Insect Stings and Allergic Reactions

Avoiding insect stings may not always be possible. However, knowing how to respond if your child has an allergic reaction from an insect sting may give you more peace of mind if there is an emergency.

Insect stings that most commonly cause allergic reactions

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

• 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 site of the sting. The reaction is brief, with redness and swelling followed by pain and itching. Generally, the reaction lasts only a few hours, although some may last longer. 

For other children, their immune system reacts abnormally and 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, and can include severe symptoms such as the following:

• Itching and hives over most of the body

• Swelling of the throat and tongue

• Trouble breathing and tightness in the chest

• Dizziness

• Headache

• Stomach cramps, nausea, or diarrhea

• Rapid drop in blood pressure

• Shock

• Loss of consciousness

• Hoarse voice or swelling of the tongue

Call 911. Immediate medical attention is required. 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:

• 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 use caution include swimming pools, woodpiles, under eaves of houses, and trash containers.

Treatment for insect stings

Specific treatment for insect stings will be determined by your child's health care provider based on the following:

• Your child's age, overall health, and medical history

• Extent of the reaction

• Your child's tolerance for specific medications, procedures, or therapies

• Expectations for the course of the reaction

• Your opinion or preference

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

How to provide immediate treatment for an allergic reaction that is not life-threatening:

• When possible, immediately remove the stinger using a pair of tweezers. Try not to squeeze the stinger, which may force the venom into the body. Still, speedy removal is the most important step.

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

• Raise the affected arm or leg. 

• Apply ice or a cold compress to reduce swelling and pain. 

• Clean the area with soap and water. 

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

• Give your child a dose of an oral antihistamine (like diphenhydramine) to relieve itching and prevent a more severe allergic reaction.

• An emergency treatment kit containing life-saving adrenaline (also known as an epinephrine auto-injector, prescribed by your child's healthcare provider) should be kept nearby at all times. Ask your child's provider about what it should include.

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