always treat a serious reaction with epinephrine. Never use antihistamines instead of epinephrine in serious reactions.

Share emergency plans with anyone who cares for your child, including relatives and school officials.

Together, agree on a plan in case of a serious reaction at school, including making sure that injectable epinephrine is available at all times.

If your child is old enough to carry the epinephrine, it should be in a purse or backpack that's with your child at all times, not in a locker. Also consider having your child wear a medical alert bracelet.

How Can Parents Help?

The best way to prevent allergic reactions to insect stings is to avoid getting stung in the first place. Teach your child to:

  • Avoid walking barefoot while on the grass.
  • Avoid playing in areas where insects to be, such as flower beds.
  • Avoid drinking from open soda or juice cans and be sure to keep food covered when eating outside. Check for insects in drink cups and straws when outside.
  • Remain calm and quiet around stinging insects. Moving slowly, back away without any arm-waving or swatting.
  • Never disturb an insect nest. Have an exterminator get rid of nests near your home.
  • When in wooded areas, keep as covered up as possible. Long-sleeved shirts, long pants, socks, and closed-toe shoes can help keep the bugs away. (Loose clothing can allow insects to get between the clothes and skin.)
  • Avoid perfumes, scented body products, and brightly colored and flowered clothing because they all attract insects.

If your child is stung and a stinger remains in the skin, use your fingernail or a credit card to scrape the stinger from the skin. Removing the stinger quickly can help prevent more venom from going into the body. Don't use tweezers because they can cause more venom to be released.

Talk with your doctor about whether your child should see an allergy specialist about getting allergy shots. These can help the body react less to insect venom, which can make a serious reaction less ly.

Reviewed by: Larissa Hirsch, MD

Date reviewed: November 2019