Insect Sting Allergies

Wasp or bee stings commonly cause significant swelling at the site of the sting, known as a local reaction. In adults, large local reactions may occur in up to a quarter of individuals. Although unpleasant, local reactions are relatively common and not in themselves serious.  

How To Know If You Have An Insect Sting Allergy 

Insect sting allergies affect an estimated 0.3-7.5% of adults, this is where an allergy to the venom contained in stings can trigger a more serious reaction.  Incidence is much more more common in people who have been stung multiple times and in practice this usually means adults, not children.  Most typically beekeepers or people who work in environments where they are much more likely to be stung. 

What Are The Symptoms Of An Insect Sting Allergy?

The symptoms of an insect sting allergy can be:

  • nettle rash reaction (urticaria) or 
  • swelling (angioedema) separate from the sting site
  • a more severe allergic reaction causing problems with breathing or the blood circulation (anaphylaxis) can lead to collapse and is a medical emergency.

What To Do If You’ve Been Bitten Or Stung 

Most reactions are mild but if you suspect an allergic reaction, then an antihistamine is useful. If you suspect a more severe reaction after a sting, with difficulty in breathing or lightheadedness, then call for urgent medical assistance.

What Causes An Insect Sting Allergy? 

It isn’t clear why some people develop allergy to stings but thankfully, it is uncommon but seems to happen more in people who are regularly stung such as beekeepers. People with other common allergy issues such as hayfever or food allergies, do not appear to be at an increased risk.

Can You suddenly Develop Insect Sting Allergies? 

Nobody is born with an insect venom allergy – they develop as an inappropriate immune response after having been stung at least once – this means an allergic reaction if you have never been stung before is extremely unlikely.

How Do You Get Tested For An Insect Sting Allergy?

Insect venom allergy is best diagnosed by a careful clinical history although blood (and less commonly skin prick) tests can be helpful in confirming the diagnosis. Blood tests are not helpful as screening tools as false positives to insect venom are not uncommon.

How To Treat A Bee Or Wasp Sting Allergy

Someone who may have experienced an allergic reaction to a wasp or bee sting should always be referred to an allergy specialist for evaluation. An assessment will include allergy testing if indicated and identification of risk factors for further severe reactions. Patients with a confirmed bee or wasp sting allergy will normally be prescribed an adrenaline auto-injector for emergencies, with training provided to them or their carers in using the injector. For those who have experienced severe reactions a course of desensitisation treatment (also known as immunotherapy) may also be recommended. Mosquito bites can also cause local allergic reactions, typically with an itchy bump that progresses to a larger red lump lasting a few days. Such reactions can be treated with antihistamine tablets or a steroid based-cream.

 How To Prevent Insect Stings 

If you know you are allergic to insect stings you should

  • consider avoiding visiting places you are more likely to be stung,
  • wear long sleeves/trousers
  • use insect repellent
  • have emergency medication to hand
  • be assessed for the possible value of desensitisation treatment.

 

Written by

Professor Adam Fox

Date reviewed: December 2021

Adam Fox is a Professor of Paediatric Allergy with over 20 years experience in both the NHS and private sector. Professor Fox is Commercial Medical Director at Guy’s & St Thomas’ Hospitals NHS Foundation Trust and Professor of Paediatric Allergy at King’s College London and the founding Director of the KCL Allergy Academy, a postgraduate educational programme, which was a finalist at the BMJ Awards in 2018.

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Insect Sting Allergies

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