07/17/2015
Stinging Insect Reactions
Normal Reactions
In the summer many people are stung by bees, wasps, hornets, yellow jackets or fire ants (yes fire ants have a stinger). Though reactions may be uncomfortable most are not serious and do not require emergency treatment.
Common reactions at the site of the sting include:
Stinging
Burning
Itching
Redness
Swelling
Pain
Fire ant stings tend to burn a lot (hence the name ‘fire ant’) and usually develop a small pimple or pustule the day after the sting that may last up to 1 week. Though this looks like a pimple it is not infected and antibiotics are not usually required.
Even a large amount of swelling tends to respond to conservative treatment as out lined below. Reactions do not generally worsen with future stings. However, any sting can result in a serious reaction.
Treatment
If a stinger is present, immediately remove it. Don’t squeeze it but scrape it out with the edge of something like a credit card. Honey bees leave stingers which contain more venom.
Wash the area with soap and water and apply a cold compress or ice pack
Take an over the counter antihistamine like Benadryl, Zyrtec or Claritin for itching
Take Tylenol for pain
A cream containing pramoxine (like Aveeno Anti Itch or Gold Bond) can be soothing
Topical cortisone creams (like Cortaid) may lessen swelling and irritation
Try not to scratch. Scratching can break open the skin and possibly lead to an infection
Avoid creams containing Benadryl (diphenhydramine) or neomycin (like Neosporin) as these sometimes cause allergic skin reactions
If the sting site looks infected, over the counter bacitracin ointment can be applied several times a day
See a physician if swelling persists or is very large, the area of the sting becomes significantly infected (oozing, crusting, increased redness, fever etc), or you feel ill. Fortunately most sting reactions resolve in a few days.
Serious Sting Reactions
Some people become sensitive to insects stings and may be at risk for serious or life threatening reactions. Symptoms that suggest serious sensitivity usually start within minutes of the sting and include:
Hives or itchy rash all over
Giant swelling distant from the site of the sting, like face, lips, tongue
Trouble breathing, coughing, wheezing or shortness of breath
Throat tightness, airflow blockage, hoarseness or trouble swallowing
Rapid pulse, dizziness, fainting or shock
Anyone experiencing these symptoms after a sting should call 911 for immediate help and transfer to an emergency room. A person who has had a serious reaction to a sting should always carry auto injectable epinephrine (EpiPen or Auvi Q) with them at all times. Epinephrine stops progression of a reaction and begins to reverse symptoms within minutes. The quicker epinephrine is given, the less likely a severe reaction.
Treatment
Remove stinger if present and apply icepack
Inject EpiPen or Auvi Q, this may be repeated in 10 minutes if not improving
Call 911 or immediately transport to emergency room
Take Benadryl or over the counter antihistamine for itching. Benadryl is not a substitute for epinephrine and will not stop a serious reaction
Anyone with a history of a serious allergic reaction to a stinging insect should see a Board Certified Allergist for evaluation. Allergists are experts in advice about avoiding stings and treatment of reactions. Allergy testing can determine sensitivity and the potential for future serious reactions. A sensitive person who has experienced a serious reaction has a 60 percent or greater chance of a serious reaction with future stings.
Fortunately, allergy shots for stinging insects can reduce the chance of future reactions to less than 5 percent.
See an allergist, call 610-478-1737
Get tested
Know what to do in case of a reaction in the future
