Insect Sting Allergy - Treatment

If a person has been stung by an insect that has left its stinger, it should be removed by flicking the fingers at it. Avoid squeezing the venom sac, as this can force more venom into the skin. If fire ants have stung the person, they should be carefully brushed off to prevent repeated stings. Local treatment is normally all that is needed for small skin reactions. The affected arm or leg should be elevated and an ice pack applied to the area to reduce swelling and pain. Over-the-counter products can also be used to decrease the pain and itching. These include the following:

• products with a numbing effect, including topical anesthetics like benzocaine and phenol


• hydrocortisone products, which may decrease inflammation and swelling


• skin protectants, such as calamine lotion and zinc oxide, which have astringent, cooling, and antibacterial affects


• diphenhydramine, an antihistamine, which will help to control itching, and will counter some of the substances produced as part of the reaction


• ibuprofen or acetaminophen for pain relief

It is important to keep the area of the sting clean. The site should be gently cleansed with mild soap and water. Avoid breaking any blisters, as this can increase the chances of a secondary infection.Any symptoms that progress beyond the local area of the sting require immediate attention. Allergic reactions to insect stings are considered medical emergencies. The physician will treat the person with epinephrine (adrenaline), which is usually given as an injection into the arm. An antihistamine such as diphenhydramine is usually given by mouth or injection to diminish the histamine reaction. Gluococorticoids, such as prednisone or methylprednisolone, are often given to decrease any swelling and to suppress the immune response. The physician may write prescriptions for both antihistamines and steroids to take after the person leaves the hospital. After a person has experienced a severe allergic reaction and received emergency treatment, the doctor may write a prescription for a self-injecting epinephrine device. This device should be carried by the person at all times, especially when the person is out of reach of medical care, such as on an airplane or in the woods. However, sometimes epinephrine is not enough, and other treatment may be needed. Whenever person with a known severe insect sting allergy are stung, they should receive prompt medical attention, even if they have received an epinephrine injection. Allergy shots for insect stings, also called venom immunotherapy, are the most effective known treatment to prevent allergic reactions to stings from honeybees,yellow jackets, hornets, paper wasps, and fire ants. Venom immunotherapy is offered to all patients who have had anaphylaxis following a sting and to adults who have had acute hives after a sting. In addition, patients with very large, aggressive local reactions who have positive skin tests may be considered as candidates, as shots have been recently shown to reduce the intensity of these reactions and a sting to the neck or face could have dire consequences. If a person has no symptoms of allergic reactions to insect stings but is tested and found positive to a venom skin test, the chance of developing anaphylaxis with future stings is approximately 17%. In this circumstance, because a positive test now exists, venom allergy shots should be offered, given the small but significant chance of a severe allergic reactions in the future. For an allergic patient, there are a number of ways to prevent future insect stings. Suggestions include:

1. Avoid using perfumes, scented soaps, and other sweet or pungent body products.


2. Avoid wearing bright colors that might attract bees.


3. Stay away from blooming flowers when you are outdoors.


4. Avoid eating sweet foods while your are outdoors.


5. Consider wearing protective clothing when outdoors, including long-sleeved shirts, gloves, and hats.


6. Wear shoes when walking outside.


7. When driving, keep your windows rolled up.


8. Have a professional inspection performed, and remove bee hives or other sources of stinging insects near your home.


9. Always be prepared for the possibility of a future sting by carrying emergency epinephrine with you.


10. Purchase a medical identification bracelet (Medic- Alert) that identifies you as having an insect sting allergy. This identification is extremely important in the event that you have a serious reaction and cannot communicate.


11. Discuss with your doctor the possibility of starting allergy shot therapy to reduce your hypersensitivity to stinging insects.