Treating Insect Stings

Reviewed by: HU Medical Review Board

Nearly everyone gets stung by an insect at least once in their life. For most people, this results in a painful but brief reaction. This includes mild swelling, itching, and redness at the sting site that lasts for a few hours to a few days.1,2

However, about 3 out of 100 children and 7 out of 100 adults in the United States are severely allergic to stinging insects. For these people, an insect sting is more serious and even cause life-threatening anaphylaxis.1

Treating stings begins with avoiding these insects. If you do get stung, treatment includes first aid and removing the stinger as quickly as possible. For people with mild allergic skin reactions like local swelling, redness, and pain, treatment may involve an antihistamine and an anti-inflammatory drug such as acetaminophen or ibuprofen. People with life-threatening reactions, such as difficulty breathing, will require venom immunotherapy.1

Treatment goals

The goals of treating insect allergies include:1,2

  • Knowing which insects you are allergic to
  • Avoiding these insects as much as possible
  • Understanding the difference between a normal reaction and an allergic reaction
  • Knowing what first aid and emergency care is right for you
  • Educating family and friends about how to respond

Know your allergies

Knowing what insects can cause you to have an allergic reaction is the first step in a treatment plan. An allergist can help you identify which insects you are allergic to.

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Some people may react to a single stinging insect, and others may be sensitive or allergic to more than one. The main stinging insects include:2,6

  • Honeybees
  • Yellow jackets
  • Hornets
  • Wasps
  • Fire ants

Allergen avoidance

To reduce or eliminate allergic reactions, people with stinging insect allergies are told to avoid exposure. Each of these insects live in a different kind of environment. Understanding where they nest and their general behavior can help you avoid them and reduce the chances of being stung.1-6

Some lifestyle changes can help you manage exposure and include:2,3,5,6

  • Do not walk barefoot in the grass
  • Wear clothing that covers your skin when outside, including closed-toe shoes
  • Avoid wearing colors outside
  • Avoid wearing perfumes and other strong scents
  • Keep garbage cans covered with tight-fitting lids and spray them with insecticide
  • Stay as far as possible from garbage cans and tables of food at picnics
  • Keep food and drinks outside covered until you are ready to eat
  • Double-check for insects before drinking open cans of soda or other beverages

If a stinging insect flies near you or lands on you:2

  • Try not to swat at it
  • Calmly wait for it to fly away or walk away yourself

Basic symptom relief

Anyone stung by an insect should follow the same basic steps to clean and treat a sting:1,2

  • Remove the stinger quickly, if possible.
  • Scrape the stinger, do not pinch it. This prevents some of the venom from entering the body.
  • Wash the area with soap and water.
  • Apply a cool compress for 10 to 20 minutes to reduce pain and swelling.
  • Elevate the area, if possible, to reduce swelling.
  • Take an antihistamine to reduce itching and swelling.
  • Take a pain reliever to help with pain and reduce inflammation.
  • Apply hydrocortisone, calamine lotion, or a baking soda paste until symptoms go away.

Treating anaphylaxis

Some allergic reactions can be life-threatening. Symptoms often progress quickly and require immediate medical attention. A severe allergic reaction is called anaphylaxis. Anaphylaxis can cause:1,2

  • Itching and hives
  • Swelling in the throat, tongue, or eyelids
  • Difficulty breathing
  • Dizziness
  • Stomach cramps, nausea, or diarrhea

Some people can go into shock and lose consciousness. Immediate treatment with an epinephrine auto-injector can prevent death. Two injections may be needed to bring symptoms under control. A trip to the emergency room should always follow. People with anaphylaxis must be evaluated by an allergist for venom testing and immunotherapy.1,2

Having an emergency allergy action plan and insect allergy kit with you can help resolve a severe reaction and save your life.

Immunotherapy for venom allergies

There are a few types of immunotherapy.

Subcutaneous immunotherapy (allergy shots) is the most available form for insect sting allergies. An allergist will perform tests to determine which stinging insects a person is allergic to. The venom is the allergen and will go into the allergy shots. With allergy shots, tiny amounts of allergens are injected under the skin. The doses are small at first and slowly increase over time. This process is called desensitization.3

Shots are generally given once or twice a week for 6 to 8 months. As immunity increases, shots are given weeks apart. Once a maintenance dose is reached, venom immunotherapy shots can be given every 4-8 weeks and are determined by the allergist.3

This maintenance phase may last for 3 to 5 years. Venom immunotherapy reduces the risk the person will have a severe reaction if stung again. Sometimes a person’s allergic reaction disappears for years. However, some people allergic to venom may need to be on life-long therapy.3