Insect stings that most commonly cause allergic reactions

Insects that are members of the Hymenoptera family most commonly cause allergic reactions. These include:

• Honey bees

• Wasps

• Hornets

• Yellow jackets

• Fire ants

What are the symptoms of an allergic reaction to an insect sting?

Most children who are stung by an insect have a local reaction at the sting site. The reaction is brief, with localized redness and swelling followed by pain and itching. Generally, the reaction lasts only a few hours. But some may last longer. 

For other children, their immune system reacts abnormally. It causes an allergic reaction that can spread to other parts of the body. Sometimes this reaction can be life-threatening.

This severe reaction is a medical emergency that can happen very quickly. It is called anaphylaxis or anaphylactic shock. It can include severe symptoms such as:

• Itching and hives over most of the body

• Swelling of the throat and tongue

• Trouble breathing and chest tightness

• Dizziness

• Headache

• Stomach cramps, nausea, or diarrhea

• Quick drop in blood pressure

• Shock

• Loss of consciousness

• Hoarse voice or swelling of the tongue

Call 911. Immediate medical care is needed. If your child has an epinephrine auto-injector pen, use it as directed.

Can insect stings be prevented?

Helping your child avoid insect stings is the best preventive measure. Try the following:

• Teach your child not to disturb insect nests and mounds.

• When outdoors, make sure children who have severe reactions wear socks, shoes, long pants, and long-sleeved shirts.

• When outdoors, make sure your child is careful if eating or drinking uncovered foods or drinks, which can attract insects.

• Keep your child from going barefoot. He or she should wear closed-toe shoes when walking in grassy areas.

• When playing outdoors, make sure you and your child watch for insect nests in trees, shrubs, and flower beds. Other areas in which to be careful include swimming pools, woodpiles, under eaves of houses, and trash containers.

• Before letting children play in an area, check for nests. These can be found in older tree stumps, holes in the ground, and rotting wood. Car tires used in playgrounds can also contain nests.

• If your child is allergic to insect bites, don't let him or her play outside alone when stinging insects are active. Even a dead insect can sting if a child step on its stinger to picks it up.

• Teach children to walk away slowly from insects. Don't teach them to swat at insects or run away. This can trigger an attack.

• A child with an insect sting allergy should wear a medical alert bracelet or necklace.

Treatment for insect stings

Treatment will depend on your child's symptoms, age, and general health. It will also depend on how severe the condition is.

If your child has had a serious reaction to an insect sting, make an appointment with an allergist. An allergist can do skin testing, diagnose the allergy, and figure out the best form of treatment. In some cases, insect venom allergy shots (immunotherapy) are very effective. 

Here's how to provide immediate treatment for an allergic reaction that is not life-threatening:

• Stay calm. Your composure will help your child remain calm too.

• When possible, remove the stinger right away using a pair of tweezers. Try not to squeeze the stinger. That could force the venom into the body. But speedy removal is the most important step.

• Call your child's healthcare provider if he or she gets several stings. Or if hives develop in a part of the body away from the sting itself.

• Raise the affected arm or leg. This will help reduce swelling. 

• Apply ice or a cold compress to reduce swelling and pain. To make an ice pack, put ice cubes in a plastic bag that seals at the top. Wrap the bag in a clean, thin towel or cloth. Nevert put ice or an ice pack directly on the skin.

• Clean the area with soap and water. 

• Apply a topical steroid cream to the sting site to ease itching. 

• Give your child a dose of an antihistamine taken by mouth (such as diphenhydramine) to ease itching. If your child has a serious health condition or takes prescription medicines, check with the healthcare provider before giving the antihistamine.

• For children with a history of a severe allergic reaction to a sting, always keep an emergency treatment kit nearby. The kit should contain life-saving adrenaline (also known as an epinephrine auto-injector, prescribed by your child's healthcare provider). Alert your child's school and have an emergency plan and an emergency kit immediately accessible.

• If your child's symptoms get worse, call 911 and seek emergency care.